Alcon AcrySof Research Articles

Persistent cyanopsia following non-diffractive extended depth-of-focus intraocular lens implantation

We report the first case of cyanopsia following implantation of a non-diffractive extended depth-of-focus (EDOF) intraocular lens (IOL). A 79-year-old male artist underwent cataract extraction with a non-diffractive EDOF ultraviolet absorbing toric IOL (Alcon AcrySof IQ Vivity DAT315) and then experienced persistent cyanopsia in fluorescent lighting following surgery. His symptoms persisted and were visually debilitating. He underwent secondary IOL exchange with a yellow-tinted non-diffractive EDOF toric IOL (Alcon AcrySof IQ Vivity DFT315) and the recurrent cyanosis abated. Surgeons should be aware of cyanopsia following implantation of ultraviolet absorbing IOLs and be prepared to address these complaints should they arise.

Prediction of effective lens position (ELP) and its changes in different monofocal intraocular lens (IOL’s)

Objectives: To evaluate effective lens position (ELP) is more accurately predicted by anterior chamber depth (ACD) alone or by ACD + ½ lens thickness (LT) and to compare the ELP and refractive outcome of different monofocal intraocular lens (IOLs) in patients undergoing phacoemulsification. Materials and Methods: A total of 122 eyes with senile cataract underwent phacoemulsification with three different types of IOL implantation. Biometry data were obtained by IOL master 700 (SS-OCT) and IOL power was calculated using Barrett Universal II formula. Two prediction formulae for ELP were compared, one with ACD + ½ LT and other with ACD alone; furthermore, comparison was done among three types of IOL. Mean prediction error was calculated for both methods and among three IOL groups. Results: In the study, predicted ELP according to ACD + ½ LT was 5.27 ± 0.27 and Mean pre-op ACD was 3.069 ± 0.349 mm, achieved ELP (post-op ACD) was 4.98 ± 0.47 mm and between the two; ACD + ½ LT is closer to achieved ELP. The difference between mean ACD + ½ LT (5.22) and achieved ELP (4.71) was 0.50 in ALCON ACRYSOF IQ (SN60WF) and difference of ACD + ½ LT (5.33) and achieved ELP (5.07) was 0.25 in J and J TECNIS 1 (ZCB00), while the difference of ACD + ½ LT (5.28) and achieved ELP (5.16) was 0.114 in ZEISS CT LUCIA (611P). Residual refraction predicted by IOL master 700 and achieved residual refraction at post-op 1 month was −0.15 ± 0.19 and −0.10 ± 0.30 in ACRYSOF IQ, was −0.11 ± 0.18 and −0.01 ± 0.20 in TECNIS 1 and was −0.10 ± 0.20 and + 0.396 ± 0.22 in ZEISS CT LUCIA, respectively. Conclusion: ELP may be better predicted by formulae ACD + ½ LT than ACD alone with mean differences of 0.29 and 1.92 in two prediction groups, respectively. ALCON ACRYSOF IQ (SN60WF) and J and J TECNIS 1 (ZCB00) group had myopic shifts of 0.10 and 0.11, respectively, while ZEISS CT LUCIA (611P) group had hyperopic shifts of 0.5002 which was statistically significant, as ALCON ACRYSOF IQ (SN60WF) and J and J TECNIS 1 (ZCB00) ELP is positioned more anterior and ZEISS CT LUCIA (611P) relatively posterior.

Randomized multicenter trial to assess posterior capsule opacification and glistenings in two hydrophobic acrylic intraocular lenses

To evaluate the long-term posterior capsule opacification (PCO) formation, and glistening rate of the HOYA Vivinex (XY1) IOL compared to Alcon AcrySof (SN60WF). In this prospective, multicentric, randomized, paired-eye, open-label study, we included 87 subjects that underwent cataract surgery with IOL implantation, with 67 patients completing the 3-year follow-up. The completer population consisted of 32 subjects implanted with XY1 and 35 implanted with SN60WF. Primary endpoints consisted of the evaluation of glistenings and measurement of PCO. Secondary outcomes included Best Corrected Distance Visual Acuity (BCVA), Contrast Acuity (CA), uncorrected visual acuities, subjective refraction, medical and lens complication rates, adverse events, and optical/visual symptoms. Follow-up visits occurred at 6-months, 1-, 2- and 3-years. At 3-years follow-up, mean PCO score was 0.121 ± 0.193 for eyes implanted with Vivinex versus 0.239 ± 0.463 for AcrySof (p = 0.026). The Vivinex IOL showed statistically significantly lower glistening occurrence through 3-years postoperatively (0.14 ± 0.26) compared to AcrySof (1.79 ± 1.43; p < 0.0001). Postoperative visual acuities improved from baseline in both IOL groups (p < 0.0001), and remained stable through the 3-year follow-up period. Eyes implanted with a HOYA Vivinex IOL exhibited significantly lower occurrence of glistening at 3-years versus Alcon AcrySof (p < 0.0001). Incidence of PCO was very low and comparable in both Vivinex and AcrySof eyes.

Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in patients with axial hyperopia.

This study was conducted to evaluate the accuracy of intraoperative aberrometry (IA) in intraocular lens (IOL) power calculation and compare it with conventional IOL formulas. This was a prospective case series. Eyes with visually significant cataract and axial hyperopia (AL <22.0 mm) underwent IA-assisted phacoemulsification with posterior chamber IOL (Alcon AcrySof IQ). Postoperative spherical equivalent (SE) was compared with predicted SE to calculate the outcomes with different formulas (SRK/T, Hoffer Q, Haigis, Holladay 2, Barrett Universal Ⅱ and Hill-RBF). Accuracy of intraoperative aberrometer was compared with other formulas in terms of mean absolute prediction error (MAE), percentage of patients within 0.5 D and 1 D of their target, and percentage of patients going into hyperopic shift. Sixty-five eyes (57 patients) were included. In terms of MAE, both Hoffer Q (MAE = 0.30) and IA (MAE = 0.32) were significantly better than Haigis, SRK/T, and Barrett Universal Ⅱ (P < 0.05). Outcomes within ±0.5 D of the target were maximum with Hoffer Q (80%), superior to IA (Hoffer Q > IA > Holladay 2 > Hill-RBF > Haigis > SRK/T > Barrett Universal Ⅱ). Hoffer Q resulted in minimum hyperopic shift (30.76%) followed by Hill-RBF (38.46%), Holladay 2 (38.46%), Haigis (43.07%), and then IA (46.15%), SRK/T (50.76%) and Barrett Universal Ⅱ (53.84%). IA was more effective (statistically significant) in predicting IOL power than Haigis, SRK/T, and Barrett Universal Ⅱ although it was equivalent to Hoffer Q. Hoffer Q was superior to all formulas in terms of percentage of patients within 0.5 D of their target refractions and percentage of patients going into hyperopic shift.

Optical Biometry and IOL Calculation in a Commercially Available Optical Coherence Tomography Device and Comparison With Pentacam AXL

Optical devices are the gold standard for ocular biometry, however, they are unable to obtain high quality optical coherence tomography (OCT) images. The current study aimed to evaluate ocular measurements and intraocular lens (IOL) calculation employed in an anterior/posterior segment OCT device and compare the results to a validated biometer. Prospective evaluation of a diagnostic tool. This study enrolled healthy subjects at the Hygeia Clinic, Gdańsk, Poland, between October 2021 and November 2021. All individuals had ocular biometry measured with a validated biometer (Pentacam AXL) and with a new module of an anterior-posterior segment OCT device (Revo, Optopol Technologies, Zawiercie, Poland). All IOL calculations were performed for the right eye with keratometric values from the Pentacam for one IOL: the Alcon AcrySof IQ SN60WF, with plano target setting. The mean age of the 144 participants was 25.23±7.15 years. The AL measured with Revo was longer than with Pentacam AXL (24.08±1.13 vs. 23.98±1.13; p<0.0001), a 0.10±0.04 mm difference. This translated into a significantly lower IOL power to achieve emmetropia for all formulas (-0.34±0.15; -0.32±0.13; -0.34±0.19; -0.30±0.15 for the Hoffer Q, Holladay I, Haigis and SRK/T formulas, respectively). The study showed high agreement between the devices: nearly 90% of eyes were within ±0.50 D for all of the analyzed formulas (r>0.99). The present study demonstrates the results of IOL calculation with the OCT biometer have a very strong correlation with those obtained with the Pentacam AXL; however, AL measurements and calculated IOL power cannot be considered interchangeable.

Comparison of clinical outcomes of astigmatic correction using toric intraocular lens

AIM: To compare the clinical effects of two brands of Toric intraocular lens used in surgical correction of cataract with corneal astigmatism. METHODS: Totally 35 patients (50 eyes) with corneal astigmatism who underwent ophthalmic surgery from April 2019 to July 2019 were retrospectively analyzed. Among them, 25 eyes of 20 patients were implanted with Rayner 623T, while 25 eyes of 15 patients with Alcon AcrySof Toric intraocular lens (IOL). Three months after surgery, the uncorrected distance visual acuity (UCDVA), best corrected distance visual acuity (BCDVA), residual astigmatism, rotational degree of intraocular lens, contrast sensitivity, objective visual quality and the National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) scale score were compared. Vector analysis was performed using the Alpins method. RESULTS: The mean postoperative UCDVA and BCDVA (logMAR) in the Rayner group were 0.17±0.20 and 0.08±0.15, respectively (P&gt;0.05), while those in the Alcon group were 0.21±0.16 and 0.10±0.11, respectively (P&gt;0.05). The mean residual astigmatism in the Rayner group was -0.57±0.24 D while that in the Alcon group was -0.50±0.28 D (P&gt;0.05). There was no statistically significant difference between the two groups in IOL rotational stability, vector analysis parameters, contrast sensitivity and objective visual quality (P&gt;0.05). The NEI VFQ-25 scale score was 85.16±5.91 in the Rayner group while it was 82.08±6.16 in the Alcon group (P&gt;0.05). CONCLUSION: The two brands of toric intraocular lens-Rayner 623T and Alcon AcrySof toric show no significant difference in their clinical outcomes.

Visual outcomes of a new nondiffractive extended depth-of-focus intraocular lens targeted for minimonovision: 3-month results of a prospective cohort study.

To evaluate visual outcomes, spectacle independence, and optical phenomena after bilateral implantation of a nondiffractive extended depth-of-focus (EDoF) intraocular lens (IOL) targeted for minimonovision. University Eye Clinic Maastricht, the Netherlands. Prospective case series. Patients with age-related cataract were bilaterally implanted with a nondiffractive EDoF IOL (Alcon AcrySof IQ Vivity), targeted for minimonovision. Outcome measures were the uncorrected distance visual acuity (UDVA), corrected distance visual acuity, uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), distance corrected intermediate visual acuity, distance corrected near visual acuity, refractive outcomes, defocus curves, spectacle independence, photic phenomena, and Catquest-9SF questionnaire. 44 eyes of 22 patients were included. The mean binocular UDVA, UIVA, and UNVA were -0.07 (±0.10), 0.04 (±0.09), and 0.23 (±0.12) logMAR, respectively. The percentage of eyes within ±1.0 diopters (D) and ±0.5 D of target was 100% and 95% for the dominant eye and 100% and 86% for the nondominant eye, respectively. The binocular defocus curve was better than 0.10 logMAR over a range from -2.0 D to +0.5 D. The percentage of patients who reported not or rarely using spectacles for distance, intermediate, and near viewing distance was 96%, 68%, and 38%, respectively. The percentage of patients who experienced no halos, glare, or starbursts were 91%, 91%, and 100%, respectively. The Catquest-9SF showed a high patient satisfaction for daily life activities. Bilateral AcrySof IQ Vivity IOL implantation targeted for minimonovision provided good visual acuity results for far and intermediate with functional near vision, high level of patient satisfaction and spectacle independence, and a monofocal disturbance profile.

Nd:YAG capsulotomy incidence associated with five different single-piece monofocal intraocular lenses: a 3-year Spanish real-world evidence study of 8293 eyes

ObjectivesTo investigate the associations between different single-piece monofocal intraocular lenses (IOLs) and neodymium-doped yttrium aluminum garnet laser (Nd:YAG) capsulotomy incidence 3 years after cataract surgery in a Spanish cohort.MethodsThis is a longitudinal retrospective cohort study. Data were extracted from the electronic medical records of two large regional hospitals in Spain. Patients aged ≥65 years receiving cataract surgery with placement of five different IOLs and with ≥6 months of baseline data were included. We report the Nd:YAG capsulotomy incidence 3 years post cataract surgery, and the survival plot over the 3 years of follow-up time. The associated adjusted (age, gender, and diabetic retinopathy) multivariate analysis with odds ratios (ORs) and 95% CIs is also presented.ResultsThe cohort (53% female, mean age 75 ± 5.9 years) included 14,519 eyes (Alcon AcrySof = 2968, AJL LLASY60 = 1776, Medicontur Bi-flex = 5176, Zeiss Asphina = 4478, and IOL Tech Stabibag = 121). Of these, 8293 were retained until 3-year follow-up. At 3 years after cataract surgery, the Nd:YAG capsulotomy incidence was 5% for Alcon AcrySof, while it ranged from 21.2% to 31.1% for the other IOLs (p < 0.0001 for each comparison). The odds for Nd:YAG capsulotomy were significantly higher (p < 0.0001) for other IOLs compared with those of Alcon AcrySof (ORs = 8.85, 5.86, 5.74, 5.21 for AJL LLASY60, Medicontur Bi-flex, IOL Tech Stabibag, and Zeiss Asphina, respectively).ConclusionsThe lower Nd:YAG capsulotomy rates for Alcon AcrySof IOLs compared to the other IOLs support the importance of lens choice in reducing patient burden and treatment costs.

Optical Bench Analysis of 2 Depth of Focus Intraocular Lenses

Background: The aim of the study was to analyze the objective optical properties of 2 enhanced depth of focus (EDoF) intraocular lenses (IOLs) using optical bench analysis. Methods: This experimental study investigates 2 new EDoF IOLs, the Alcon AcrySof IQ Vivity and the Bausch & Lomb LuxSmart Crystal, on the optical bench, using OptiSpheric IOL PRO2 (Trioptics, Germany) in order to assess the optical quality according to ISO 11979 with ISO-2 Cornea. IOLs (power 22.0 D) were evaluated regarding modulation transfer function (MTF) at 50 lp/mm and Strehl ratio (SR) using a 3.0-mm and a 4.5-mm aperture. In addition, wavefront measurements were obtained using WaveMaster® IOL 2 device (Trioptics, Germany), and USAF targets were analyzed. Results: Centered: the MTF (mean) at 50 lp/mm (AcrySof IQ Vivity/LuxSmart Crystal) with 3.0 mm aperture was 0.250/0.257 and with 4.5 mm aperture 0.202/0.243. The SR (mean) with 3.0 mm aperture was 0.261/0.355 and with 4.5 mm aperture 0.176/0.206. Decentered by 1 mm: the MTF (mean) at 50 lp/mm (AcrySof IQ Vivity/LuxSmart Crystal) with 3.0 mm aperture was 0.266/0.247 and with 4.5 mm aperture 0.126/0.215. The SR (mean) with 3.0 mm aperture was 0.272/0.234 and with 4.5 mm aperture 0.133/0.183. Tilted by 5 degree: the MTF (mean) at 50 lp/mm (AcrySof IQ Vivity/LuxSmart Crystal) with 3.0 mm aperture was 0.221/0.360 and with 4.5 mm aperture 0.214/0.229. The SR (mean) with 3.0 mm aperture was 0.232/0.428 and with 4.5 mm aperture 0.225/0.229. The simulated visual function using USAF test targets showed corresponding qualitative results. Wavefront measurements proved a complex optical design. Higher order aberrations in the central part of the optics were modulated up to the 10th order to enhance the range of functional vision to near distance, leaving the peripheral parts of the optics aberration free or as aberration correcting. Conclusion: The diversity of EDOF IOLs, their optics, and their respective impact on the vision quality must be understood in order to select the appropriate IOL in each individual case. This analysis of new, innovative IOL optics based on increased negative spherical aberration may help the ophthalmic surgeon to select the IOL which meets the individual requirements of the patient for best postoperative outcomes. It seems that there is no perfect IOL that is equally suitable for all patients, but the right choice is an individual, customized approach dealing with patients’ expectations.

Comparative analysis of in vitro accelerated glistening formation in foldable hydrophobic intraocular lenses

PurposeTo analyse and compare the propensity to form glistenings in 4 different types of hydrophobic acrylic intraocular lenses (IOLs): Alcon AcrySof ® MA60AC, HOYA iSert® PC-60AD, Bausch&Lomb enVista, and Kowa Avansee™ PU6A.MethodsWe used an accelerated laboratory method to create glistenings. IOLs were first immersed in saline at 45 °C for 24 h and then at 37 °C for 2.5 h. Microvacuole (MV) density and size were documented and calculated using an image analysis program.ResultsMedian density of glistenings [MV/mm2] for Alcon AcrySof ® MA60AC was 623 (range 507–804), for HOYA iSert® PC-60AD 1358 (range 684–2699), for Bausch&Lomb enVista 2 (range 1–2), and for Kowa Avansee™ PU6A 1 (range 1–4). The prevailing MV size was: 0–5 µm for Hoya IOLs, 5–10 µm for Alcon IOLs, 20–50 µm for Bausch&Lomb IOLs, and 5–50 µm for Kowa IOLs.ConclusionsGlistenings could be induced in all studied IOLs using the accelerated laboratory method. The Alcon AcrySof ® MA60AC and HOYA iSert® PC-60AD IOLs showed MV of high density, while the glistenings in the Hoya IOLs were smaller in size compared to the Alcon IOLs. The MV density was minimal in the Bausch&Lomb enVista and Kowa Avansee™ PU6A IOLs. The propensity of the Alcon AcrySof ® MA60AC IOLs to form glistenings in vitro correlated with the findings of clinical results that are already published.

Incidence and causes of negative dysphotopsia after uncomplicated cataract surgery – A randomized clinical trial

Purpose:The purpose of this study is to find incidence of negative dysphotopsia (ND) in eyes undergoing clear corneal phacoemulsification and identify its causes including corneal wound hydration and type of intraocular lens (IOL).Methods:In this randomized clinical trial, consenting adult patients undergoing phacoemulsification were randomized to receive a hydrophobic (Alcon Acrysof® SN60WF) or a hydrophilic acrylic IOL (CT Asphina® 603P, Carl Zeiss Meditec) in a 1:1 ratio. At time of surgery, eyes were again randomized in 1:1 fashion to receive stromal wound hydration or not (n = 80 each in four groups). Primary outcome measure was the incidence of ND between eyes receiving stromal hydration versus no hydration. Those with ND were observed for 5 years after surgery.Results:Of the 320 eyes, 29 (9.06%) reported ND of which 24 (83%) were transient. Eyes with wound hydration had significantly higher proportion of ND (n = 21/160, 13%) compared to no hydration (n = 8/160, 5%) (P = 0.01). Additionally, eyes with wound hydration were three times more likely to experience ND (odds ratio = 3.29, 95% CI = 1.3–8.2, P = 0.01). Majority of eyes (20/21, 95%) with ND after hydration had it transiently while half (4/8, 50%) of those with ND without wound hydration had it persistently at 6 weeks (P < 0.001) and continued to experience ND for 5 years but did not request intervention.Conclusion:ND occurred in 9% cases with majority being transient. Corneal wound hydration led to significant higher likelihood of experiencing transient ND. Those with persistent ND for more than 6 weeks (1.5%) continue to experience ND for at least 5 years.

Comparison between bilateral implantation of a trifocal intraocular lens (Alcon Acrysof IQ® PanOptix) and extended depth of focus lens (Tecnis® Symfony® ZXR00 lens).

To compare the visual performance outcomes following bilateral cataract surgery using trifocal intraocular lens (Alcon Acrysof IQ® PanOptix) and extended depth of focus lens (Tecnis® Symfony® ZXR00 lens). In this prospective, non-randomized, comparative trial, a total of 40 subjects (80 eyes) were divided into two different groups and submitted to bilateral cataract surgery and implantation of the two different IOLs, Alcon Acrysof IQ® PanOptix® TNFT00 in group A and Tecnis® Symfony® ZXR00 lens (Johnson & Johnson Vision) in group B, was assessed. The uncorrected and corrected near (33cm), intermediate (60cm), and far (4m) binocular visual acuity was measured, and visual binocular defocus curves were also measured in the photopic condition with a long-distance visual acuity and the qualitative visual function was assessed by NEI VFQ-25. Group A comprised 20 patients; 11 women (55%) and 9 men (45%) with a mean age of 62.1 ± 5.4. In group B 20 patients were recruited; 12 women (60%) and 8 men (40%) with a mean age of 63.2 ± 6.1. The postoperatively calculated mean sphere was + 0.35 ± 0.12 D and - 0.14 ± 0.13 D in groups A and B, respectively. The postoperative uncorrected distance visual acuity (UDVA) as well as uncorrected intermediate visual acuity (UIVA) were statistically equal in both groups (P = 0.12, P = 0.17); meanwhile, the postoperative uncorrected near visual acuity (UNVA) was significantly better in patients with PanOptix IOL implantation (P = 0.01) compared to the binocular defocus curve; the results of the PanOptix group were better than the Symfony group in intermediate and near distance (P = 0.089, P = 0.001) and according to the VFQ-25 questionnaire, then ear vision score as well as sum score turned out to be significantly higher in groups A than B (P = 0.001 and P = 0.015, respectively). Both strategies were able to provide good vision for far, intermediate and near distances.

Eradication of Posterior Capsule Opacification: Documentation of a Marked Decrease in Nd:YAG Laser Posterior Capsulotomy Rates Noted in an Analysis of 5416 Pseudophakic Human Eyes Obtained Postmortem

(1) To report the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy rate (%) of eight rigid and foldable intraocular lens (IOL) designs in a series of 5416 pseudophakic human eyes obtained postmortem, accessioned in our center between January 1988 and January 2000. (2) To identify factors that are instrumental in reducing the incidence of posterior capsule opacification, (PCO, secondary cataract) and hence the need for Nd:YAG laser posterior capsulotomy. Comparative autopsy tissue analysis. A total of 5416 globes with posterior chamber intraocular lens (PC-IOLs) obtained postmortem received from Lions Eye Banks between 1988 and2000. Miyake-Apple posterior photographic technique. Special reference was given to the presence or absence of Nd:YAG laser posterior capsulotomy orifice on the posterior capsule of each eye. The Nd:YAG laser posterior capsulotomy rate (%) as of January 2000 was documented. In addition, the Nd:YAG laser posterior capsulotomy rate for each lens was plotted on a monthly basis for the same period, creating a computerized trend or "timeline" for each IOL style. Relatively high Nd:YAG laser posterior capsulotomy rates ranging from 20.3% to 33.4% were noted with four relatively older designs (high incidence of implantation between 1988 and the early 1990s). Four modern foldable lOLs manufactured from silicone and acrylic materials had significantly lower Nd:YAG laser posterior capsulotomy rates ranging from 0.9% (Alcon Acrysof) to 17.1%. The difference in Nd:YAG rates among the eight IOL designs was found to be significant (P < 0.0001, chi-square test). Comparing foldable versus rigid designs, the foldable IOLs were associated with a much lower Nd:YAG laser posterior capsulotomy rate (14.1% vs. 31.1%). By use of the six factors regarding surgical technique and IOL choice described in this article, we strongly believe that the overall incidence of PCO and hence the incidence of Nd:YAG laser posterior capsulotomy is now rapidly decreasing from rates as high as 50% in the 1980s to early 1990s. Surgical tools and IOLs are now available to bring these rates down to single digits. Careful application and use of these tools by surgeons can genuinely lead in the direction of virtual eradication of secondary cataract, the second most common cause of visual loss worldwide.

Refractive results after cataract surgery using Optical biometry

Purpose: To assess the refractive outcome of optical biometry (Nidek AL-scan) after elective phacoemulsification in a study of 30 eyes.&#x0D; Study Design: Descriptive case series.&#x0D; Place and Duration of Study: Elective cataract surgeries done at a private clinic from July 2015 to June 2016 were selected and their records were analyzed.&#x0D; Material Methods: The measurements of IOL calculation was done using optical biometry with partial coherence interferometry (Nidek AL-scan) that provides information about axial length, central keratometry, white to white diameter and anterior chamber anatomical depth. SRK-T formula was used to calculate IOL power. All patients underwent a complete ophthalmological examination. Phacoemulsification with clear corneal incision of 2.75 mm was done and IOL was implanted in the bag (Alcon Acrysof SN60WF IOL and MA60AC IOL). Post-operative refraction was taken with autorefractor (Huvitz HRK-7000) after 4 weeks and it was compared with pre-operative objective refraction. Comparison of K readings taken by AL-scan and autorefractor were done.&#x0D; Results: We studied 30 eyes of 23 patients who underwent elective cataract surgery with foldable IOL. Post-operative spherical equivalent was plano in 53% of cases with mean of -0.05 after 4 weeks postoperatively. The mean keratometric power using autorefractor was 44.4 D while with AL-scan it was 44.7 D. There were no intraoperative complications or postoperative subjective complaints (such as halo or glare) in our patients.&#x0D; Conclusion: Intraocular lens power calculations done by optical biometry are easy to use, reliable and result in excellent refractive outcomes. Ultrasound biometry may still be required in case of mature and dense posterior subcapsular cataract.

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...

Scanning electron microscopy study of different one-piece foldable acrylic intraocular lenses after injection through microincisional cataract surgery cartridges.

To evaluate possible surface alterations of different models of one-piece foldable acrylic intraocular lenses (IOLs) after folding and ejecting process through 2.2-mm microincisional cataract surgery (MICS) cartridges. In this experimental laboratory study, the following IOLs were studied: Johnson&Johnson PCB00, HOYA iSert 251, Alcon AcrySof IQ SN60WF, Bausch&Lomb enVISTA MX-60. A total of 80 IOLs were analyzed. Twenty intraocular lenses of each type were studied: ten with a power of + 21 D ± 1 and ten with a power of + 28 D ± 1. IOLs were injected through a dedicated 2.2-mm MICS cartridge into a 50-mL vial containing 10mL of deionized water. After rinsing and metallization process, scanning electron microscopy images were acquired. All IOLs presented high-quality construction biomaterials. Some IOLs showed superficial scratches and tears on the optic surface, mainly positioned according to the direction of the stress induced by the folding process. In other cases, small superficial tears were seen in a more peripheral position. All lenses showed excellent surface quality. After folding and injection process some superficial scratches and tears of the IOL optic were detected in some models. Further studies are needed to assess the possible effects of those superficial damages on the optical quality of the IOLs.

5 year incidence of YAG capsulotomy and PCO after cataract surgery with single-piece monofocal intraocular lenses: a real-world evidence study of 20,763 eyes

ObjectivesTo evaluate the 3- and 5-year incidence of posterior capsule opacification (PCO) and neodymium-doped yttrium aluminium garnet (Nd:YAG) capsulotomy in patients following cataract surgery, comparing results for different single-piece acrylic hydrophilic and hydrophobic monofocal intraocular lens (IOL) models and other patient factors.Patients and methodsElectronic medical record data collected from seven United Kingdom (UK) National Health Service (NHS) ophthalmology clinics for routine, age-related (≥65 years) cataract surgeries that implanted single-piece acrylic monofocal IOLs during 2010–2013 were used to calculate 3- and 5-year incidence of Nd:YAG and PCO. IOL models of Alcon Acrysof, AMO Tecnis, Bausch & Lomb (B & L) Akreos, LenStec Softec, and Rayner Flex were analyzed. Pairwise comparisons were conducted between AcrySof IOLs and other IOLs using Bonferroni adjustment for multiplicity. Multivariate analyses were conducted adjusting for known confounders.ResultsThe incidence of Nd:YAG capsulotomy ranged between 2.4–12.6% at 3 years and 5.8–19.3% at 5 years post-cataract surgery. Similarly, the incidence of PCO ranged between 4.7–18.6% at 3 years and 7.1–22.6% at 5 years. When comparing all of the single-piece IOLs, AcrySof demonstrated the lowest incidence rates for both PCO and Nd:YAG (P < 0.001 for each comparison). From adjusted logistic regression analysis, AcrySof were associated with lower 3- and 5-year odds of Nd:YAG and PCO incidence.ConclusionsFollowing cataract surgery with single-piece monofocal IOLs different incidence rates of PCO were observed with different IOLs. AcrySof IOLs were associated with significantly lower incidence of PCO requiring Nd:YAG treatment over periods of 3 and 5 years.

Comparison of visual outcomes after bilateral implantation of two intraocular lenses with distinct diffractive optics.

PurposeThe aim of this study was to compare the visual outcomes and subjective visual quality between bilateral implantation of an extended depth of focus intraocular lens, J&J Vision Tecnis Symfony® ZXR00 (Group A) and bilateral implantation of a diffractive trifocal intraocular lens, Alcon Acrysof IQ PanOptix® TNFT00 (Group B).MethodsThis prospective, nonrandomized, comparative study of consecutive cases assessed 52 eyes of 26 patients operated on by the same surgeon (WTH) and binocularly implanted with multifocal intraocular lenses between May 2016 and July 2018. Binocular visual acuity for far, intermediate and near was tested in all cases. Ophthalmological evaluation included the measurement of binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA) at 40 cm, uncorrected intermediate visual acuity (UIVA) at 70 cm, monocular visual defocus curve and the quality of life (QoL) questionnaire, National Eye Institute Visual Functioning Questionnaire - 25 ( NEI-VFQ 25).ResultsPostoperative UDVA was 0.00 and 0.09 logMAR (P<0.001), UIVA was 0.20 and 0.39 logMAR (P<0.001) and UNVA was 0.16 and −0.01 logMAR (P<0.001) in groups A and B, respectively; postoperative CDVA was −0.05 and 0.06 logMAR (P<0.001) in groups A and B, respectively.ConclusionBoth groups reported good subjective quality of vision regarding long, intermediate and short distances. Group A had a better performance for binocular UDVA, UIVA at 70 cm and CDVA, while regarding the monocular defocus curve, Group A outperformed Group B for long distances. Furthermore, Group B surpassed it in the short to very short distances, between the range of ≥2.00 D to 5.00 D of vergence. While Group A had a better performance regarding the vergences between 0.00 and 1.00 D (P<0.05) and at the vergence of +2.50 D (P=0.007). Group B outran Group A for UNVA at 40 cm.

An In Vitro Human Lens Capsular Bag Model Adopting a Graded Culture Regime to Assess Putative Impact of IOLs on PCO Formation.

To develop a culture regime for the in vitro human lens capsular bag model that better reflects clinical events following cataract surgery and to use this refined model to evaluate the putative impact of IOLs on PCO formation. Capsulorhexis and lens extraction were performed on human donor eyes to generate capsular bags attached to the ciliary body by the zonules. Preparations were secured by pinning the ciliary body to a silicone ring and maintaining in 6 mL serum-free EMEM for 28 days or in a graded culture system (days 1-3, 5% human serum and 10 ng/mL TGFβ2; days 4-7, 2% human serum and 1 ng/mL TGFβ2; days 8-14, 1% human serum and 0.1 ng/mL TGFβ2; days 15-28, serum-free EMEM), which better mimics clinical changes. Preparations were monitored with phase-contrast and modified-dark-field microscopy. Cell coverage and light scatter were quantified using image analysis software. The transdifferentiation marker, α-SMA and matrix component, fibronectin were assessed by immunocytochemistry. To assess IOLs in the model, Alcon Acrysof or Hoya Vivinex IOLs were implanted in match-paired capsular bags. Match-paired experiments showed that graded culture enhanced growth, facilitated matrix contraction, increased transdifferentiation, and promoted matrix deposition relative to serum-free culture. The graded culture protocol was applied to match-paired bags implanted with a Hoya Vivinex or an Alcon Acrysof IOL. The Vivinex demonstrated a lag in growth across the posterior capsule. However, by day 28, coverage was similar, but light-scatter was greater with Acrysof implanted. Cell growth on the Acrysof IOL anterior surface was significantly greater than Vivinex. The graded culture human capsular bag model serves as an excellent system to evaluate and develop intraocular lenses. The Hoya Vivinex IOL showed an overall better level of performance against postsurgical wound healing and PCO than the Alcon Acrysof using this model.

Refrakcyjna wymiana soczewki z wszczepieniem soczewki trójogniskowej Alcon AcrySof® IQ PanOptix® – kontrowersja czy standard

Refractive lens exchange is still relatively new and slightly controversial method of correcting the refractive errors. The surgery consists of extracting the patient’s own lens using phacoemulsification technique in non-existent or irrelevant for sight opacifications in lens and implant of artificial intraocular lens. With modern surgery technique improvements and higher multifocal intraocular lens availability allowing the wide spectrum of acute vision, this technique becomes an attractive alternative to laser vision correction, especially in societies with higher presbyopia rates. The study included 7 patients (11 eyes) operated solely for refractive errors and/or presbyopia with Alcon AcrySof® IQ PanOptix® implant. In examination we evaluated refractive errors, both corrected and uncorrected visual acuity for distance and near, and improved quality of life and patient satisfaction after surgery. Refractive lens exchange is an effective alternative to laser eye surgery, at the same time being free from laser limitations such as high myopia or hyperopia, cornea thickness or dry eye syndrome.