AcrySof Lens Research Articles

Incidence of dysphotopsia following uneventful cataract surgery [phacoemulsification] in patients implanted with different types of monofocal intraocular lenses

Background and objectives: Pseudophakic dysphotopsia is one of the major causes of patient dissatisfaction after cataract surgery. Our aim was to assess the incidence of dysphotopsia after phacoemulsification with implantation of three types of monofocal intraocular lenses. Methods: This prospective clinical study which contained 200 eyes from 195 patients was done at Dr. Aso eye hospital in Sulaimania city between June 2022 to June 2023. Those 200 eyes (participants) were divided into three different groups according to their IOL types were followed-up for 6 months to estimate the incidence and symptoms of dysphotopsia. Results: overall incidence of dysphotopsia was (22%). 34 cases (17%) reported their symptoms in the first three weeks of follow-up. This figure decreased to (4% and 1%) after 3 and 6 months, respectively. The most common phenomenon noted was temporal shadow/darkness; declared by 34.09% of patients who reported dysphotopsia. Optical phenomena occurred more frequently in patients with Acryfold lens group. The great majority of the patients (94.5%) were satisfied with their post-operative visual function. Both, overall incidence of dysphotopsia and its higher rate in the 1st group (Acryfold) were statistically significant values (p= 0.0399 and 0.0418), respectively. Conversely, there was no statistically significant difference between Rayner and Acrysof lenses in terms of dysphotopsia occurrence (p-value= 0.053). Conclusion: Although monofocal intraocular lenses showed significant rates of dysphotopsia, they were still associated with high patient satisfaction level because majority of the symptoms were mild and went away with time.

The Clareon Vs AcrySof PanOptix Trifocal IOL: A Comparative Study of Patient Satisfaction and Visual Performance.

To evaluate patient-reported outcomes of cataract surgery using the Clareon Panoptix and Panoptix Toric trifocal lenses and to compare these to the data collected previously for the AcrySof Panoptix and Panoptix Toric. Prospective, open-label, multicenter analysis of satisfaction, spectacle independence, presence of unwanted side effects, and best-corrected visual acuity among patients undergoing cataract surgery who had been implanted at least 1 month previously with the Clareon PanOptix or PanOptix Toric trifocal IOL bilaterally. Results were compared to outcomes measured two years ago from a similar study with the AcrySof version of the same lens. No significant differences in patient satisfaction rates were reported between the two cohorts. Spectacle independence was similar with 88% of Clareon Panoptix and 83% of AcrySof Panoptix patients having no need for any corrective lenses. Quality of vision was not statistically different with 7% of Clareon vs 15% of AcrySof patients reporting "very much" or more of glare/halo severity. Significantly more AcrySof (66%) than Clareon (42%) patients achieved a spherical equivalent outcome within 0.25 D of target. Best corrected distance visual acuity differences were not statistically significant, and no safety concerns were reported. The Clareon PanOptix trifocal lens provides similar satisfaction and spectacle independence and has a similar side effect profile and BCVA outcome to the identical lens made of the predecessor AcrySof lens.

Evaluation of Clinical Results of Implantation of Toric Intraocular Lenses Including their Rotational Stability.

The aim of the study was to evaluate the clinical results of the implantation of the toric intraocular lens Acrysof IQ Toric SN6AT3_8(Alcon Laboratories, Inc., Fort Worth, TX, USA), including an evaluation of its rotational stability. 30 eyes of 16 patients (4 males, 12 females; mean age 68 years) with regular corneal astigmatism ranging from -1.5 to -4.0 Dcyl were included in this retrospective study. All the patients underwent uncomplicated cataract surgery with the implantation of a toric intraocular lens (TIOL) at the Department of Ophthalmology of the Faculty of Medicine and Dentistry of Palacký University in Olomouc and University Hospital Olomouc during the course of 2020. Follow-up examinations were performed 3-6 months after cataract surgery. We monitored the resulting uncorrected distance visual acuity (UDVA), postoperative refraction, rotational stability of the implanted lens and subjective patient satisfaction. mean preoperative corneal astigmatism was -2.41 ±0.67 Dcyl. UDVA improved from a mean value of 0.45 ±0.25 (expressed in decimal Snellen optotype values) to 0.91 ±0.16. The spherical equivalent value of 0.41 ±2.92 improved to -0.11 ±0.27 postoperatively. The mean deviation from the planned axis was 4.87 ±4.75. Subjective satisfaction was rated by patients on a scale of 1-5, with a mean score of 1.5. TIOL implantation is a safe and effective solution for patients with corneal astigmatism and cataract. Our results demonstrate improved UDVA, rotational stability of the TIOL and subjective patient satisfaction with the outcome of the surgery.

Долгосрочные результаты имплантации новой недифракционной ИОЛ с расширенной глубиной фокуса

Purpose. To evaluate long-term results of AcrySof IQ Vivity non-diffractive extended-focus intraocular lens (IOL) implantation. Material and methods. 20 patients (20 eyes) underwent phacoemulsification and implanted non-diffractive IOL with expanded depth of focus. The mean age of the patients was 64.4 years (54 to 70 years). All patients were followed up for one year. Long-term results were analyzed. The postoperative period was smooth. Two patients developed secondary cataract 6 months later and IAG-laser discectomy of the posterior capsule was performed. Results. In 12 months after surgery, the uncorrected visual acuity (UCVA) in the distance was — 0.88 ± 0.06, at the middle distance — 0.77 ± 0.02, in the vicinity — 0.60 ± 0.05. Best corrected visual acuity in the distance — 0.93 ± 0.04, in the middle distance — 0.81 ± 0.07, in the vicinity — 0.65 ± 0.01. One patient (5 %) had periodic light scattering circles (halo) and one patient (5 %) — had glare. There were no difficulties with driving in any of the patients. Conclusions. The AcrySof IQ Vivity IOL will provide improved visual acuity at all distances. Some patients will need to use additional spectacle correction, for near distance. 85 % patients rated the results as «excellent», 15 % — «good». Keywords: cataract, surgical management, phacoemulsification, intraocular lens AcrySof IQ Vivity, visual acuity improvement

The Incidence of Optic Cracks or Fractures During a Foldable AcrySof or Acriva BB Acrylic Monofocal Intraocular Lens Implantation via the Manual Monarch Injector System With the Cartridge in Phacoemulsification Surgery.

To evaluate the incidence of optic cracks and/or fractures during foldable acrylic intraocular lens (IOL) implantation via the manual Monarch delivery system with the cartridge and to determine factors that help to avoid such complications. Small-incision phacoemulsification surgery was performed in 702 eyes with visually significant cataract formation. A foldable acrylic soft IOL (AcrySofâMA60BM/MA30BA, Alcon, Fort Worth, TX, USA) or a single-piece acrylic soft IOL (Acriva BBâ, VSY Biotechnology, Amsterdam, The Netherlands) was inserted in all eyes using a cartridge and viscoelastic agents (sodium hyaluronate, Healon®, Advanced Medical Optics, Santa Ana, CA, USA). Postoperative central, paracentral, or peripheral optic cracks or fractures were encountered in a total of six of 702 eyes (0.85%). Four of six lenses (0.57%) had optic cracks within the IOL substance, whereas two of 702 cases (0.28%) had full-thickness IOL fractures in the substance in multiple locations. Three of the four lenses with optic cracks were noted to be handled by tying forceps during the cartridge insertion, and one of them was the complication of holding forceps. Two IOLs with full-thickness optic fractures were encountered during the insertion of the IOLs in the capsular bag as a result of direct trauma to the lens optic by the plunger of the injector system overriding the lens optic during cartridge passage. None of the patients suffered from glare or other visual disturbances postoperatively, and, therefore, none of the six eyes required lens replacement. The unintentional extensive pressure effect of the forceps during the holding process of the IOL or the direct trauma to the lens optic by the plunger of injector systems may cause optic cracks or fractures. Physicians should continue to monitor the eyes postoperatively regularly and must determine the benefits and risks to be derived from lens replacement, if such patients complain of significant glare, image degradation, and visual disturbances. We recommend the use of preloaded lenses, which have their own delivery systems and cartridges, to minimize the risk of such complications.

Comparison of glistenings formation and their effect on forward light scatter between the Acrysof SN60WF and Eternity Natural Uni NW-60 intraocular lenses

AimsTo compare the characteristics of glistenings and forward light scatter between the Alcon Acrysof SN60WF and Santen Eternity Natural Uni NW-60 intraocular lenses (IOLs).MethodsFive Acrysof SN60WF and five Eternity Natural...

Effect of AcrySof versus other intraocular lens properties on the risk of Nd:YAG capsulotomy after cataract surgery: A systematic literature review and network meta-analysis.

ObjectiveThe purpose of this study was to evaluate the impact of different intraocular lens materials (IOL) and optic edge designs on the incidence of Nd:YAG laser capsulotomy.MethodsRandomized controlled trials (RCTs) reporting incidence of Nd:YAG capsulotomy in patients with monofocal IOLs were identified for systematic literature review (SLR) using Cochrane methodology. A network meta-analysis was conducted under a Bayesian framework. Mean hazard ratios (HRs), 95% credible intervals, and one-sided p-values were estimated for Nd:YAG capsulotomy incidence by comparing AcrySof IOLs with a group of non-AcrySof hydrophobic acrylic, hydrophilic acrylic, silicone, and PMMA IOLs. Sensitivity analysis was conducted comparing the risk of Nd:YAG capsulotomy between sharp- and round-edged designs of the above IOLs.ResultsAcrySof IOLs had a lower risk of Nd:YAG capsulotomy compared to hydrophobic acrylic (HR: 2.68; 95% CrI: 1.41, 4.77; p < 0.01), hydrophilic acrylic (HR: 7.54; 95% CrI: 4.24, 14.06; p < 0.001), PMMA (HR: 3.64, 95% CrI: 1.87, 6.33; p < 0.001), and silicone (HR: 1.13; 95% CrI: 0.59, 1.91; p <0.1) IOLs. The risk for Nd:YAG was highest among sharp-edged IOLs for hydrophilic acrylic IOLs (HR: 9.32; 95% CrI: 4.32, 19.29; p < 0.01), followed by other hydrophobic acrylic (HR: 2.91; 95% CrI: 1.27, 5.88; p < 0.01), silicone (HR: 0.838; 95% CrI: 0.328, 1.74; p = 0.69), and PMMA (HR: 0.39; 95% CrI: 0.042, 1.49; p = 0.93) IOLs, compared to AcrySof. Acrysof IOLs had a lower risk of Nd:YAG compared to PMMA (HR: 3.25; 95% CrI: 1.21, 7.37; p < 0.01) and silicone, round edge IOLs (HR: 3.84; 95% CrI: 1.08, 10.64; p = 0.015).ConclusionThe risk of Nd:YAG capsulotomy is lower in eyes implanted with AcrySof IOLs compared to non-AcrySof hydrophobic or hydrophilic acrylic IOLs. Sharp-edged AcrySof, PMMA, and silicone IOLs are comparable in terms of reducing the risk of Nd:YAG laser capsulotomy.

Cognitive functions in patieCognitive functions in patients after cataract phacoemulsification and implantation of multifocal and monofocal intraocular lnts after cataract phacoemulsification and implantation of multifocal and monofocal intraocular lenses

Introduction: The study has to determine whether implantation of diffractive multifocal lenses during cataract phacoemulsification causes distortion of the cognitive aspects of processing perceptual information. Material and methods: 25 patients who underwent cataract phacoemulsification with the implantation of diffractive multifocal lens Acrysof Restor SN6AD1 in both eyes (multifocal group) and 26 patients with the implantation of monofocal intraocular lens Acrysof IQ SN60WF in both eyes (monofocal group) were enrolled. All patients underwent ophthalmic examination and cognitive function– Trial Making Test (Part A and Part B) and Stroop Test (Stroop Test 1 and Stroop Test 2) tests at least 6 months after cataract surgery of the other eye. Results: Mean patient age and visual acuity with correction for near and far vision did not differ between groups. Average Trail Making scores were 32.80 ± 11.86 s and 84.08 ± 33.26 s for Parts A and B, respectively, in the multifocal group, while scores in the monofocal group were 36.61 ± 13.63 s and 93.34 ± 40.49 s in Parts A and B. Stroop Test scores were 79.09 ± 17.69 s and 133.64 ± 17.60 s for Stroop Test 1 and Stroop Test 2, respectively, in the multifocal group; in the monofocal group, scores were 82.04 ± 17.51 s and 152.88 ± 65.72 s, respectively. The groups did not differ for either test. Conclusions: Differences between cognitive function tests results between patients with multifocal and monofocal intraocular lenses were not statistically significant suggesting the lack of influence of the type of lens on visual perception at least in good light conditions. Further clinical trials using more sophisticate tests in different light conditions are needed.

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.

Variation in the time length for the occurrence of Posterior Capsular Opacification following PMMA versus AcrySof Intraocular lens implants

Aim: To evaluate the significance of the biomaterial composition of the implanted Intra Ocular Lenses, in the occurrence of Posterior Capsular Opacification following a cataract surgery. Methods: A total of 75 patients who underwent IOL implant surgery were studied. The patients were classified based on the biomaterial of the IOL implanted in the eye following a cataract surgery. Group A consisted of eyes implanted with Polymethyl Methacrylate IOLs and Group B consisted of eyes implanted with AcrySof IOLs. The patients were later treated with YAG laser to clear the Posterior Capsular Opacification at the Ujjain laser center, Ujjain, Madhyapradesh. Results: The incidence of Posterior Capsular Opacification was found to develop earlier in the eyes implanted with PMMA IOLs as compared to Posterior Capsular Opacification occurrence in eyes implanted with AcrySof IOLs. Conclusion: The incidence of Posterior Capsular Opacification was found to be delayed by the use of AcrySof IOLs when compared to the use of PMMA IOLs. Index terms:Intraocular lenses, Polymethyl Methacrylate, AcrySof, Posterior Capsular Opacification, Lens epithelial cells, Capsulotomy, Biocompatibility I. Introduction The occurrence of Posterior Capsular Opacification is a prominent complication observed postoperatively in patients implanted with IOLs following a cataract surgery. The surgery involves removal of the anterior capsular bag, leaving the posterior capsular bag and the anterior capsular edge. Thereafter the lens nucleus and cortex is removed via phacoemulsification, small incision cataract surgery or any other standardized method. The surgery leaves the capsular bag with traces of Lens Epithelial Cells and fibers. The leftover Lens epithelial cells proliferate, undergo abnormal differentiation and migrate from the equator to the center, causing visual axis obscuration and dimness in vision. The factors that play a role in Posterior Capsular Opacification include biomaterial of the IOL, the edge of the IOL and the surgical skills of the surgeon. This study presents a comparison in the significance of the biomaterial of the IOLs and the shape of the IOLs, in the time length variation for the occurrence of Posterior Capsular Opacification following a cataract surgery. All the surgeries that have been used for this study were performed by the same surgeon thus eliminating any errors that can be caused by differences in surgical skills. Posterior Capsular Opacification can be treated by posterior capsule scrapping, which is a surgical method or by Nd: YAG laser capsulotomy, which is a non-surgical method. Under various studies, AcrySof IOLs have been found to have very low incidence of Posterior Capsular Opacification when compared to Posterior Capsular Opacification incidence in PMMA IOLs. This reduced incidence of Posterior Capsular Opacification in AcrySof IOLs is due to lower migration of lens epithelial cells (LECs) on the posterior capsule and their subsequent regression (1). AcrySof lenses have presented no signs of regeneration of Posterior Capsular Opacification after the capsulotomy via Nd:YAG laser. The following paper represents a comparative study of the occurrence of Posterior Capsular Opacification following PMMA vs AcrySof IOL implantation.

Secondary membrane formation after cataract surgery with primary intraocular lens implantation in children

To evaluate the risk factors for secondary membrane (SM) formation after congenital cataract surgery with intraocular lens (IOL) implantation. A retrospective non-interventional comparative study. Thirty-nine patients (63 eyes) aged 1-135 months. The study included patients who underwent cataract extraction and primary IOL implantation between 1994 and 2001 at the University Hospital. The postoperative follow-up was 6-24 months. Thirty-three eyes received a poly(methyl methacrylate) (PMMA) IOL without square edges, 29 eyes received a hydrophobic acrylic IOL with truncated square edges (AcrySof), and there was no data for IOL type in one eye. Thirty-nine eyes had primary posterior capsulotomy (PPC) and anterior vitrectomy (AV) and in 24 eyes the posterior capsule was left intact. Cox proportional hazard regression analysis was performed to identify significant risk factors for SM formation, and Wilcoxon test to evaluate the difference in time from surgery to SM formation. SM developed in 24 eyes (38 %)--58 % of eyes with an intact posterior capsule and 26 % of eyes having PPC and AV, 42 % of eyes with a PMMA IOL, and 34 % of eyes with an AcrySof lens. In multivariate Cox regression analysis intraoperative PPC and AV (P = 0.02) and AcrySof lens implantation (P = 0.097) were associated with decreased postoperative incidence of SM formation. Median time until SM development was 2.9 months with PMMA IOLs (range 1-17 months) and 6 months with AcrySof lenses (range 1-21.8 months) (P = 0.037). Posterior capsule management as well as IOL design and material influence the incidence and the timing of SM formation after primary IOL implantation in children.

Does the apodized diffractive intraocular lens Acrysof ReSTOR NaturalTM interfere with FDT Matrix perimetry results?

To compare the effect of an apodized diffractive intraocular lens (IOL) (Acrysof ReSTOR Natural) and its yellow counterpart (Natural IQ) on frequency doubling technology (FDT) perimetry results. This study included 37 eyes from 22 patients at the 'Centro Oftalmológico Tranjan' who had undergone uncomplicated phacoemulsification and intraocular lens implantation (17 Acrysof ReSTOR Natural, 20 Natural IQ) performed by the same surgeon, at least three months prior to the study. Patients were subject to frequency doubling technology Matrix Perimeter testing. The patients were between 41 to 79 years old (mean, 70.78 +/- 9.83) in the Natural IQ and 49 to 81 years old (mean, 67.11+/- 11.48) in the Acrysof ReSTOR Natural group, and the mean IOP was 13.64 +/- 2.02 mmHg in the Natural IQ 12.94 +/- 1.39 mmHg in the Acrysof ReSTOR Natural group. The mean pupillary diameter under scotopic conditions was 6.63 +/- 1.16 mm in the Natural IQ group and 7.20 +/- 1.8 mm in the Acrysof ReSTOR Natural group (p=0.20). The mean deviation was -1.83 +/- 3.46 dB in the Natural IQ group and -1.77 +/- 3.94 dB in the Acrysof ReSTOR Natural group (p=0.28). The pattern standard deviation was 3.49 +/- 0.79 dB in the Natural IQ group and 3.20 +/- 0.86 dB in the Acrysof ReSTOR Natural group (p=0.27). There was no difference in the results of FDT Matrix perimetry in eyes that received apodized diffractive IOLs implant or eyes that received monofocal intraocular lens implant.

Comparison of Higher Order Aberrations with Spherical and Aspheric Iols Compared to Normal Phakic Eyes

To compare higher order aberrations (HOA) in AcrySof SN60AT and Acrysof IQ SN60WF intraocular lenses (IOLs) and natural crystalline lenses in an age-matched population. Sixty-nine eyes of 55 patients were examined. Group I included AcrySof spheric lenses, group II AcrySof aspheric lenses, and group III included patients with the natural crystalline lens. The HOA data were obtained with a LADARWave aberrometer (Alcon Inc.). Analysis was based on the RMS of coma, spherical aberrations (SA), and HOA. Statistical comparisons were performed with Kruskal Wallis variance analysis. In the case of coma, there were statistically significant differences between spheric and aspheric AcrySof (p<0.005) and between spheric AcrySof and natural crystalline lenses (p<0.005). The differences between aspheric AcrySof and natural crystalline lens group were not significant (p>0.05). SA were significantly different between spheric and aspheric AcrySof group, and spheric AcrySof and natural crystalline lens group (p<0.005), as well as between aspheric AcrySof and natural crystalline lens group (p<0.05). In case of HOAno significant differences were observed between aspheric AcrySof and natural crystalline lens group (p>0.05), but differences between groups AcrySof spheric and aspheric, and spheric AcrySof and natural crystalline lens, showed high significance (p<0.005). The AcrySof Natural IQ aspheric model SN60WF IOL did not change the optical quality of vision compared to a healthy population of 60-80 years of age. The AcrySof Natural model SN60AT spherical IOL resulted in higher HOAs relative to both the natural crystalline lens population and eyes after aspheric AcrySof IQ model SN60WF IOL implantation.

Light Scatter on the Surface of AcrySof® Intraocular Lenses: Part II. Analysis of Lenses Following Hydrolytic Stability Testing

To investigate the surface light scatter and optical quality of AcrySof lenses (Alcon Laboratories, Inc., Fort Worth, TX) following simulated aging of 20 years. AcrySof lenses were exposed to exaggerated thermal conditions to simulate up to 20 years of aging and were tested for surface light scatter and optical quality (modulation transfer function). There were no significant differences from baseline for either the surface light scatter or optical quality of the lenses over time. The current study demonstrated that surface light scatter on AcrySof lenses did not increase under conditions simulating 20 years of aging. Because the simulated aging environment contained no protein, this work indirectly supports the finding that surface light scatter is due to the deposition of a biomaterial on the lens surface rather than changes in the material. Optical performance integrity of the test lenses was maintained under severe environmental conditions.

Aberration-correcting effect of ThinOptX IOL

To evaluate spherical aberration and visual function after microincision cataract surgery using the ThinOptX rollable intraocular lens. Prospective, comparative, and interventional case series. SettingSingle-centre institutional practice. This prospective study evaluated 58 patients with cataracts who underwent bimanual microphaco cataract surgery in both eyes. A ThinOptX lens was introduced into one eye and an Alcon Acrysof lens, as a control, into the other. One month after cataract surgery, the corneal, whole-eye, and internal spherical aberration, and contrast sensitivity in both eyes were measured. We also measured the spherical aberration in artificial model eyes bearing Acrysof and ThinOptX lenses. Two-sided paired t-test was used for assessing all data. The root mean square (RMS) for both whole-eye and internal spherical aberrations was smaller in eyes bearing ThinOptX (P=0.03 and P=0.07, respectively). Although there was no statistically significant difference in the RMS for internal spherical aberration between ThinOptX- and Acrysof-bearing eyes, according to the Zernike polynomial expansion, all human and model eyes bearing ThinOptX registered negative internal spherical aberration in Z(4,0) and Z(6,0). On the other hand, all human and model eyes bearing Acrysof registered positive internal spherical aberration in Z(4,0) and Z(6,0). The ThinOptX lens yielded slightly higher contrast sensitivity in all cycles. As the ThinOptX lens is designed for negative spherical aberration, we encountered smaller whole spherical aberrations and higher contrast sensitivity than with the Acrysof lens. The implantation of ThinOptX IOL after microincision cataract surgery yielded good visual function.

Effect of AcrySof versus Silicone or Polymethyl Methacrylate Intraocular Lens on Posterior Capsule Opacification

To investigate the effect of AcrySof intraocular lenses (IOLs) on the development of posterior capsule opacification (PCO) compared with silicone or polymethyl methacrylate (PMMA) IOLs for patients with senile cataracts. Meta-analysis of randomized controlled trials (RCTs). Patient data from previously reported RCTs. A comprehensive literature search was performed using the Cochrane Collaboration methodology to identify RCTs comparing AcrySof with silicone or PMMA IOLs in patients with senile cataract. A meta-analysis was performed on the results of RCTs. Posterior capsule opacification score, neodymium:yttrium-aluminum-garnet (Nd:YAG) capsulotomy rate, and best-corrected visual acuity (BCVA) of 0.5 or better after cataract surgery. In total, 10 RCTs involving 1202 eyes with senile cataract were included in this meta-analysis. The results suggested that AcrySof had lower PCO scores than round-edged silicone IOLs (standard mean difference [SMD], -0.25; 95% confidence interval [CI], -0.42 to -0.08; P = 0.003) and a somewhat higher PCO score than sharp-edged silicone IOLs (SMD, 0.48; 95% CI, 0.29-0.68; P<0.00001). AcrySof had a lower Nd:YAG capsulotomy rate than round-edged silicone IOLs (odds ratio [OR], 0.29; 95% CI, 0.14-0.62; P = 0.001) and did not differ from sharp-edged IOLs (OR, 1.72; 95% CI, 0.23-13.13; P = 0.60). AcrySof had a lower PCO score (SMD, -1.07; 95% CI, -1.29 to -0.85; P<0.00001) and a lower Nd:YAG capsulotomy rate (OR, 0.09; 95% CI, 0.04-0.20; P<0.00001) than round-edged PMMA IOLs. Furthermore, there was no significant difference in BCVA between AcrySof and round-edged silicone IOLs (OR, 2.28; 95% CI, 0.66-7.82; P = 0.19) or PMMA IOLs (OR, 3.20; 95% CI, 0.78-13.16; P = 0.11). AcrySof and sharp-edged silicone IOLs are similarly effective in inhibition of PCO after cataract surgery. In patients implanted with the AcrySof lens, significantly less PCO developed than in those who had round-edged silicone or PMMA IOLs. The results of this meta-analysis support the theory that a major factor in preventing PCO development is a sharp-edged IOL design.

Unfolding characteristics of a new hydrophobic acrylic intraocular lens, and possible association with complications in triple procedures

To evaluate the relationship between complications observed in triple procedures and the unfolding characteristics of the HOYA AF-1 lens. Intraoperative and postoperative complications of 242 eyes undergoing vitrectomy, phacoemulsification and intraocular lens (IOL) implantation were reviewed. Ninety eyes were implanted with the AF-1 lens (VA60BB), 100 eyes with a polymethylmethacrylate lens (824C) and 52 eyes with an AcrySof lens (SA60AT). The unfolding characteristics of the VA60BB and SA60AT were also experimentally examined. Intraoperative iatrogenic posterior capsular holes caused by the vitreous cutter were observed in two eyes with the VA60BB, in three eyes with the 824C, and in one eye with the SA60AT. Significant rotation of the curled IOL in the capsular bag during implantation, with dislocation of the IOL into the vitreous cavity through the hole occurred in the two eyes with the VA60BB. Postoperatively, posterior synechia of the iris occurred more frequently in the VA60BB group (seven eyes) than in the 824C group (one eye) or the SA60AT group (one eye). In the experimental study, the unfolding time of the VA60BB lens was longer than that of the SA60AT lens. The overall diameter of the VA60BB lens after unfolding remained shorter than that before folding. Incomplete unfolding of the VA60BB appears to cause intraoperative rotation of the IOL in the capsular bag, resulting in IOL dislocation into the vitreous cavity in the presence of a posterior capsular hole. This lens also appears to be associated with higher rate of postoperative complications in triple procedures.

Outcomes of Bilateral Cataract Surgery in Tanzanian Children

To investigate outcomes of bilateral pediatric cataract surgery in east Africa. Retrospective interventional case series. Two hundred forty-three children who underwent bilateral cataract surgery at the Comprehensive Community-Based Rehabilitation for Tanzania Disability Hospital between 2001 and 2004. Demographic, surgical, preoperative, and postoperative clinical characteristics obtained from patient records were entered into a database (Microsoft Excel; Microsoft, Redmond, WA), and statistical analysis was conducted using SPSS software for Windows (SPSS, Inc., Chicago, IL). Postoperative visual acuities and factors affecting them and postoperative refraction results. Intraocular lenses were inserted in the first eyes of 232 children (149 Alcon AcrySof [Alcon Laboratories, Fort Worth, TX], 83 polymethyl methacrylate [PMMA]). Fifty-eight (62%) of 94 patients with final follow-up acuities recorded in both eyes achieved 20/60 or better in their better eye and 13 (13%) of 94 patients were blind. Of the various predictors of good visual outcome identified for children or eyes, only absence of preoperative blindness (odds ratio [OR], 7.3; 95% confidence interval [CI], 3.0-18.0; P<0.0005) remained significant in a multivariate logistic regression model. One hundred nine (51%) of 212 refracted first eyes had early postoperative refractive error spherical equivalent magnitudes of 2 diopters (D) or more. Ninety-nine (47%) of 212 eyes had initial postoperative cylinders of 3 D or more, dropping to 30 (18%) of 164 of those who had later follow-up refraction. Presence of biometric data was not associated with smaller postoperative refractive errors. Eyes with AcrySof lenses were less likely (OR, 2.5; 95% CI, 1.04-6.06) to have more than 3 D of astigmatism at latest follow-up. AcrySof lenses also were more likely (OR, 2.1; 95% CI, 1.2-3.7) to be fixated in the bag than PMMA lenses. Acute fibrinous uveitis occurred in 30 cases (12%), and transient corneal haze occurred in 20 cases (8%). Twenty-seven (11%) had chronic complications, 69 (28%) underwent a further general anesthetic procedure, and 9 (4%) underwent yytrium-aluminum-garnet capsulotomy. Preoperative blindness was the strongest predictor of poor postoperative visual outcome; the use of AcrySof lenses as opposed to PMMA lenses made in-the-bag fixation more likely and also reduced postoperative astigmatism.

Optical Quality Measurements of Hydrophobic Acrylic Intraocular Lenses

To compare the optical quality of several models of hydrophobic acrylic intraocular lenses (IOLs). Modulation transfer function (MTF) measurements were performed using a model eye system on four models of hydrophobic acrylic IOLs. Models tested were the AcrySof SA60AT, MA60AC, and MA60BM (Alcon, Ft Worth, Tex), as well as the model VA-60BB (Hoya, Tokyo, Japan). For benchmarking, the Alcon model MZ60BD polymethylmethacrylate (PMMA) lens was also measured. Three lenses of each model were tested at frequencies of 50 and 100 line pairs (lp)/mm (corresponding to 20/40 and 20/20, respectively). With a 3-mm aperture, the Alcon AcrySof models had mean MTF values ranging from 58.5% to 60.3% at 100 lp/mm and 78.0% to 79.7% at 50 lp/mm. The Hoya model VA-60BB provided statistically significantly lower (P<.05) MTF values than the Alcon AcrySof models at both frequencies (47.3 +/- 1.2% at 100 lp/mm and 71.8 +/- 1.9% at 50 lp/mm). With a 5-mm aperture, the Alcon AcrySof models had MTF values ranging from 32.9% to 34.3% at 100 lp/mm and 45.2% to 46.7% at 50 lp/mm. Under these larger aperture conditions, the Hoya model VA-60BB also had statistically significantly lower MTF values (20.9 +/- 0.8% at 100 lp/mm and 27.2 +/- 1.1% at 50 lp/mm). Under both apertures and frequencies, the Alcon PMMA lens had statistically significantly higher MTF values than the Hoya lens and statistically significant lower MTF values than all AcrySof models. Using both 3- and 5-mm aperture settings as well as frequencies corresponding to 20/20 and 20/40 vision, statistically significantly higher MTF values were obtained for AcrySof lenses, which were greater than the PMMA lens, which were greater than the Hoya model VA-60BB. The differences in MTF values between lens models are more exaggerated with a 5-mm aperture and may highlight differences in lens manufacturing processes.

Influence of blue light spectrum filter on short-wavelength and standard automated perimetries

To evaluate the influence of a blue light spectrum filter (BLSF), similar in light spectrum transmittance to the intraocular lens Acrysof Natural, on standard automated perimetry (SAP) and short-wavelength automated perimetry (SWAP). Twenty young individuals (< 30 y.o.), without any systemic or ocular alterations (twenty eyes) underwent a random sequence of four Humphrey visual field tests: standard automated perimetry (SAP) and short-wavelength automated perimetry (SWAP) with and without a blue light spectrum filter. All patients had intraocular pressure lower than 21 mmHg, normal fundus biomicroscopy, and no crystalline lens opacity. Foveal threshold (FT), mean deviation (MD), and pattern standard deviation (PSD) indexes obtained from the visual field tests and the difference caused by eccentricity in short-wavelength automated perimetry examinations were analyzed using paired t test. Interindividual variability (standard deviation) was calculated using Pitman's test for correlated samples. Statistically significant reductions in the mean deviation (p < 0.001) and in the foveal threshold (p < 0.001) measured by short-wavelength automated perimetry with the use of the blue light spectrum filter in comparison to short-wavelength automated perimetry without the use of the blue light spectrum filter were observed, but not in standard automated perimetry exams. No other parameters showed statistically significant differences in the short-wavelength automated perimetry and standard automated perimetry tests. Interindividual standard deviation of the test points in the short-wavelength automated perimetry exams increased with eccentricity both with and without the use of the blue light spectrum filter, as sensitivity for inferior and superior hemifields (inferior hemifield minus superior hemifield), but no statistically significant difference in the variability when comparing the use or not of the blue light spectrum filter was noted. When comparing only the four most inferior points and the four most superior points, the inferior-superior difference increases in both situations - without and with the use of the blue light spectrum filter. The difference between without and with the use of the blue light spectrum filter was not statistically significant. Statistically significant reductions in mean deviation and foveal threshold in the short-wavelength automated perimetry with the use of the blue light spectrum filter were observed, but not in standard automated perimetry examinations. Additional studies are necessary to determine the influence of intraocular lenses with short-wavelength light filter after cataract extraction on short-wavelength automated perimetry.