Optical and visual quality comparison of implantable collamer lens and femtosecond laser assisted laser in situ keratomileusis for high myopia correction.

AIM: To compare clinical outcomes and refractive stability of implantable collamer lens (ICL) implantation and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) for high myopia correction. METHODS: The Optical Quality Analysis System (OQAS) was used to evaluate clinical outcomes objectively after operation for high myopia correction. We compared the two procedures in terms of 1-year changes in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), safety index, efficacy index, spherical equivalent, modulation transfer function (MTF) cutoff frequency, strehl ratio (SR) and objective scatter index (OSI). RESULTS: At 1y postoperatively, the safety indices were 1.33±0.27 in ICL group, and 1.17±0.24 in FS-LASIK group. 39.58% in the ICL group and 27.59% in the FS-LASIK group gained CDVA in 2 lines or better than that in preoperative CDVA. The efficacy indices were 1.28±0.22 in ICL group, and 1.13±0.26 in FS-LASIK group. The changes of spherical equivalent from 1wk to 1y postoperatively was -0.12±0.37 D in ICL group, and -0.79±0.58 D in FS-LASIK group (P<0.05). Spherical equivalent within ±0.50 D was achieved in 97.92% in ICL group and 68.97% in FS-LASIK group. MTF cutoff frequency were higher with ICL as compared to FS-LASIK (P<0.05) at each postoperative follow-up stage; for postoperative 1mo later, SR was statistically significant difference between two groups (P<0.05); with no statistically significant difference in OSI between two groups (P>0.05) in postoperative 3mo later. CONCLUSION: ICL implantation and FS-LASIK procedures both provide good safety and predictability in high myopia correction. ICL implantation provides better clinical outcomes and refractive stability than FS-LASIK.

Femtosecond laser-assisted cataract surgery combined with trifocal intraocular lens implantation / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical efficacy of femtosecond laser-assisted cataract surgery combined with trifocal intraocular lens(IOL)implantation.<p>METHODS:From September 2016 to November 2017, 42 cases(59 eyes)of cataract patients receiving trifocal IOL implantation in Shanxi Eye Hospital were retrospectively enrolled in this study. Moreover, the visual and refractive outcomes, defocus curve, refractive stability, high order aberrations, patient satisfaction, and spectacle independence were evaluated at 1wk, 1mo, 3mo and 6mo after surgery, respectively.<p>RESULTS: All patients had attained good visual acuity of >0.1 LogMAR at different distances during the follow-up period; besides, the visual acuity at each distance was remarkably higher compared with that before surgery(<i>P</i><0.05). The defocus curve had displayed no significant decrease between 0D to -2.5D at 6mo postoperatively, with the visual acuity better than 0.8. At 6mo postoperatively, 63%(37 eyes)eyes had a spherical equivalent(SE)of ±0.25D, and 88%(52 eyes)eyes had a SE of ±0.50D. The incidences of high order aberrations, coma, spherical aberration and trefoil of all eyes were evidently lower than those before surgery, and the difference was statistically significant(<i>P</i><0.05). <p>CONCLUSION: Femtosecond laser-assisted cataract surgery combined with trifocal IOL implantation can provide patient with a comfortable and natural full-range vision, which can greatly improve the postoperative satisfaction of patients.

Retrospective study on the changes of refractive state and stability after cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare and contrast different operation after cataract patients with refractive change rules. To analyze the patients with refractive stability after cataract surgery, and to provide a reference for cataract patients with clinical surgery after visual quality. ●METHODS: Retrospective study. A total of 126 cases (150 eyes) were selected from Jan. 2014 to Dec. 2015 in Changzhou First People′s Hospital of cataract extraction combined with foldable intraocular lens implantation for cataract patients as the research samples. According to the different operation for three groups, the first group of 42 patients ( 50 eyes ) underwent above 3 mm clear corneal incision;52 cases in group 2 (60 eyes) underwent temporal side 3 mm clear corneal incision. The third group, 32 cases (40 eyes) underwent 3 corner above the scleral tunnel incision. All the cases were measured at different time point in patients with naked eyes far visual acuity, best corrected visual acuity, spherical degree, the degree of astigmatism and astigmatic axial, comparative analysis of after cataract surgery in patients with refractive change regularity and stability of refraction. ●RESULTS: The uncorrected distance visual comparison within the group, and each time point after preoperative differences were significant ( P 0. 05 ), three groups of patients were compared with the preoperative best corrected distance visual acuity were increased significantly, and were in stable after 1wk; relatively spherical degree within the array, after 1d and 3d was not significantly different (P>0. 05), hyperopia drift, after 1wk and 1, 3d was significantly different (P0. 05 ). Three groups of patients′spherical degrees after 1wk were stabilized. Comparative degree of astigmatism within the array, postoperative compared with preoperative corneal astigmatism were increased 1d after surgery. Corneal astigmatism in each group reached the maximum, and then decreases 1wk and 1d after surgery, compared with postoperative 3d was significantly different ( P0. 05 ) . Three groups of patients were compared with preoperative astigmatism were significantly increased, and in operation after 1wk were stabilized;astigmatic axis were three groups in the preoperative astigmatism against the rule, the first and third group after 1d, three Tianshun rule astigmatism proportional were increased, and then decreased. Group 2 the- rule astigmatism proportion, after 1wk, 1 and 3mo, the first and third group gradually reduced the proportion of cis regulatory astigmatism, and compared with preoperative increased, increasing the-rule astigmatism group 2 ratio, and increased compared with preoperative. ●CONCLUSION: Above 3 mm the transparent corneal incision, temporal clear corneal incision and above the scleral tunnel incision different surgical postoperative visual acuity are good. lt can be used as a routine surgical procedure in treatment of cataract;phacoemulsification in cataract patients with former majority against the rule astigmatism. After cataract surgery, early refractive state is a state of mild hyperopia and stabilized about 1wk, combined with clinical guide glasses.

Comparison of Long-Term Results between One-piece and Three-piece Acrylate Intraocular Lens

PURPOSE: To compare the long-term clinical results of one-piece Acrysof(R) (SA60AT) hydrophobic acrylic intraocular lens (IOL) implantation compared with implantation of three-piece Acrysof(R) (MA60BM) hydrophobic acrylic IOL. METHODS: We retrospectively analyzed each 50 eyes of 50 patients underwent MA60BM or SA60AT IOL implantation and followed for at least 6 months. RESULTS: Final visual acuity of 0.5 or better was 38 eyes (76%) and 0.8 or better was 20 eyes (40%) in the SA60AT group. In the MA60BM group, it was 41 eyes (82%) and 23 eyes (46%) respectively. There were no significantly differences in predictability, intraocular pressure, endothelial cell density, astigmatism, and incidence of posterior capsule opacification between the two groups. Spherical equivalent at postoperative 1 week was -0.50+/-0.95D in SA60AT group and was -0.31+/-0.88D in MA60BM group (P=0.04). However, there was no significant difference between the two groups during follow up period. In MA60BM group, anterior chamber depth (P=0.02) and distance between iris and IOL (P=0.04) reduced significantly during the first postoperative month. CONCLUSIONS: Early postoperative axial displacement and changes in spherical equivalent can be occurred in MA60BM group. However there was no difference in long-term clinical results between SA60AT and MA60BM groups.

Comparative Assessment of Clinical Results in Various Acrylate IOLs

PURPOSE: To assess the clinical results of various acrylic intraocular lenses (IOLs) after cataract surgery with respect to the tilting and decentration of IOLs, postoperative high-order (HO) aberration, and duration to gain of refractive stability. METHODS: This prospective study comprised 60 eyes of 53 patients after uneventful cataract surgery with IOLs implantation. Patients were randomized into four groups of 15 eyes each based on IOLs type: MA60BM, SA60AT, AR40e, or Akreos. We analyzed the extent of IOL decentration, tilting and the difference between preoperative predictive refraction and postoperative actual refraction at 1 day, 1 week, 1 month and 2 months after surgery. The postoperative HO aberration was determined at 2 months after surgery. RESULTS The extent of IOL decentration and tilting was not statistically significant among any of the groups (p>0.05). The spherical aberrations, the triangular coma aberrations and HO RMS values were, however, statistically significantly different among the groups (p<0.05). Refractive stability was gained by 2 months in all four groups, but the four IOLs differed in the time to refractive stability: 2 months in the MA60BM group, 1 month in the SA60AT group, 1 day in the AR40e group, and 1 week in the Akreos Adapt group. CONCLUSIONS: All four acrylic IOLs provided satisfactory postoperative results, but there were differences in the time to gain of refractive stability and HO aberration between the four IOLs. These results suggest that a surgeon could achieve a better clinical outcome after cataract surgery by selecting the most suitable IOL for his intention.

Comparative Assessment of Clinical Results in Various Acrylate IOLs

PURPOSE: To assess the clinical results of various acrylic intraocular lenses (IOLs) after cataract surgery with respect to the tilting and decentration of IOLs, postoperative high-order (HO) aberration, and duration to gain of refractive stability. METHODS: This prospective study comprised 60 eyes of 53 patients after uneventful cataract surgery with IOLs implantation. Patients were randomized into four groups of 15 eyes each based on IOLs type: MA60BM, SA60AT, AR40e, or Akreos. We analyzed the extent of IOL decentration, tilting and the difference between preoperative predictive refraction and postoperative actual refraction at 1 day, 1 week, 1 month and 2 months after surgery. The postoperative HO aberration was determined at 2 months after surgery. RESULTS The extent of IOL decentration and tilting was not statistically significant among any of the groups (p>0.05). The spherical aberrations, the triangular coma aberrations and HO RMS values were, however, statistically significantly different among the groups (p<0.05). Refractive stability was gained by 2 months in all four groups, but the four IOLs differed in the time to refractive stability: 2 months in the MA60BM group, 1 month in the SA60AT group, 1 day in the AR40e group, and 1 week in the Akreos Adapt group. CONCLUSIONS: All four acrylic IOLs provided satisfactory postoperative results, but there were differences in the time to gain of refractive stability and HO aberration between the four IOLs. These results suggest that a surgeon could achieve a better clinical outcome after cataract surgery by selecting the most suitable IOL for his intention.