Aspheric Monofocal Intraocular Lens Research Articles

Through-focus performance and off-axis effects in aspheric monofocal intraocular lenses.

This study aimed to determine the through-focus performance and the effect of misalignment on the optical quality of different aspheric monofocal intraocular lenses (IOLs). To this end, optical quality was assessed in three IOL models with different optic surfaces: standard aberration neutral model and two spherical aberration (SA) correcting, one of which utilizes higher-order aspheric terms. The optical quality was measured by means of the modulation transfer function at 3- and 4.5-mm pupils and under monochromatic and polychromatic light with different corneal SA. The optically derived range of vision and tolerance to misalignment were also tested. The study demonstrated that the type of IOL surface affects the monofocal implant's performance. Although a standard primary-SA correction may improve scotopic image quality, misalignment may diminish this advantage. The higher-order aspheric surface used to correct SA provided an improved performance against decentration and offered a higher optical quality than the aberration-neutral design when tested in a model eye. The latter, however, demonstrated a high tolerance to misalignment, offering a slight extension of the range of vision, potentially resulting from uncorrected optical aberrations.

Comparison Between Monofocal and Aspheric Monofocal Intraocular Lens With Higher Order Aspheric Optic in Pediatric Patients: Early Outcomes.

To retrospectively compare the visual acuity outcomes for far, intermediate, and near vision of an aspheric monofocal intraocular lens (IOL) with higher order aspheric optic with a monofocal IOL in pediatric patients. Thirty-eight eyes of 38 patients (mean age: 9.0 ± 2.3 years) affected by monolateral infantile cataract were evaluated 6 months after surgery performed with simultaneous IOL implantation. The Tecnis Eyhance ICB00 aspheric monofocal IOL (Johnson & Johnson Vision) was implanted in 17 eyes (Tecnis Eyhance group, mean age: 8.9 ± 2.5 years) and the Tecnis PCB00 monofocal IOL (Johnson & Johnson Vision) was implanted in 21 eyes (control group, mean age: 9.1 ± 2.2 years). Corrected visual acuity expressed in logarithm of the minimum angle of resolution (logMAR) was assessed for distance (CDVA) and, expressed in Jaeger standard, for intermediate (DCIVA) and near vision (CNVA). DCIVA was measured with distance correction and without addition. The Mann-Whitney test for two independent samples was performed, and a P value less than .05 was considered statistically significant. Six months postoperatively, mean CDVA was 0.20 ± 0.2 logMAR and mean DCIVA and CNVA were 5 ± 1 and 2 ± 1 Jaeger, respectively, in the Tecnis Eyhance group. In the control group, mean CDVA was 0.21 ± 0.2 logMAR and mean DCIVA and CNVA were 8 ± 1 and 3 ± 1 Jaeger, respectively. Only DCIVA showed a significant statistical difference between groups (P < .0001). In pediatric patients, the aspheric monofocal IOL with higher order aspheric optic seems to provide better intermediate distance visual acuity than a monofocal one, whereas no significant difference was observed for CDVA and CNVA. [J Refract Surg. 2024;40(10):e724-e727.].

Impact of Aspheric Monofocal Intraocular Lens Implantation on Uncorrected Intermediate Visual Acuity: a Combined Analysis.

To evaluate binocular intermediate visual acuity (IVA), depth of focus, and other visual outcomes achieved with a monofocal aspheric intraocular lens (IOL) using pooled data from 2 randomized, double-masked, controlled trials. The studies conducted at 32 sites included patients aged ≥22 years with bilateral cataracts, preoperative corneal astigmatism 1.0 D, and lens power 18.0-25.0 D. Patients received bilateral AcrySof IQ IOLs (SN60WF). Primary endpoint data were collected at month 6. Binocular uncorrected and corrected distance visual acuity (UDVA and CDVA) at 4 m, binocular uncorrected and corrected IVA (UIVA and DCIVA) at 66 cm, manifest refraction spherical equivalent (MRSE), and binocular defocus curve at 4 m were assessed under photopic conditions. Validated questionnaires were used to assess spectacle use and quality of vision. Of 233 patients who received SN60WF, 228 had visual acuity data at 6 months. Under photopic conditions, 51% of the eyes had pupils >4 mm, 40% had pupils 3-4 mm, and 9% had pupils <3 mm. Mean ± SD UDVA and CDVA were -0.019 ± 0.110 and -0.088 ± 0.082 logMAR, respectively. Mean ± SD UIVA and DCIVA were 0.125 ± 0.145 and 0.196 ± 0.139 logMAR, respectively. UIVA and DCIVA of 20/32 or better were achieved by 83% (188/228) and 71% (162/228) of patients, respectively. Mean ± SD MRSE was -0.007 ± 0.404 D for the first eye and 0.036 ± 0.371 for the second eye. The defocus curve demonstrated binocular vision of 0.24 logMAR or better from +1.2 to -1.5 D. Spectacle independence for distance and intermediate vision was reported by 86% and 41% of the patients, respectively. Based on questionnaires, 61%, 79%, and 65% of the patients did not experience starbursts, halos, or glare. A monofocal aspheric IOL (SN60WF) assessed in a large, pooled study provided excellent distance vision and clinically functional intermediate vision.

In vitro optical assessment of three types of non-diffractive extended depth-of-focus intraocular lenses

Objective: To evaluate the in vitro optical performance of three types of non-diffractive extended depth-of-focus (EDoF) intraocular lenses (IOLs). Methods: Experimental study. Three Vivity IOLs, three Eyhance IOLs, and three ES60 IOLs were included. The professional optical bench OptiSpheric® IOL PRO 2 and an ISO-2 corneal model were applied. The through-focus modulation transfer function (MTF) and predicted visual acuity (logarithm of the minimum angle of resolution) of different spatial frequencies and different focuses under apertures of 3.0 mm and 4.5 mm were recorded. The aspheric monofocal (Tecnis ZCB00), diffractive EDoF (Tecnis Symfony), and trifocus (STF1) IOLs, as well as the lowest visual requirement criteria of EDoF IOLs of American Academy of Ophthalmology served as assessment controls. Results: For the 3.0-mm aperture, the peak value of the MTF was highest with ZCB00, followed by Eyhance, ES60, Vivity, Symfony, and STF1. All experimental non-diffractive EDoF IOLs had two MTF peaks, and the distance between both peaks was longest with Vivity (1.76 D), followed by ES60 (1.43 D) and Eyhance (1.36 D). Among the control IOLs, Symfony had two MTF peaks, and the peak MTF of the intermediate focus was highest. STF1 had three MTF peaks, and the peak MTF of the near focus was highest. For the 4.5-mm aperture, the ranking of the MTF peak of the six types of IOLs was the same as that for the 3.0-mm aperture. Vivity had an increased MTF peak of the distance focus, but a decreased intermediate focus MTF peak, while the MTF peaks of the distance, intermediate, and near focuses in the other IOLs decreased, compared to those for the 3.0-mm aperture. The predicted visual acuity of the distance focus of the three types of non-diffractive EDoF IOLs was all better than 0.0. The predicted visual acuity of the intermediate focus of the Vivity IOL and the ES60 IOL was 0.11 and 0.05 better than that of the Eyhance IOL, respectively. Based on the predicted visual acuity of 0.2, Vivity and ES60 had a depth of focus of at least 0.50 D exceeding ZCB00, while Eyhance had a depth of focus of 0.40 D exceeding ZCB00. Conclusion: In the experiments in vitro, the three types of non-diffractive EDoF IOLs exhibited varying degrees of intermediate to near focus optical performance while maintaining distance focus optical performance. The Eyhance IOL showed better distance focus optical performance than ES60 and Vivity IOL. The Vivity IOL and the ES60 IOL showed better depth of focus extensions than the Eyhance IOL and met the lowest visual requirement criteria of EDoF IOLs of American Academy of Ophthalmology.

Aspheric hydrophobic acrylic intraocular lens outcomes in patients with additional ocular pathology

Objectives: The objective of the study was to examine the real-world visual performance, refractive outcomes, and glistening occurrence of a hydrophobic acrylic aspheric monofocal intraocular lens (IOL) in patients with ocular comorbidities. Materials and Methods: All cases of cataract surgery with the implantation of a hydrophobic acrylic aspheric monofocal IOL in a single centre between September 2020 and March 2022 were reviewed in a retrospective cohort study. Refraction (autorefract), visual acuity, peri- and post-operative complications, and the presence of posterior capsular opacification (PCO) and glistenings were recorded. Due to facility and surgeon preference, this lens was utilised predominantly for younger patients with additional ocular pathology. Results: Data regarding 15 patients (21 eyes) were collected. The mean age was 57.3 years (Range: 37–70). Eleven patients (73%) had ocular pathology in addition to cataracts. One patient was excluded due to a lack of follow-up. Post-operative refraction was available for 13 eyes (61%). The median follow-up time was five months. Corrected distance visual acuity (logarithm of the minimum angle of resolution) improved from 0.52 ± 0.54 to 0.17 ± 0.21 (mean ± standard deviation; P = 0.01); 95% confidence interval 0.08–0.26). 77% of eyes were within 0.5 D of the refractive target, and 92% were within 0.7 D. Six patients (30%) had documented PCO, with two requiring YAG capsulotomy. No patients had IOL glistenings. Conclusion: The hydrophobic aspheric monofocal IOL performs well for young patients with ocular pathology in addition to cataracts. Further, long-term follow-up will help to support its use for patients who require greater than standard longevity from an IOL.

Positive dysphotopsia after implantation of an EDOF intraocular lens

Introduction: This report describes a case of positive dysphotopsia (PD) after refractive lens exchange (RLE) with implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL). Patient and Clinical Findings: A healthy 48-year-old man underwent RLE with bilateral implantation of a nontoric EDOF IOL and suffered from monocular triplopia in both eyes. The visual acuity was suboptimal with an uncorrected distance visual acuity of 20/25 in the right eye and 20/30 in the left eye. Diagnosis, Intervention and Outcomes: Slitlamp examination showed well-centered implanted IOLs, without capsular distension syndrome. Bilateral IOL exchange was performed with an aspheric monofocal IOL with a 7.0 mm optic diameter, which diminished the PD complaints. Conclusions: This case report describes disturbing PD after bilateral implantation of an EDOF IOL. Exchange of these EDOF IOLs with a larger optical diameter monofocal IOL resulted in resolution of symptoms.

The Novel Optical Design and Clinical Classification of a Wavefront-Shaping Presbyopia-Correcting Intraocular Lens.

To evaluate the clinical rationale of wavefront-shaping technology, describe how intraocular lenses (IOLs) using wavefront-shaping technology are differentiated from refractive or diffractive optical presbyopia-correcting designs, and describe the mode of action of this technology. Extended depth of focus (EDoF) IOLs are the latest class of presbyopia-correcting IOLs addressing the growing demand of patients for reduced spectacle dependence. These use various optical technologies, including diffractive designs (eg, TECNIS Symfony ZXR00 and AT LARA 29 MP) and non-diffractive designs such as small aperture (eg, IC-8 IOL and XtraFocus Pinhole Implant), spherical aberration (eg, MINI WELL Ready and LuxSmart), and wavefront shaping (eg, AcrySof IQ Vivity DFT015 and Clareon Vivity CNWET0). Despite some improvement in visual acuity at intermediate and near distances, these technologies can still be associated with increased rate of visual disturbances or poorer distance vision compared with monofocal IOLs. One way to overcome such limitations is using a wavefront-shaping optical principle. Clinical data show that wavefront-shaping technology results in a continuous EDoF compared with a monofocal IOL while exhibiting a minimal halo, similar to an aspheric monofocal IOL. Clinically, this translates to a lens that has proven to exceed the American National Standards Institute/American Academy of Ophthalmology criteria for an EDoF IOL. The novel wavefront-shaping optic technology allows patients to achieve a continuous range of vision from distance to functional near with low levels of visual disturbances comparable with aspheric monofocal IOLs.

Laboratory Evaluation of Optical Performance of Aspheric Monofocal Intraocular Lenses With Various Anti-misalignment Designs Under the Influence of Decentration and Tilt.

To assess the effectiveness and characteristics of aspheric monofocal intraocular lenses (IOLs) with different anti-misalignment designs. Three types of anti-misalignment IOLs (with aspheric balance curve design, ZO optic design, and high-order optical aspheric surface design) and no anti-misalignment IOLs were involved. From each type of these IOLs, +8.00, +17.00, and +26.00 diopter (D) lenses were used for detection at the 3- and 4.5-mm apertures. The modulation transfer function (MTF) and 50% of the maximum value of the MTF (MTF50) were measured while IOLs were centered, decentered by 0.3, 0.5, and 0.7 mm, and tilted by 3, 5, and 7 degrees. Within the average clinical range of IOL malpositions (0.3-mm decentration or 3.00-D tilt), the anti-misalignment design slightly reduced the negative effect of decentration and tilt (P = .1845 and .6495, t test) on the optical performance of IOLs. Beyond the average range, the anti-misalignment design narrowed the reductions of MTF50 from 23.18% to 8.60% for decentration and from 40.31% to 27.96% for tilt (P = .0010, two-factor analysis of variance). The optical performance varied in anti-misalignment IOLs with different diopters, types, and degrees of malpositions at different aperture sizes. In both photopic and mesopic conditions and all probable misalignments, from the perspective of MTF50, better sharpness generally may be achieved with the 8.00-D ZO optic designed lens and 17.00-D high-order optical aspheric surface designed lens. For 26.00-D IOLs with different misalignments, the ABC design was more resistant to decentrations, whereas the high-order optical aspheric surface design was more resistant to tilts. Aspheric monofocal IOLs with an anti-misalignment design can effectively resist decentration and tilt. Anti-misalignment IOLs for complicated cataract could be selected according to diopter of IOL and types and degrees of probable IOL malpositions. [J Refract Surg. 2023;39(7):446-455.].

Clinical outcomes with an aspheric monofocal and a new enhanced monofocal intraocular lens with modified optical profile

PurposeThis study aimed to evaluate and compare the clinical outcomes obtained after cataract surgery with an aspheric monofocal intraocular lens (IOL) and an enhanced IOL with a modified optical profile.MethodsRandomised clinical trial enrolling 70 patients (age, 52–87 years) undergoing cataract surgery. Two groups were created according to the type of IOL implanted: Vivinex iSert from Hoya Surgical Optics (Vivinex group, 35 patients) and Tecnis Eyhance ICB00 from Johnson & Johnson Vision (Eyhance group, 35 patients). Uncorrected (UDVA) and corrected distance visual acuity (CDVA), uncorrected (UIVA) and distance-corrected intermediate visual acuity (DCIVA), refraction, and self-perceived visual function (Catquest-9SF) were evaluated during a 3-month follow-up.ResultsNo significant differences were found between IOL groups in UDVA and CDVA (p ≥ 0.093). In contrast, monocular and binocular UIVA and DCIVA were significantly better in the Eyhance group at 1 (p ≤ 0.015) and 3 months postoperatively (p ≤ 0.002). Postoperative DCIVA 20/25 or better was obtained in 71.4% and 20.0% of patients in Eyhance and Vivinex groups, respectively. Differences in postoperative Rasch calibrated Catquest scores between Eyhance and Vivinex groups did not reach statistical significance (p ≥ 0.102). However, significant correlations were only found between the change in UIVA and Catquest scores (0.364 ≤ r ≤ 0.444, p ≤ 0.041) in the Eyhance group.ConclusionsThe modified monofocal IOL evaluated provides better intermediate visual function in comparison with a standard aspheric monofocal IOL, but the impact of this benefit on the self-perceived level of vision achieved after surgery according to the patient seemed to be limited.

Latest Development in Extended Depth-of-Focus Intraocular Lenses: An Update.

In recent years, there has been an overwhelming influx of different types of intraocular lenses (IOLs) as treatment for presbyopia. The extended depth-of-focus (EDOF) technology creates a single elongated focal point to enhance depth of focus, in contrast to the multiple foci of multifocal (MF) lenses. In this way, the EDOF lenses aim to reduce photic phenomena, glare, and halos, which have been reported in MF IOLs. A potential disadvantage of this is a blur due to decreased retinal image quality when the amount of the aberrations is increased excessively. Multifocality and EDOF characteristics are not exclusive of each other. Frequently, EDOF IOLs are combined with MF optical designs, a bifocal IOL may exhibit EDOF characteristics, likewise an aspheric monofocal IOL or a diffractive or refractive trifocal IOL. Thus, EDOF lenses are commonly subjected to confusion. A wide range of different types of EDOF lenses are available on the market to surgeons. In this practical update, we aim to clarify what is a true EDOF lens, classify the different types of the EDOF lenses based on their optical principle and review their recently reported outcomes. Comprehensive patient examination and selection, combined with knowledge of the most updated options and adequate patient counseling, can avoid dissatisfaction and yield the desired outcomes.

A Cost-Effectiveness Analysis of AcrySof IQ Vivity Intraocular Lens (IOL) from Private Health Fund Perspective in Australia

PurposeAcrySof IQ Vivity is a unique non-diffractive extended depth of focus intraocular lens with wavefront-shaping X-WAVE technology. This study evaluated the cost-effectiveness of AcrySof IQ Vivity intraocular lens (DFT015) compared with standard aspheric monofocal intraocular lens (SN60WF), from a private health fund perspective in Australia.MethodsA Markov model was developed using the following health states: well, need for spectacles (near/distance/bifocal/varifocal), very bothersome visual disturbances (glare/haloes/starbursts) – with/without spectacles, and death. Model inputs were sourced from a randomized clinical study (NCT03010254), published literature, prostheses list and clinical opinion. A lifetime horizon (up to 30 years) was considered, and cost and health outcomes were discounted at 5% per annum. Model outcomes included incremental cost–effectiveness ratio defined as incremental cost per quality adjusted life year gain. Sensitivity and scenario analyses were also conducted.ResultsBilateral implantation of DFT015 intraocular lens provided quality adjusted life year gain of 0.16 at an incremental cost of AU$307 compared to bilateral SN60WF, leading to an incremental cost-effectiveness ratio of AU$1908/quality adjusted life year, well below the cost-effectiveness threshold (Range: AU$45,000-AU$75,000) typically used by Medical Services Advisory Committee in Australia. Results were most sensitive to intraocular lens costs, post-operative spectacle dependence, and disutility due to wearing glasses. Robustness of the results was further confirmed by probabilistic sensitivity analysis and scenario analyses.ConclusionAcrySof IQ Vivity intraocular lens is a highly cost-effective treatment strategy with improved vision-related quality of life outcomes for presbyopic cataract surgery patients.

Enhanced Stereopsis of Rotationally Asymmetric Multifocal Intraocular Lens With + 1.5 Diopters Near Addition.

To the Editor: Stereopsis is the highest level of binocular vision and contributes to the determination of depth and distance in solid object recognition. Currently, multi-focal intraocular lenses (IOLs) with various added powers are selected based on patient preferences and lifestyles. The European Society of Cataract and Refractive Surgery (ESCRS) Functional Vision Working Group report1 emphasized the importance of the postoperative functionality of near and intermediate vision, which are necessary for everyday activities. Conventional multifocal IOLs with 2 distinct foci provide patients with good far and near vision, but unsatisfactory intermediate vision. The use of low-addition multifocal IOLs (low-add IOLs) can improve intermediate vision.2 Herein, we discussed the stereopsis from far to near in patients implanted with low-add IOLs. Twenty-one patients bilaterally implanted with the low-add IOL (Lentis Comfort LS-313MF15 IOL, Santen Pharmaceutical) (69.7 ± 5.2 years, Low-add group) and 22 with the aspheric monofocal IOL (Tecnis ZCB00 V, Johnson & Johnson Surgical Vision) (69.7 ± 5.2 years, Monofocal group) were examined. All surgeries were performed using a standard technique of sutureless phacoemulsification under topical anesthesia by the same experienced surgeon. The low-add IOL was a foldable plate-haptic, rotationally asymmetric, refractive multifocal IOL, combining an aspheric distance vision zone and a sector-shaped near vision zone with an add power of + 1.5 diopters (D) on the lens plane, that was positioned inferiorly. Inclusion criteria were: 1) having postoperative distance-corrected visual acuity (DCVA) of Snellen 20/25 or better in both eyes, 2) refraction difference of < 2.0 D between both eyes, and 3) without manifest strabismus. DCVA and stereoacuity were measured at far (5 m, 2 m), intermediate (1 m, 70 cm, 50 cm), and near (30 cm) using a Binoptometer 4 P (Oculus Optikgeräte GmbH) at 2 months postoperatively. Significantly better distance-corrected intermediate visual acuity, and distance-corrected near visual acuity were attained in the Low-add group than in the Monofocal group (P < 0.001 for 50 cm and 70 cm; P < 0.01 for 30 cm and 1 m) (Supplemental Digital Content Fig. 1A, http://links.lww.com/APJO/A122) Stereoacuity at 30 cm and 50 cm was significantly better in the Low-add group than in the Monofocal group (Supplemental Digital Content Fig. 1B, http://links.lww.com/APJO/A122). The rates of normal range3 (≤ 100 seconds of arc for 5 m, 2 m, 1 m, 70 cm, 50 cm, and 30 cm) were 85%, 77%, 81%, 58%, 53%, and 24% in the Low-add group, while they were 82%, 64%, 59%, 37%, 18%, and 0% in the Monofocal group. The rates of normal range at 30 cm (P = 0.002) and 50 cm (P = 0.017) in the Low-add group were significantly higher than those in the Monofocal group. Consistent with a previous study,4 a low-add IOL provided good postoperative far and intermediate visual acuity. Unlike the double-peak curve pattern observed with conventional far/near bifocal IOLs, the DCVA showed a gradual decrease from far to near. The Titmus stereoscopic test is the most common test measured at a standardized distance (40 cm) as near ster-eoacuity. The current study measured ster-eoacuity under binocular natural viewing conditions at several distances to assess stereopsis similar to those experienced in everyday life. In the Monofocal group, the DCVA and the rates of the normal range of stereoacuity decreased with a shorter target distance. At a distance of 30 cm, no patient showed a normal range of stereoacuity. The effects of optical blur on stereopsis5 have been reported and are comparable to the results in the Monofocal group. In contrast, a normal range of stereoacuity was attained for 1 m to 5 m in approximately 80% of patients in the Low-add group. The Cat-quest-9SF QoL questionnaire6 for assessing intermediate vision1 should have been utilized; however, its validated Japanese version is not currently available. In summary, the rotationally asymmetric multifocal IOLs with + 1.5 D near addition provided enhanced stereoacuity and vision at near and intermediate levels compared with monofocal IOLs. It may be an option for enhanced functional vision, leading to better overall patient satisfaction.

Exploring Vision-Related Quality of Life: A Qualitative Study Comparing Patients' Experience of Cataract Surgery with a Standard Monofocal IOL and an Enhanced Monofocal IOL.

PurposeTo explore quality of life related with intermediate vision of patients before and after cataract surgery, and to make patients’ experience available for the design of future scales that assess visual function related with intermediate distance.Patients and MethodsA qualitative research methodology based on thematic content analysis was used to explore vision-related quality of life based on the experiences of patients with cataract. Patients were recruited at the Service of Ophthalmology of the Hospital de Sant Pau (Barcelona, Spain). Data were collected through nineteen semi-structured interviews conducted with patients diagnosed with cataract and implanted with a standard aspheric monofocal intraocular lens (IOL) (Tecnis® ZA9003) (n = 6), an enhanced monofocal IOL (Tecnis® Eyhance ICB000) (n = 6), and patients from the waiting list (n = 7). The data analysis consisted in coding, aggregation, and theme development of the transcribed audios.ResultsPatients on waiting lists reported difficulty and insecurity in performing daily and meaningful tasks related to near visual ranges (eg: threading a needle, reading price tags), intermediate (eg: using a computer or dialling numbers on a smartphone), and distant (eg: recognizing faces, walking on uneven surfaces). Patients after surgery with the standard IOL reported improvement in performing activities mainly in the distant visual range, but also the need for a better communication with clinical staff to adjust their own expectations on the results of the surgery. Finally, patients implanted with the enhanced IOL reported satisfaction and improved visual function in performing daily activities, especially those related to the intermediate visual range.ConclusionOur exploratory study found that patients after cataract surgery with the enhanced IOL reported a better performance in activities that require the intermediate vision. These results will inform the development of scales to assess vision-related quality of life in the intermediate visual range prioritizing outcomes according to patients’ daily and meaningful activities.

Comparison of visual performance between two aspheric monofocal intraocular lens models

ABSTRACT Clinical relevance It is important to distinguish between visual acuity, optical quality and quality of vision when outcomes obtained with intraocular lenses are evaluated. These parameters, that includeobjective and subjective tests, should be assessed to obtain results that are not biased. Background To assess the difference in visual and optical quality between two monofocal intraocular lens models. Methods : This was a prospective, parallel and randomised clinical study conducted at Miranza IOA, a private clinic in Madrid, Spain. Sixty patients were implanted bilaterally, 30 per group, with two aspheric IOLs with induced spherical aberration of −0.27 μm for Group A and −0.20 μm for Group B. Visual outcomes obtained at 1 and 3 months after surgery included both uncorrected (UCVA) and corrected monocular distance visual acuity (DCVA), objective scattering index (OSI), modulation transfer function (MTF) cut-off, Strehl Ratio (SR), contrast sensitivity defocus curve (CSDC), intraocular lens spherical aberration (SA), and longitudinal chromatic aberration of the eye. Activity limitations in daily life were assessed using CatQuest-9SF questionnaire. Results There were statistically significant differences for DCVA (0.04 LogMAR; p = .008) and SR (0.03; p = .003) between groups. Outcomes related to CSDC showed statistically significant differences for vergences between −0.50 D and +1.00 D (3 mm pupil) and for vergences of 0.00 D and +0.50 D (4.5 mm pupil) between groups. Overall, Group A showed better results regarding visual and optical quality, including a lower longitudinal chromatic aberration result in comparison to Group B. Patient satisfaction evaluated with CatQuest-9SF showed that Group A achieved better outcomes, although the differences were statistically significant only for the ‘Reading text on television’ item (p = 0.027). Conclusions Both intraocular lens models showed excellent quantity of vision, optical and visual quality as well as high patient satisfaction. Despite this, the the Group A model provided slightly better outcomes than the Group B model.

Comparison Between an Intraocular Lens With Extended Depth of Focus (Tecnis Symfony ZXR00) and a New Monofocal Intraocular Lens With Enhanced Intermediate Vision (Tecnis Eyhance ICB00).

Purpose:This study compared the extended depth of focus (EDOF) intraocular lens (IOL) (ZXR00; Tecnis Symfony, Johnson & Johnson Vision, Santa Ana, CA, US) to a novel, higher-order aspheric monofocal IOL (ICB00; Tecnis Eyhance, Johnson & Johnson Vision, Santa Ana, CA, US) which uses the same platform and material.Methods:Medical records of patients undergoing cataract surgery with ZXR00 or ICB00 implantation between March 2020 and January 2021 and with the data available for the 3-month visit were reviewed. The uncorrected near, intermediate, and distance visual acuity (VA); corrected distance VA; and optical quality parameters were the main outcome measures.Results:Among the 174 enrolled patients, 72 and 102 received the ZXR00 and ICB00, respectively. The average patient ages were 59.6 ± 10.6 (range: 49 to 70) and 65.2 ± 8.2 (range: 45 to 82) years in the ZXR00 and ICB00 groups, respectively, with significantly older patients in the ICB00 group. The other baseline parameters were not different for the 2 groups. Compared to the ICB00 group, the ZXR00 group showed markedly superior near VA (P < 0.05) at 3 months postoperatively. In terms of optical quality, ICB00 was, statistically, significantly superior to ZXR00.Conclusions:The ZXR00 showed remarkable near vision and defocus curve smoothness, while the ICB00 achieved better optical quality. The 2 IOLs had comparable distance and intermediate vision.

Profile of a new extended range-of-vision IOL: a laboratory study

PurposeTo evaluate the surface profile of a new-generation extended range-of-vision intraocular lens (IOL) and to compare it with that obtained for a monofocal IOL based on the same platform.MethodsProspective, experimental, laboratory study comparing the surface profile of the DFT015 (AcrySof IQ Vivity; Alcon Laboratories, Inc.), a new-generation presbyopia-correcting IOL, with the profile of the SN60WF (AcrySof IQ; Alcon Laboratories, Inc.), an aspheric monofocal IOL based on the same platform. Raw profiles were obtained using contact profilometry. The best-fit form was then subtracted from each raw profile to highlight potential differences.ResultsNo significant differences were appreciated in raw profiles. On the contrary, after form removal, the new extended range-of-vision IOL showed a peculiar profile characterized by the presence of two altitudinal symmetrical changes in the order of 1 µm, localized in the central portion of the optic.ConclusionsThe new-generation extended range-of-vision IOL evaluated showed a smooth change of its surface compared to the same platform monofocal IOL. The altitudinal changes blended in the central design of the new presbyopia-correcting IOL, although micrometric, might play a crucial role in creating a continuous focal range while minimizing visual disturbances.

Long-Term Clinically Significant Posterior Capsular Opacification Development Pattern in Eyes Implanted with an Aspheric Monofocal Intraocular Lens with a Square Optic Edge.

Purpose To analyse the posterior capsular opacification (PCO) development pattern in the long term in eyes implanted with a monofocal intraocular lens (IOL) with a square edge all around the optic. Methods Longitudinal retrospective study is data analyzed from a total of 7059 eyes from 4764 patients (mean age: 75.8 years) undergoing cataract surgery with implantation of an aspheric monofocal IOL (Bi-Flex HL 677AB/677P, Medicontur, Budapest, Hungary). These data were retrospectively collected using the electronic medical record of the hospitals involved. Nd : YAG capsulotomy rates were calculated per year during a follow-up of more than 10 years. The Kaplan–Meier analysis was used to establish the transparent capsule survival rate. Results The Nd : YAG capsulotomy rate increased from 1.1% at 1 year postoperatively to 17.2% at 5 years after surgery. No significant differences were found between eyes with and without capsulotomy in terms of age (p = 0.202), gender (p = 0.061), type of anaesthesia used (p = 0.128), and presence of conditions such as hard cataract (p = 0.111) or pseudoexfoliation (p = 0.137). IOL power was significantly lower in those eyes of patients requiring Nd : YAG capsulotomy during the follow-up (p < 0.001). Significantly more eyes implanted with the preloaded model of the IOL required capsulotomy (p < 0.001). Mean survival time and rate were 9.38 years and 85.9%, respectively. Conclusions Most eyes undergoing cataract with implantation of the Bi-Flex IOL do not develop a clinically significant PCO requiring Nd : YAG capsulotomy in the long term. IOL material and design may be the main factors accounting for this finding.

Contrast Sensitivity Test After Phacoemulsification with Implantation of Hydrophobic Aspheric Monofocal Intraocular Lens (IOL) at Family Medical Center Hospital Sentul

In Indonesia, the prevalence of cataract is 80 %. The main purpose of phacoemulsification with theimplantation of intraocular lens (IOL) is to improve visual acuity on cataract patient. The outcome ofcataract surgery should be evaluated based on visual acuity and quality of vision. Contrast sensitivityexamination can provide important information about the visual capabilities of individuals. The aim of thisresearch is to find out the contrast sensitivity value on cataract patients after phacoemulsification with theimplantation of hydrophobic aspheric monofocal IOL at FMC Hospital, Sentul on December 2018 untilJanuary 2019. This research used cross sectional descriptive design. The contrast sensitivity test isconducted on subject that fulfill the inclusive and exclusive criteria. This test is conducted using Vistech6500. The mean value of contrast sensitivity of 50 eyes at 1.5 cpd was 184.11, at 3 cpd was 235.5, at 6 cpdwas 207.360, at 12 cpd was 119.830, and at 18 cpd was 52.914. The result, the mean contrast sensitivity of50 eyes at the 1.5 and 3 cpd is higher compared to maximum value of Vistech 6500. However at 6, 12 and 18cpd the mean contras sensitivity depleted compared to maximum value of Vistech 6500. The result of meancontrast sensitivity based on age was the middle-aged (45-59 years) had a better contrast sensitivitycompare than young old (60-74 years) and very old category (75-90 years).

Multicountry clinical outcomes of a new nondiffractive presbyopia-correcting IOL.

To evaluate the effectiveness and safety of a new presbyopia-correcting intraocular lens (IOL) with a nondiffractive design, DFT015, compared with an aspheric monofocal IOL, SN60WF. 19 investigational sites in 4 countries: Australia, Canada, Spain, and the United Kingdom. Prospective, randomized, parallel-group, controlled, assessor- and patient-masked clinical study. Participants aged ≥22 years with bilateral cataracts were randomized to DFT015 or SN60WF in a 5:4 ratio and masked until final postoperative follow-up at month 6. The primary effectiveness objective was superiority of DFT015 over SN60WF in mean monocular photopic distance-corrected intermediate visual acuity (DCIVA) at month 3. Secondary effectiveness objectives included noninferiority of DFT015 to SN60WF in mean monocular photopic corrected distance visual acuity (CDVA) and superiority in the mean monocular photopic distance-corrected near visual acuity (DCNVA) at month 3. Visual disturbances were assessed at month 6. 282 patients were randomized to DFT015 (n = 159) or SN60WF (n = 123). All effectiveness objectives were achieved at month 3 in first eyes. For monocular photopic results in first eyes, DFT015 demonstrated superior mean DCIVA (least squares means of -0.139 logMAR in favor of DFT015, P < .001), noninferior mean CDVA (97.5% upper confidence limit [UCL] of the difference was <0.1 logMAR) and superior mean DCNVA (95% UCL of the difference was <0.0 logMAR) compared with SN60WF at month 6. DFT015 exhibited a similar visual disturbance profile to that of SN60WF. DFT015 provided superior intermediate and near vision and a similar visual disturbance profile compared with an aspheric monofocal IOL.

Response to comments on: Comparison of an aspheric monofocal intraocular lens with a new generation monofocal lens using defocus curve

Response to comments on: Comparison of an aspheric monofocal intraocular lens with a new generation monofocal lens using defocus curve