Comparison of bilateral implantation of an extended depth of focus lenses and a blend approach of extended depth of focus lenses and bifocal lenses in cataract patients.

BACKGROUND: To compare the visual outcomes, spectacle independent rate and stereopsis in patients who underwent bilateral implantation of extended depth of focus (EDOF) intraocular lens (IOL), or a blend approach of EDOF and bifocal IOL. METHODS: A total of 60 cataract patients, who were scheduled for phacoemulsification and intraocular lens implantation in both eyes in West China Hospital of Sichuan University, were enrolled and divided into Micro monovision group(-0.5D~-1.0D), Non-micro monovision group (< 0.5D) with Symfony IOL, and Mixed group with Symfony and ZMB00 IOLs. Three months postoperatively, we compared the visual acuity, modulation transfer function (MTF), defocus curve, stereopsis, spectacle independence, and photic phenomena among the three groups. RESULTS: Compared to the Non-micro monovision group (UNVA: 0.07 ± 0.04), Micro monovision group (UNVA: 0.00 ± 0.07, P < 0.001) and Mixed group (UNVA: -0.02 ± 0.06, P < 0.001) showed improvement in binocular uncorrected near visual acuity (UNVA). Additionally, Mixed group exhibited lower MTF10 (MTF10: 0.38 ± 0.24) and point spread function (PSF: 0.192 ± 0.269) results in their non-dominant eye compared to both Micro monovision group (MTF10: 0.56 ± 0.21, P = 0.027; PSF: 0.417 ± 0.282, P = 0.034) and Non-micro monovision group (MTF10: 0.55 ± 0.19, P = 0.038; PSF: 0.408 ± 0.285, P = 0.003). Spectacle independence for near vision were higher in both the Micro monovision (45%) and Mixed (55%) group compared to the Non-micro monovision group (40%). The Mixed group also reported higher incidence of photic phenomena (25%). However, there were no significant differences in stereoscopic function among the three groups. CONCLUSION: Both micro monovision and mix-and-match methods can help patients to obtain better visual outcomes at different distances. Mix-and-match method has better near visual acuity, while micro monovision method has better intermediate visual acuity. Non-micro monovision methods will affect patients' near vision outcomes. Binocularly implanted EDOF IOL has better contrast sensitivity. CLINICAL TRIAL REGISTRATION: Registration date:11/07/2023. TRIAL REGISTRATION NUMBER: ChiCTR2300073433. TRIAL REGISTRY: West China Hospital of Sichuan University retrospectively registered.

Calculating intraocular lens power in anterior megalophthalmos: A case report.

Introduction: We report a case of a man with cataract and anterior megalophthalmos (AM), in which some myopia was retained when calculating intraocular lens (IOL) power using the Haigis formula to avoid postoperative farsightedness. Case description: A 59-year-old Chinese man was referred to our clinic for cataract surgery in his right eye. He had strong bilateral megalocornea, and his left eye had undergone surgery four times. After complete preoperative examinations and repeated biometry, the Haigis formula was used, and a 3-piece IOL was implanted with a target power of -1.97 D. At 1-year follow-up, the patient showed the best-corrected distance vision of 20/20 with the refraction of -1.50 DC × 160°, and the IOL was stable. Conclusion: Our patient with anterior megalophthalmos showed postoperative hyperopia drift even though the Haigis formula was used as suggested in previous studies. To prevent farsightedness after surgery, some myopia should be retained when calculating IOL power. The Kane, Holladay II with AL adjustment, and Barrett Universal II formulas may be more accurate for calculating IOL power in such patients.

Intraocular lens power calculation after radical keratotomy and photorefractive keratectomy: A case report.

RATIONALE: To report a rare case of calculating the IOL power in a cataract patient who underwent both radial keratotomy (RK) and photorefractive keratectomy (PRK). PATIENT CONCERNS: A 48-year-old woman underwent bilateral RK at age 22 and bilateral PRK at age 46. She developed bilateral corneal haze and corneal endothelial inflammation and received steroids therapy for long time after PRK. Then she was referred to our hospital due to decreased vision in the both eyes. DIAGNOSES: The patient was diagnosed with binocular complicated cataract, corneal haze, high myopia and post corneal refractive surgery (RK and PRK). INTERVENTIONS: The patient underwent bilateral phacoemulsification. The IOL power was calculated using SRK/T formula for RK and Haigis-L formula for PRK, respectively. We finally selected the Haigis-L formula and the intraocular lens (SN60WF) was implanted within the capsular bag. OUTCOMES: After the surgery, both eyes showed myopia drift, and the right eye continuously fluctuated in refractive results. However, by nearly 1 year later, refractive results in both eyes had stabilized, and no other complications had occurred. LESSONS: IOL power in patients who undergo both RK and PRK can be reliably calculated using the Shammas-PL, Average of multiple formulas, or Barret True-K No History formulas. Haigis-L formula is not suitable. Such patients require at least three months after surgery to attain refractive stability in both eyes.