AcrySof IQ Research Articles

Preloaded and non-preloaded intraocular lens delivery system and characteristics: human and porcine eyes trial.

To compare characteristics of preloaded and non-preloaded intraocular lens (IOL) delivery systems during IOL delivery procedures. Total 101 human eyes were included in this prospective observational case series. Delivery characteristics of 5 types of IOLs including iSert250 NC60 (NC60), EnVista MX60 (MX60), AcrySof IQ SN60WF (SN60WF), TECNIS ZCB00 (ZCB00), and TECNIS PCB00 (PCB00) were investigated. NC60 and PCB00 were injected via preloaded delivery systems and other IOLs were injected via non-preloaded systems. In the human trial, time taken from IOL loading to completion of implantation was measured in all eyes undergoing conventional cataract surgery. Using 4 excised porcine eyes, dynamics of ophthalmic viscosurgical device (OVD) between an IOL injector and a porcine eye was analyzed using fluorescein sodium-stained OVD. The average time for IOL implantation was 22.0s for NC60, 43.2s for MX60, 32.3s for SN60WF, 41.4s for ZCB00, and 14.6s for PCB00 respectively. The number of cases with IOL manipulation with a second instrument was 6 for MX60, 2 for ZCB00, 0 for SN60WF, NC60, and PCB00. Amount of OVD pushed into a porcine eye was smaller with a preloaded system than with non-preloaded systems. IOL delivery with preloaded systems is faster and more predictable. Moreover, a preloaded delivery system shows relatively less OVD pushed into a porcine eye than non-preloaded systems.

Сравнительная оценка попадания в рефракцию цели у трех монофокальных гибких интраокулярных линз

Purpose. The purpose of this study was to estimate a stability of hit at a target refraction using three types of monofocal IOL: AcrySof IQ (SN60WF), CT Aspira-aAy and Asphina 409M. Material and methods. This retrospective randomized study included 208 patients (208 eyes), which underwent micro-coaxial phacoemulsification. The algorithm in the calculation of IOL optical power was based on 4 formulas: Holladay 1, Haigis, Hoffer Q, SRK/T. Depending on the type of the implanted IOL the patients were divided into 3 groups: AcrySof IQ (SN60WF) – 42, Aspira-aAy – 98, Asphina 409M – 68. Three predicting errors were assessed 1-3 months after each surgery: the mean numerical prediction error (ME), the mean absolute prediction error (MAE), the median absolute prediction error (MedAE). Results. ME, MAE and MedAE were the following: -0.29, +0.01, -0.13; ±0.244, ±0.159, ±0.169 and 0.75, 0.5, 0.5 in IOLs IQ, Aspira and Asphina, respectively. There were detected no statistically significant differences between IOLs (p>0.05). The deviation of ±0.25 diopter in percentage of eyes with prediction errors was obtained in 76%, 77.5%, 77.9% of cases, a ±0.5 diopter deviation – in 85.7%, 92.8%, 89.7%, ±1.0 diopter – in 92.8%, 97.9%, 98.5%, and 2.0 diopter – in 97.6%, 100%, 100% after implantation of IOLs IQ, Aspira and Asphina respectively. Conclusion. All three types of monofocal IOLs have shown a high precision of hit in the target refraction.

Wave front aberrations and patient satisfaction of aspheric intraocular lenses

Aim The aim was to study postoperative wave front higher order aberrations of eyes implanted with aspheric intraocular lens (IOL) in comparison with those with standard spherical IOL and to assess the subjective satisfaction in relation to both IOL designs. Patients and methods The study included 40 patients with bilateral cataract. Patients were enrolled in a prospective comparative case series from December 2013 till January 2015. All patients underwent a complete preoperative assessment. Phacoemulsification was done for all patients in both eyes. Aspheric IOL (Acrysof IQ SN60WF) was implanted in the right eye and standard spherical IOL (AcrySof SA60AT) in the left eye. Wave front examination was done at 3 months postoperatively to measure the higher order aberrations. A questionnaire was used to record the patients’ satisfaction regarding the two IOL designs. Results There were no significant differences between the two IOLs regarding the postoperative visual acuity or the mean refractive spherical equivalent. Spherical aberrations were significantly lower in the aspheric IOL group, with only 35% of the patients reported that it was the best eye. There were no significant differences in other aberrations. Conclusion Aspheric IOLs and standard IOLs have the same visual outcome regarding visual acuity. However, aspheric IOLs induced significantly less spherical aberrations. Aspheric IOL gave better qualitative visual functions in some patients especially during night.

Influence of corneal power on intraocular lens power of the second eye in the SRK/T formula in bilateral cataract surgery

sBackgroundTo evaluate the effect of different adjustments of the refractive outcome of the first eye according to corneal power (K) in order to improve the intraocular lens (IOL) power calculation of the second eye in the SRK/T formula.MethodsOne hundred thirty-four patients who underwent uncomplicated bilateral, sequential phacoemulsification with AcrySof IQ implantation were enrolled. The optimal partial adjustment of the refractive outcome of the first eye according to K was retrospectively analyzed using a regression formula.ResultsIn all patients, the optimal partial adjustment of the refractive outcome of the first eye was calculated as 56%. For K values between 42.8 D and 44.6 D, the optimal partial adjustment was calculated as 30%; however, this adjustment of the first eye did not significantly improve the refractive outcome in the second eye of the subgroup with K values between 42.8 D and 44.6 D. For K values greater than 44.6 D or less than 42.8 D, the optimal partial adjustments were calculated as 69% and 81%, respectively. According to these results, the adjustment of the first eye significantly improved the refractive outcome in the second eye from 0.36 to 0.26 D (P < 0.001) in the entire data set. This result was significantly lower than that using a single partial adjustment (56%) (0.28 D; P = 0.027).ConclusionsFor K values greater than 44.6 D or less than 42.8 D, an approximately 70–80% adjustment of the first eye error should be considered. In contrast, for K values between 42.8 D and 44.6 D, a 30% or less adjustment should be considered in the SRK/T formula.

Glistening phenomenon in acrylic hydrophobic intraocular lenses – how do perioperative factors and concomitant diseases effect it’s incidence and severity.

The aim: To evaluate the effect of selected perioperative factors and concomitant diseases on glistening of acrylic hydrophobic intraocular lens after phacoemulsification in a prospective study. Material and methods: 252 consecutive patients undergoing phacoemulsification with IOLs AcrySof IQ implantation were enrolled. The relationship between glistening and such factors as time of the surgery, the mean power and time of ultrasound energy, temperature of infusion fluids, type of cartridge, mean power of intraocular lens, trypan blue staining as well as some concomitant systemic and local diseases were analysed. The aforementioned factors were assessed a month 1. and 6. as well as after 1 and 2 years postoperatively. Results: Glistening incidence and severity increased significantly at each follow up. The use of cartridge D during intraocular lens implantation was related with significantly higher incidence of glistening as compared to using cartridge C. Higher refractive power of intraocular lens was related with increased incidence of glistening. Significantly higher intensity of the glistening was assessed in patients who suffered from diabetes. In turn, patients with uveitis presented with statistically lower severity of glistening. There was no association between other analysed factors and glistening. Conclusion: Glistening commonly occurs in patients after phacoemulsification and acrylic hydrophobic intraocular lenses (AcrySof Alcon Labs) implantation. Some intraoperative factors such as refractive power of the lens and smaller diameter of thecartridge were assessed to be significantly correlated. It might indicate that potential damage to the intraocular lens may play a role in development of glistening. Significantly higher severity of glistening was shown in patients with diabetes, which may imply the role of breakdown of physiological intraocular barriers. It is further supported by the demonstrated lower intensity ofglistening in patients uveitis receiving high intensity steroid therapy.

Comparison of visual outcomes after bilateral implantation of a diffractive trifocal intraocular lens and blended implantation of an extended depth of focus intraocular lens with a diffractive bifocal intraocular lens.

PurposeThe purpose of this study was to compare the visual outcomes and subjective visual quality between bilateral implantation of a diffractive trifocal intraocular lens, Alcon Acrysof IQ® PanOptix® TNFT00 (group A), and blended implantation of an extended depth of focus lens, J&J Tecnis Symfony® ZXR00 with a diffractive bifocal intraocular lens, J&J Vision Tecnis® ZMB00 (group B).MethodsThis prospective, nonrandomized, consecutive, comparative study included the assessment of 40 eyes in 20 patients implanted with multifocal intraocular lens. Exclusion criteria were existence of any corneal, retina, or optic nerve disease, previous eye surgery, illiteracy, previous refractive surgery, high axial myopia, expected postoperative corneal astigmatism of >1.00 cylindrical diopter (D), and intraoperative or postoperative complications. Binocular visual acuity was tested in all cases. Ophthalmological evaluation included the measurement of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), and uncorrected intermediate visual acuity (UIVA), with the analysis of contrast sensitivity (CS), and visual defocus curve.ResultsPostoperative UDVA was 0.01 and −0.096 logMAR (p<0.01) in groups A and B, respectively; postoperative CDVA was −0.07 and −0.16 logMAR (p<0.01) in groups A and B, respectively; UIVA was 0.14 and 0.20 logMAR (p<0.01) in groups A and B, respectively; UNVA was −0.03 and 0.11 logMAR (p<0.01) in groups A and B, respectively. Under photopic conditions group B had better CS at low frequencies with and without glare.ConclusionBoth groups promoted good quality of vision for long, intermediate, and short distances. Group B exhibited a better performance for very short distances and for intermediate and long distances ≥−1.50 D of vergence. Group A exhibited a better performance for UIVA at 60 cm and for UNVA at 40 cm.

Visual Performance of a Quadrifocal (Trifocal) Intraocular Lens Following Removal of the Crystalline Lens

To evaluate visual performance after implantation of a quadrifocal intraocular lens (IOL). Setting: Department of Ophthalmology, Goethe University, Frankfurt, Germany. Twenty-seven patients (54 eyes) received bilateral implantation of the PanOptix IOL (AcrySof IQ PanOptixTM; Alcon Research, Fort Worth, Texas, USA) pre-enrollment. Exclusion criteria were previous ocular surgeries, corneal astigmatism of >1.5 diopter (D), ocular pathologies, or corneal abnormalities. Intervention or Observational Procedure(s): Postoperative examination at 3months including manifest refraction; uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) in 4 m, 80cm, 60cm, and 40cm slit-lamp examination; defocus testing; contrast sensitivity (CS) under photopic and mesopic conditions; and a questionnaire on subjective quality of vision, optical phenomena, and spectacle independence was performed. At 3months postoperatively, UCVA and DCVA in 4 m, 80cm, 60cm, and 40cm (logMAR), defocus curves, CS, and quality-of-vision questionnaire results. Mean spherical equivalent was-0.04 ± 0.321 D 3months postoperatively. Binocular UCVA at distance, intermediate (80cm, 60cm), and near was 0.00 ± 0.094 logMAR, 0.09 ± 0.107 logMAR, 0.00 ± 0.111 logMAR, and 0.01 ± 0.087 logMAR, respectively. Binocular defocus curve showed peaks with best visual acuity (VA) at 0.00 D (-0.07 logMAR) and-2.00 D (-0.02 logMAR). Visual performance of the PanOptix IOL showed good VA at all distances; particularly good intermediate VA (logMAR > 0.1), with best VA at 60cm; and high patient satisfaction and spectacle independence 3months postoperatively.

Clinical observation on monovision of cataract surgery with different near addition

Objective: To observe the influence on spectacle independence, satisfaction and visual function after cataract surgery monovision with different ADD. Methods: Prospective clinical study. All patients were collected from the department of ophthalmology, Shanghai JiaoTong University Affiliated Sixth People's Hospital who were diagnosed as bilateral cataract from Oct. 2013 to Mar. 2015. This study comprised 64 cases (128 eyes). All consecutive patients scheduled to undergo bilateral cataract phacoemulsification and implantation of a monofocal AcrySof IQ IOL. The average age of patients was (65.4± 6.0) years old, ranged from 51 to 70 years. 28 males and 36 females. According to the different demands of spectacle independence and living habits of patients, all cases were divided into two groups: MV1 group (32 patients), whose near addition being 1.25-1.75 D and MV2 group (32 patients), whose near addition being 2.25-2.75 D. Parameters 6 months postoperatively included binocular uncorrected distance, intermediate, and near visual acuities, stereo vision and refractive states were analyzed. Parameters of spectacle independence, subjective visual symptoms and patient satisfaction according to visual function questionnaire were analyzed at the same time. T test was used to compare uncorrected visual acuity. Whitney U test was operated in stereo vision comparison. Chi-square test was applied in sex-distribution comparison and visual function questionnaire between two groups. Results: The uncorrected distance vision in MV1 group was (0.09±0.09), while it was (0.11±0.08) in MV2 group. The uncorrected intermediate vision in MV1 group was (0.27±0.25), and it was (0.30±0.22) in MV2 group. There were no significant difference between two groups in bilateral uncorrected distance vision (t=1.62, P=0.264, LogMAR), intermediate (t=- 0.23, P=0.876, LogMAR). However, there was significant difference between two groups in uncorrected near vision (t=2.38, P=0.021, LogMAR). It was (0.06±0.06) in MV1 group and (0.02±0.07) in MV2 group. Moreover, near stereo vision was better in MV1 group than MV2 group (Z=- 1.29, P=0.031). On the questionnaire, all patients in two groups had no significant difference in their daily lives discomfort (χ(2)=0.10, P=0.756). In MV2 group, there were 2 patients complained obstacles while walking stairs dimly. In MV1 group, there were 3 patients had to wear low degrees of presbyopic glasses when they were on near work. Percentage of patients spectacle independence was less than 90% in MV1 groups. In MV2 group, one case needed low degrees of myopic glasses when he was on intermediate computer work and playing table games. Conclusion: Different near addition has similar advantages to different patients on spectacle independence, satisfaction and visual function after cataract surgery. (Chin J Ophthalmol,2017,53: 451-454).

In vitro optical quality of monofocal aspheric toric intraocular lenses: effect of cylindrical power.

To assess the in vitro optical quality of monofocal aspheric toric intraocular lenses (IOLs) as a function of the cylindrical power. The in vitro optical quality of the AcrySof IQ Toric IOLs SN6AT2, SN6AT3, SN6AT4, SN6AT5 and SN6AT6 (Alcon Laboratories Inc., Forth Worth, TX, USA) was assessed with an instrument conceived for measuring Zernike's coefficients at 3.0- and 5.0-mm apertures. As a reference, the aspheric monofocal lens AcrySof IQ Aspheric SN60WF (Alcon Laboratories Inc., Forth Worth, TX, USA) was also measured. The area of visibility and cut-off frequency were used to describe the modulation transfer function (MTF) of each lens; meanwhile, the light in the bucket and the diameter of a circular area centred on the point-spread function (PSF) peak that captures 50% of the light energy were used to describe the PSF of each lens. Finally, an image simulation was computed from the Zernike values with reference purposes. Small differences were found on the metrics used for describing the MTF and PSF of the lenses at both tested apertures, but these were not statistically significant (p>0.05). Furthermore, the image simulation showed that these differences would not have clinical relevance at all. The optical performance of the AcrySof IQ toric IOLs in terms of MTF and PSF is good and seems to be independent of the cylindrical power and similar to a non-toric aspheric lens.

Visual and refractive outcomes following implantation of a new trifocal intraocular lens

BackgroundIndependence from all optical aids, and freedom from unwanted symptoms, following cataract and lens surgery remains the ultimate goal of both patient and surgeon. The development of trifocal IOL technology provides an ever-increasing range of options. The purpose of our study is to understand the predictability, safety and efficacy of a new trifocal intraocular lens (IOL) following cataract or refractive lens exchange (RLE) surgery.MethodsThis was a retrospective consecutive case series of patients undergoing cataract extraction or RLE followed by implantation of the Alcon IQ Panoptix IOL. Pre and postoperative refractive and visual parameters were recorded and evaluated. As the cohort followed a normal distribution, standard parametric tests were used. Paired t-test was used to compare the difference between target and postoperative refractive errors. The incidence of intraoperative and postoperative complications was also reported.ResultsThe IOL was implanted in 66 eyes of 33 patients. Mean postoperative spherical equivalent (SE) refraction was -0.08 ± 0.25 dioptres (D). This was not significantly different from the target refraction (p = 0.841). Sixty-five percent of patients were within ± 0.25 D of the target SE refraction with 100% within ± 0.50 D of intended correction. Mean postoperative uncorrected distance visual acuity (UDVA) was 0.01 ± 0.10 LogMAR. All patients achieved an unaided distance acuity of 20/40 or better postoperatively. Binocularly, 100% saw 0.20 LogMAR or better at near without correction and 88.9% achieved this level for uncorrected intermediate visual acuity. No intraoperative complications were noted. Five patients complained of moderate haloes in the early postoperative period.ConclusionThe AcrySof IQ Panoptix IOL provides functional uncorrected visual acuity at distance, intermediate and near positions. Our results remain equivalent with existing trifocal IOL outcomes and provide surgeons with a further IOL alternative for the patient motivated to obtain true spectacle independence. Surgeons should consider individual reading and working requirements when counselling patients preoperatively to optimise postoperative patient satisfaction.

Glistenings, anterior/posterior capsular opacification and incidence of Nd:YAG laser treatments with two aspheric hydrophobic acrylic intraocular lenses - a long-term intra-individual study.

To compare two hydrophobic acrylic intraocular lenses (IOLs) regarding long-term anterior/posterior capsular opacification (ACO/PCO) development and need for neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) laser treatment due to visually disturbing PCO, and to study development of glistenings in the IOL materials. In a prospective, randomized, intra-individual, comparative trial, 50 cataract patients received either an AcrySof IQ® SN60WF (Alcon, Fort Worth, TX, USA) or a Tecnis® ZCB00 (Abbott Medical Optics, Santa Ana, CA, USA) IOL in the first operated eye, and the second eye received the IOL type not implanted in the first eye. Anterior/posterior capsular opacification (ACO/PCO) and fibrosis were monitored with slit-lamp photography and semi-automated digital analysis 2 and 3years postoperatively. Glistenings were semi-quantitatively assessed in slit-lamp photographs. Nd:YAG laser treatment for visually disturbing PCO was monitored. Visual outcomes were similar for the two IOLs. Anterior capsular fibrosis and/or opacification developed more often in SN60WF eyes. Mean PCO area percentage was larger in ZCB00 eyes 3years after surgery, but severity score did not differ with statistical significance between the two IOLs. Six ZCB00 eyes and 2 SN60WF eyes underwent Nd:YAG laser treatment during a mean of 4years 8months after surgery. This difference was not statistically significant. A high amount of glistenings developed in most SN60WF IOLs, while only few ZCB00 IOLs displayed a low degree of glistenings. Visual outcomes, PCO development over time and need for Nd:YAG laser treatment were similar for the two IOLs. Anterior capsule fibrosis/contraction and glistenings were more pronounced with the SN60WF IOL.

Comparison of astigmatic prediction errors associated with new calculation methods for toric intraocular lenses

To compare the prediction errors in residual astigmatism associated with new calculation methods for toric intraocular lenses (IOLs). Hospital da Luz, Lisbon, Portugal. Retrospective case series. In eyes having cataract surgery with toric IOL implantation (Acrysof IQ), the predicted residual astigmatism by each calculation method was compared with the manifest refractive astigmatism. The prediction error in residual astigmatism was calculated by vector analysis. The study evaluated 86 eyes (86 patients). All calculation methods resulted in overcorrection of with-the-rule astigmatism and undercorrection of against-the-rule astigmatism. For the original Alcon calculator, the centroid prediction error was 0.43 @ 170, which was reduced by the application of the Baylor nomogram (0.35 @ 169) or the Abulafia-Koch formula (0.34 @ 170). For the Holladay toric calculator, the centroid prediction error was 0.40 @ 168, which was reduced by the Baylor nomogram (0.35 @ 169), the Abulafia-Koch formula (0.25 @ 158), and the Goggin coefficient of adjustment (0.38 @ 170). The Barrett calculator and the newly introduced Alcon calculator yielded the lowest centroid prediction errors (0.17 @ 165 and 0.19 @ 164, respectively). The centroid prediction error of ray-tracing calculations (PhacoOptics) using real posterior corneal surface measurements was 0.32 @171. The Barrett toric calculator and the new Alcon calculator yielded the lowest astigmatic prediction errors. Of the nomogram methods, application of the Abulafia-Koch formula achieved the best results. The outcomes of toric IOL implantation might be improved by using 1 of these calculation methods.

Accuracy of 3 new methods for intraocular lens power selection

To evaluate the accuracy of 3 new methods for intraocular lens (IOL) power selection (Hill-Radial Basis Function [Hill-RBF] method, FullMonte method, and the Ladas Super Formula) compared with that of the Holladay 1 and Barrett Universal II formulas. Ophthalmology Department, Alfred Hospital, Melbourne, Australia. Retrospective case series. Patients who had uneventful cataract surgery with insertion of the Acrysof IQ SN60WF IOL over 5years were included in the study. Data obtained from the electronic medical record and the IOLMaster device were entered into the respective calculators using self-designed computer programs. Using optimized lens constants, the predicted refractive outcome using each of the 5 methods/formulas was calculated and compared with the actual refractive outcome to give the prediction error. Eyes were separated into subgroups based on axial length as follows: short (≤22.0mm), medium (>22.0 to <24.5mm), medium-long (≥24.5 to <26.0mm), and long (≥26.0mm). The study comprised 3122 eyes of 3122 patients. A statistically significant difference in the mean absolute prediction error (MAE) between the 5 methods for IOL power calculation was found (P<.001), with the Barrett Universal II formula being the most accurate. The Ladas Super Formula had the third lowest MAE, the Hill-RBF the fourth lowest MAE, and the FullMonte the highest MAE of the 5 methods assessed. New methods for predicting the postoperative refraction failed to yield more accurate results than current formulas.

Outbreak of Subacute-Onset Toxic Anterior Segment Syndrome Associated with Single-Piece Acrylic Intraocular Lenses

To report the results of a clinical investigation after an outbreak of subacute-onset toxic anterior segment syndrome (TASS) after implantation of single-piece acrylic intraocular lenses (IOLs), which then were recalled voluntarily from the market. Retrospective, multicenter, observational case series. Cases reported to the manufacturer from January 2015 through March 2016 of unusual ocular inflammation after cataract surgery using AcrySof ReSTOR, ReSTOR toric, or AcrySof IQ toric SN6AT6-9 IOLs (Alcon Laboratories, Inc., Fort Worth, TX). The independent investigation committee, not Alcon, directly requested the surgeons for data on 304 eyes from 184 facilities. Consent for data collection was obtained for 201 eyes from 130 facilities. By excluding cases with infectious endophthalmitis and inconclusive cases, the investigation committee identified 147 cases of subacute-onset TASS. AcrySof ReSTOR or ReSTOR toric IOLs and AcrySof IQ toric SN6AT6-9 IOLs were implanted in 94 eyes (63.9%) and 53 eyes (36.1%), respectively. The mean onset time was 13.1±16.4 days after surgery (range, 1-88 days), with 84 eyes (57.1%) demonstrating symptoms within 7 days after surgery. Typical clinical symptoms were mild to moderate exacerbation of inflammation in the anterior chamber after an uneventful clinical course for a few days after surgery. One hundred four eyes (70.7%) were treated with medication alone, and 43 eyes (29.3%) underwent surgery, including irrigation of the anterior chamber, vitrectomy, and removal of the IOL. The mean best-corrected visual acuity (BCVA) at the final visit (-0.012±0.175 logarithm of the minimum angle of resolution [logMAR]) was significantly better than the BCVA at the onset of TASS (0.158±0.351 logMAR) and did not differ from that before inflammation developed (-0.004±0.162 logMAR). Overall treatment outcomes were favorable. A large-scale outbreak of subacute-onset TASS developed after implantation of a specific model of IOL.

Comparison between clinical outcomes of two different designs of toric multifocal intraocular lenses

To compare the clinical outcomes of plate haptic and open-loop haptic toric multifocal intraocular lenses (IOLs). In this retrospective, comparative clinical trial, two different designs of multifocal toric IOL were implanted in 49 eyes of 38 cases with corneal astigmatism ≥ 0.75 Diopter (D). The cases that underwent AcrySof IQ restore multifocal toric IOL (Alcon, open-loop-haptic) implantation were assigned to Group1 (n=19) and the cases that underwent Acriva Reviol multifocal toric IOL (VSY, plate-haptic) implantation were assigned to Group 2 (n=30). After surgery, the groups were compared in terms of degree of IOL rotation, residual spherical refraction and astigmatism and uncorrected near and distance visual acuity. With regard to the results of postoperative 1st month, 3rd month, 6th month and 1st year, no difference was determined in terms of uncorrected distance visual acuity, spherical equivalent (SE), degree of astigmatism (CYL), degree of rotation, and uncorrected near visual acuity (p>0.05). Significant increase was determined in all postoperative follow-up periods in terms of the distance and near visual acuity as compared to preoperative values (p0.05). Clinical outcomes of plate haptic Acriva Reviol multifocal toric IOL and open-loop haptic Acrysof IQ multifocal toric IOL are similar. Both types of IOL effectively reduce astigmatism and provide satisfactory uncorrected distance and near visual acuities.

Comparison of visual performance and after cataract formation between two monofocal aspheric intraocular lenses following phacoemulsification for senile cataract: A randomized controlled study.

Purpose:Monofocal aspheric intraocular lenses (IOLs) provide better visual outcome compared to other available IOLs following cataract surgery. However, the imported IOLs are expensive and are not affordable by all subset of patients in low- to middle-income countries like India. The aim of this study is to compare the safety and efficacy of a relatively low cost indigenous IOL (Acriol EC) with an imported aspheric IOL (AcrySof IQ).Methods:A randomized controlled trial was conducted at a tertiary care centre. Two hundred and five eyes of 137 patients >45 years of age with uncomplicated age-related cataract were recruited. All cases underwent standard phacoemulsification and randomly assigned to one of the IOL implantations (Group I: AcrySof IOL; Group II: Acriol EC IOL). Primary outcome measure was best-corrected visual acuity (BCVA). Secondary outcomes included visual function (VF) score, spherical equivalent, contrast sensitivity, optical aberrations, and posterior capsular opacification. Independent t-test to compare two means; Mann–Whitney test; Pearson's Chi-square test, and McNemar's test were used for analyzing the nonparametric data such as incidence of posterior capsule opacification.Results:There was no significant difference in the mean postoperative BCVA at 1, 3, 6, and 12 months in either group (P > 0.05). The contrast sensitivity, wavefront aberrations, VF score, and posterior capsular opacification were comparable between the groups except for higher-order aberrations and spherical aberration, which were higher in Group II.Conclusions:Acriol EC IOL provides visual outcomes comparable to other commonly used aspheric IOLs with comparable safety and efficacy at an affordable cost.

Анализ функциональных результатов имплантации новой модели трифокальной интраокулярной линзы

Today, patients often expect to achieve a high visual acuity at various distances and a spectacle correction independence after cataract surgery. Trifocal intraocular lenses have been developed to try and fulfill this demand. Due to the lack of domestic experience with the new trifocal IOL model (AcrySof® IQ PanOptix®), there is a need for clinical trials to evaluate functional outcomes. Purpose. To evaluate outcomes of visual acuity using various traditional systems of assessment for functional vision and interactive computer program in a comparative aspect, as well as a contrast sensitivity and to determine a subjective patient satisfaction after implantation of a new generation of trifocal IOL AcrySof IQ PanOptix (USA). Material and methods. The study included 19 patients (37 eyes) with cataract. Mean age was 55.6±11.4 years. Visual acuity was measured monocular using different technics at distance (4 m), intermediate (60 cm) and near (40 cm). The Optec 6500 device was used for objective assessment of contrast sensitivity function. The frequency of dysphotopsia and quality of vision were evaluated by the questionnaire. Results. High visual activity results at different distances with the decimal scale and interactive computer program «TIP-TOP» were noted on the 1st day after implantation of the new trifocal IOL model. Improvement of visual acuity at three distances 3-6 months after surgery was associated with a stabilization of refractive results and a completion of neuro-adaptation processes. Mean postoperative spherical equivalent was -0.40±0.34D 1 month postoperatively and -0.28±0.27D 6 months after surgery, respectively. The contrast sensitivity function (CSF) had a typical appearance with a maximum value in the mid-range region and a decrease in the high-frequency range. The levels of photopic and mesopic CS with and without glare increased within 6 months after the operation. Mean value of VF-14 was 95.7, indicating a high level of subjective assessment of intraocular correction. No patient noted a need to use any spectacle correction for far, near or intermediate distances after surgery. More often dysphotopsia was detected through active patient interview. In dynamics, the degree of dysphotopsia decreased, or completely disappeared in 33.3% of patients 6 months after the operation. Conclusions. The new trifocal IOL provides good near, intermediate and far distance visual functions. Evaluation of visual acuity results using different systems showed the advantage of the interactive computer program Tip-Top. The contrast sensitivity function (CSF) had a typical appearance with a maximum value in the mid-range region and a decrease in the highfrequency range. The indicators of photopic and mesopic CS with and without glare increased within 6 months after the operation, however, they did not reach the age standards. Postoperative period was characterized by a high patient satisfaction and a high spectacle correction independence.

Comparison of Visian toric collamer lens and toric acrylic intraocular lens implantation for the treatment of myopia with astigmatism

PurposeTo compare the efficacy and outcome of phakic toric implantable collamer lens (TICL) and refractive clear lens extraction with AcrySof Toric intraocular lens (TIOL) implantation for the treatment of myopic astigmatism.Patients and methodsThis study assessed eyes with myopic astigmatism >−1 D and ≤−4 D with a spherical equivalent >10 D or <10 D if the patients were unsuitable for corneal refractive surgery. These eyes were divided into group A, in which Visian Toric ICL™ Phakic TICL was implanted, and group B, which involved clear lens extraction with implantation of an AcrySof IQ toric SN60T3-9™ IOL. The outcome and complications were evaluated.ResultsThis study enrolled 63 eyes of 38 patients with a follow-up period of at least 6 months. The mean postoperative spherical equivalent was −0.19±0.31 D in group A and −0.21±0.28 D in group B (P=0.69). The mean postoperative cylinder value was −0.46±0.53 D in group A and −0.32±0.41 D in group B (P=0.35). Postoperative cylinder was <1 D in 76.47% and 79.31% of eyes in groups A and B, respectively. The mean endothelial cell count was reduced by 4.32% in group A and by 5.32% in group B (P=0.003). The mean postoperative intraocular pressure increased insignificantly in group A (P=0.22) and reduced significantly in group B (P=0.004). The complication rate was 11.76% in group A and 6.90% in group B.ConclusionBoth procedures showed predictable results and good visual results. However, the loss of accommodation and risk of retinal complications in the TIOL group suggest that the use of TICL for myopic astigmatism is a better choice in younger patients.

Vector analysis investigation of toric intraocular lens with no deviation from the intended axis.

AimThe aim of this research was to evaluate vector analysis after implantation of toric intraocular lenses (IOLs) without deviation from the intended axis.MethodsThe study included 18 eyes of 16 patients who underwent cataract surgery with the insertion of a toric implant (AcrySof IQ Toric). The postoperative IOL meridian placement completely corresponded to that planned. Using vector analysis, surgically induced astigmatism (SIA) was derived from the refractive outcome versus the predicted postoperative keratometric astigmatism and was compared with targeted induced astigmatism (TIA). The difference vector (DV) was derived by calculating the vector expression of the remaining astigmatic change.ResultsThe mean postoperative remaining refractive astigmatism of 0.73±0.55 diopters (D) was achieved versus the mean target of 0.44±0.28 D. There was a difference of 0.29 D between the target and achieved values. The mean SIA value was 1.90±0.99 D compared with the mean TIA value of 2.00±0.85 D. The mean DV value was 0.87±0.56 D. The astigmatism correction index (SIA/TIA) was 0.95, which was near the ideal value of 1. The index of success (DV/TIA) was 0.44, which was far from the ideal value of 0.ConclusionThe implantation of toric IOLs is an effective, predictable method for astigmatic correction. However, some remaining astigmatism is present even if toric IOLs are placed accurately.

Intraocular lens power formula accuracy: Comparison of 7 formulas

To assess the accuracy of 7 intraocular lens (IOL) power formulas (Barrett Universal II, Haigis, Hoffer Q, Holladay 1, Holladay 2, SRK/T, and T2) using IOLMaster biometry and optimized lens constants. Public hospital ophthalmology department. Retrospective case series. Data from patients having uneventful cataract surgery with Acrysof IQ SN60WF IOL implantation over 5years were obtained from the biometry and patient charts. Optimized lens constants were calculated for each formula and used to determine the predicted refractive outcome for each patient. This was compared with the actual refractive outcome to give the prediction error. Eyes were separated into subgroups based on axial length (AL) as follows: short (≤22.0mm), medium (>22.0 to <24.5mm), medium long (≥24.5 to <26.0mm), and long (≥26.0mm). The study included 3241 patients. The Barrett Universal II formula had the lowest mean absolute prediction error over the entire AL range (P<.001, all formulas) as well as in the medium (P<.001, all formulas), medium-long (P<.001, except Holladay 1 and T2), and long AL (P<.001, except T2) subgroups. No statistically significant difference was seen between formulas in the short AL subgroup. Overall, the Barrett Universal II formula resulted in the highest percentage of eyes with prediction errors between ±0.25 diopter D, ±0.50 D, and ±1.00 D. In eyes with an AL longer than 22.0mm, the Barrett Universal II formula was a more accurate predictor of actual postoperative refraction than the other formulas. None of the authors has a financial or proprietary interest in any material or method mentioned.