Intraocular Lens Implantation Research Articles

The influence of age and gender on ocular biometrics and corneal astigmatism in adults undergoing cataract surgery

Objectives: To assess the influence of age and gender on ocular biometric values and corneal astigmatism features in individuals undergoing phacoemulsification surgery and intraocular lens implantation. Methodology: This retrospective study measured ocular biometrics and corneal keratometric astigmatism using the IOLMaster 700 instrument prior to phacoemulsification surgery and intraocular lens implantation. Results: Analysis included ocular biometric and keratometric values from 3385 eyes of 3385 patients. Lens thickness ( p < 0.001, r = 0.387), mean keratometry ( p < 0.001, r = 0.156), and corneal astigmatism ( p < 0.001, r = 0.082) were positively correlated with age. Conversely, axial length ( p < 0.001, r = −0.133), anterior chamber depth ( p < 0.001, r = −0.244), and horizontal white-to-white corneal diameter ( p < 0.001, r = −0.226) exhibited negative correlations with age. Increasing age led to a significant shift towards against-the-rule astigmatism ( p < 0.001, r = 0.248). Mean keratometry was significantly lower in males than females ( p < 0.001). Axial length, anterior chamber depth, lens thickness, and white-to-white corneal diameter were higher in males compared to females (all ps ⩽ 0.001). Corneal astigmatism types differed significantly between genders ( p < 0.001), with against-the-rule being more prevalent among males (52.9%) and with-the-rule astigmatism having the highest prevalence among females (40.3%). Conclusions: Mean keratometry and lens thickness increased, while axial length and anterior chamber depth decreased with age. Males exhibited higher values for axial length, anterior chamber depth, and lens thickness, whereas females had steeper corneas.

Safety and Efficacy of Hydrus and I-Stent inject combined with Phacoemulsification in Primary Open Angle Glaucoma Patients: 2 year follow up study

Aims: To compare the safety and efficacy of phacoemulsification combined with two individual kinds of trabecular bypass micro-stent device insertion. This study compares Phacoemulsification with Hydrus stent versus phacoemulsification combined with I-Stent inject W in patients with medically uncontrolled primary open-angle glaucoma (POAG). Material and Methods: A retrospective comparative case series. Results: Eighty eyes of 75 patients with 2 years completed follow-up after combined phacoemulsification with trabecular by-pass stent (s) were included. Forty eyes of 37 patients had Hydrus stent (Hydrus Group-PH) and the other 40 eyes of 38 patients had I-stent inject W (I-stent Group-Pi) insertion combined with phacoemulsification and intraocular lens implantation. Patient demographics and preoperative characteristics of the two groups studied are comparable. A post-operative decrease of 20 percentage or more in the IOP was achieved in 33 eyes (82.5%) in PH group and 30 eyes (75%) in Pi group (p=0.57). The Hydrus group (PH) had a post-operative reduction in the mean number of medications in 22 eyes (55%) in comparison to 18 eyes (45%) in the I-stent group (Pi). Second stage trabeculectomy was avoided in 31 eyes (77.5%) in the Hydrus group and 27 eyes (67.5%). There was no significant difference in rate of complications between two groups. Conclusion: Both Hydrus stent and I-stent inject W combined with phacoemulsification and intra-ocular lens implantation, are efficacious and safe for treating patients with medically uncontrolled mild and moderate primary open-angle glaucoma (POAG). The reduction in the mean IOP and in the mean number of post-operative glaucoma medications was higher for the patients in Hydrus stent group than in I-stent inject W group.

Hydrophobic Trifocal Toric Intraocular Lens Outcomes in Japanese Eyes After Cataract Surgery.

To analyze the refractive and visual outcomes following cataract surgery and implantation of a new hydrophobic trifocal toric intraocular lens (IOL) in Japanese eyes with different degrees of corneal astigmatism. A total of 66 eyes from 39 patients implanted with a FineVision HP Toric IOL (Beaver-Visitec International Inc) were analyzed retrospectively. The main outcome measures considered were refraction, monocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), and distance-corrected intermediate visual acuity (DCIVA) at 80 and 66 cm, uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) at 40 cm. Eyes were evaluated at three months post-surgery. Sixty-five eyes (98.48%) were within ±0.50D of spherical equivalent, and all were within ±1.00D (mean: 0.00±0.21D). Moreover, 63 eyes (95.45%) had ≤0.50D of residual astigmatism, and all had ≤1.00D (mean: -0.08±0.23D). Similarly, 58 (87.88%) and 60 eyes (90.91%) had ≥20/20 UDVA and CDVA, respectively, with 65 (98.48%) and 66 eyes (100%) achieving ≥20/25 UDVA and CDVA, respectively. In addition, 28 (42.42%) and 23 eyes (34.85%) had ≥20/25 DCIVA at 80 and 66 cm, respectively, with 49 (74.24%) and 52 eyes (78.79%) achieving ≥20/32 DCIVA at 80 and 66 cm, respectively. Finally, 39 (59.09%) and 40 eyes (60.61%) had ≥20/20 UNVA and DCNVA, respectively, with 58 (87.88%) and 59 eyes (89.39%) achieving ≥20/25 UNVA and DCNVA, respectively. Our study shows that implantation of the new hydrophobic FineVision HP Toric IOL results in accurate refractive outcomes, with good visual acuity at different distances, in Japanese eyes.

Analysis of influencing factors of dry eyes after cataract surgery and construction of a prediction model.

To identify the influencing factors of dry eyes after cataract surgery and construct a prediction model to provide a reference for ophthalmologists in assessing the risk of postoperative dry eyes. A retrospective study was conducted from January 2023 to April 2024, involving 219 patients (219 eyes) who underwent phacoemulsification with intraocular lens implantation at the Department of Ophthalmology, Ninth People's Hospital of Suzhou. Patients were divided into two groups based on the presence or absence of dry eyes at 2 weeks postoperatively. Data from both groups were analyzed to determine the influencing factors of dry eyes after cataract surgery. A nomogram prediction model was constructed using R software. The model's discrimination was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC), and model calibration was assessed using the Hosmer-Lemeshow (H-L) goodness-of-fit test and the Bootstrap method (self-sampling technique). Decision curve analysis was employed to evaluate the clinical utility of the model. Among the 219 cataract patients, 53 (24.20%) developed dry eyes during the 2-week follow-up period. Multivariate logistic regression analysis identified smoking (OR = 1.809, P = 0.037), diabetes mellitus (OR = 3.248, P = 0.002), elevated IL-6 (OR = 3.019, P = 0.016), a high Hospital Anxiety and Depression Scale (HADS) score (OR = 2.147, P = 0.029), and longer surgical incision length (OR = 2.995, P = 0.014) as significant risk factors for postoperative dry eye. The AUC of the nomogram model was 0.857 (95% CI: 0.803-0.913), and the H-L goodness-of-fit test showed no statistical significance (χ2 = 4.472, P = 0.812), indicating good discrimination and calibration of the model. The average absolute error between predicted and actual probabilities after 1000 Bootstrap iterations was 0.021. Decision curve analysis demonstrated that the net benefit of the model was higher than the two extreme scenarios. Postoperative dry eyes in cataract patients is associated with smoking, diabetes, elevated IL-6, high HADS scores, and longer incision lengths. The nomogram model demonstrates good predictive capability for assessing the risk of dry eyes after cataract surgery.

Simulation of the effect of capsular opacification on retinal illumination

Posterior capsular opacification is the most common complication after cataract surgery with intraocular lens implantation. Different strategies have been proposed to avoid PCO including 360° continuous sharp edges of the posterior IOL optics rim, haptics angulations, or surface modification of the optics. However, depending on the IOL material and surgical technique 20 to 60% of eyes require Nd:YAG laser capsulotomy in the first 2 years after cataract surgery. In this talk we would like to define a scattering model for the posterior lens capsule and perform raytracing through the pseudophakic eye with a scattering capsule to investigate the impact of biometric parameters on the scatter characteristics and contrast transfer of the eye.

Perioperative Enteral Fasting Duration was Commonly More Than 10 h amongst Patients Undergoing Extracapsular Cataract Extraction with Intraocular Lens Implantation: A Cross-sectional Single-centric Retrospective Study from the United States

Perioperative Enteral Fasting Duration was Commonly More Than 10 h amongst Patients Undergoing Extracapsular Cataract Extraction with Intraocular Lens Implantation: A Cross-sectional Single-centric Retrospective Study from the United States

Visual and refractive outcomes of opposite clear corneal incision combined with rotationally asymmetric multifocal intraocular lens implantation.

To evaluate the visual and refractive outcomes of astigmatic cataract patients following opposite clear corneal incision (OCCI) combined with rotationally asymmetric multifocal intraocular lens (IOL) implantation. Department of Ophthalmology, Zhongshan Hospital (Xiamen), Fudan University, People's Republic of China. Retrospective cohort study. This study comprised 58 cataract eyes of 54 patients with corneal astigmatism who underwent phacoemulsification and rotationally asymmetric multifocal IOL implantation which received either OCCI (OCCI group) or a single clear corneal incision (SCCI group). The follow-up period was 3 months after surgery. Distance, intermediate and near visual acuity, refractive outcomes, and corneal anterior keratometry were compared between the two groups. Vector analysis was used to evaluate astigmatism correction. Three months after surgery, the distance, intermediate and near visual acuity, and sphere remained comparable between the two groups, but a significant difference was detected in residual astigmatism and anterior corneal keratometric astigmatism. In the OCCI group, the residual astigmatism and keratometric astigmatism were -0.60 ± 0.29 D and 0.59 ± 0.28 D, respectively, which were lower than those in SCCI groups (-1.18 ± 0.47 D and 1.15 ± 0.45 D, both p < 0.05). In vector analysis, the difference vector (DV), angle of error (AoE), absolute AoE, index of success (IoS) and correction index (CI) were statistically significantly different between the two groups (p < 0.05). OCCI combined with rotationally asymmetric multifocal intraocular lens implantation showed predictable and desirable efficacy in treating cataract patients with astigmatism.

Post-Operative Refractive Changes After Cataract Surgery in Children Less Than 4 Years of Age

Aim: To observe the changes in refraction after Cataract surgery in children less than 4 years of age using Dahans formula. Methods: The retrospective evaluation of the records of children with congenital and developmental cataracts who underwent cataract operations with intraocular lens implantation was conducted. The patients’ ages ranged from 6 months to 4 years. All the sutures of cornea were removed after 1 month of surgery. IOL power was calculated using Dahan’s formula based on axial length. Refraction was performed after 1, 3, 6, and 12 months. Results: About 40 eyes of 20 children with bilateral congenital &amp; developmental cataract (11 males and 9 females) were included. The age range was 6 months to 4 years &amp; mean was 28.8±1.38 months. Significant myopic shift was observed in all the children and maximum myopic shift was observed in children below 2 (0-24 months) years of age. Conclusion: Significant myopic shift has been observed in children. So, under corrected IOL implantation is safe to achieve target refraction.

Validation of Clinical Protocol of Astigmatism Induction in Pseudophakic Patients.

Validate a novel approach for assessing residual astigmatism's impact on visual acuity in pseudophakic patients using defocus curves and spherical equivalent compensation. Thirteen patients over 40 with cataracts and normal ophthalmological examinations were enrolled in a prospective, non-randomized cohort study. The defocus curve method was employed, wherein visual acuity was measured with spherical lenses ranging from -2.50 to +2.50 diopters in 0.5 diopter increments based on subjective refraction. Cylindrical lenses (+1, +2, and +3 diopters) were introduced at each spherical diopter's 90° and 180° axes. Curves' results were compared at each defocus point to assess the impact of astigmatism. The Kruskal-Wallis test was used to determine if astigmatism significantly affected visual acuity post-phacoemulsification surgery with intraocular lens implantation. Significant p-values were observed only for defocus curve points of -0.5, 0, +0.5, and +1, indicating rejection of the hypothesis of no difference between the 90° and 180° groups at these points. Although statistical significance was not achieved, the against-the-rule (ATR) group was inclined toward improved near and intermediate visual acuity. In contrast, the with-the-rule (WTR) group tended to enhance distance visual acuity and myopic tolerance. This novel methodology is both reproducible and valuable. It offers potential insight into residual astigmatism tolerance in pseudophakic patients. Its application may aid in surgical planning and intraocular lens decision-making.

Changes in peripheral visual field perception after intraocular lens implantation

Aims/Purpose: To assess whether the eccentricity of the perception of objects in the peripheral visual field changes when a crystalline lens is replaced by an intraocular lens (IOL).Methods: The effect of the IOL on the eccentricity at which peripheral objects are perceived was assessed using phakic and pseudophakic versions of the same eye model. Non‐sequential ray tracing simulations were used to determine the relation between the input eccentricity at which an object was positioned in the visual field and the corresponding eccentricity at which the object was perceived by the eye in every eye model. Two different IOL designs were evaluated in the pseudophakic eye model. For each IOL design five different axial positions and seven different intrinsic powers were tested. Subsequently, the results of the pseudophakic eye models were compared to the results of the phakic model.Results: For central vision, the perceived eccentricity differed less than 1 degree between the phakic and pseudophakic models. For peripheral vision, the light rays were refracted to a more central retinal location in pseudophakic eyes than in phakic eyes, therewith shifting perceived eccentricity. The amount of the perceived shift depended on the IOL design and its axial position. The maximal shift within the evaluated pseudophakic models was 5.4 degrees towards central vision.Conclusions: IOL implantation has a minor effect on how the central visual field is perceived, but it can alter the eccentricity at which objects in the peripheral visual field are perceived by over 5 degrees. Such a shift in eccentricity can, for instance, affect how peripheral visual complaints, such as negative dysphotopsia, are experienced.

Relentless bilateral accommodation spasm in an adolescent treated with clear lens extraction

Introduction: Pathologic accommodation spasm occurs when persistent contraction of the ciliary muscle of the eye induces pseudomyopia. The purpose of this report was to describe the case of an adolescent with recurrent ciliary spasm, refractory to medical treatment for several years. Patient and Clinical Findings: A 10-year-old girl was evaluated because of complaints of decreased visual acuity (VA) and frequent headaches. Diagnosis, Intervention and Outcomes: The diagnosis of pseudomyopia due to accommodation spasm was established. No organic causes were detected. She started treatment with cycloplegics, which were successively titrated at different doses, along with the use of spectacles, over the following years. After 7 years of follow-up, the lack of efficacy of treatment and intolerance to its side effects demanded further action, so a clear lens extraction was performed, with the implantation of continuous focus transition multifocal intraocular lenses. Her final uncorrected distance VA was 6/6 in each eye, with good intermediate vision and J1 near vision with +2.00 addition. Conclusions: In severe cases of ciliary spasm, medical therapy and spectacle prescription may not be sufficient to control the disease. Intraocular lens implantation may be the only remaining therapeutic option to provide quality of life to the patient.

Evaluation of the accuracy of modern intraocular lens calculation formulas when optical biometry is not possible

This study evaluates the accuracy of modern intraocular lens (IOL) calculation formulas using axial length (AL) data obtained by ultrasound biometry (UBM) compared to the third-generation SRK/T calculator. The study included 230 patients (267 eyes) with severe lens opacities that prevented optical biometry, who underwent phacoemulsification (PE) with IOL implantation. IOL power calculation according to the SRK/T formula was based on AL and anterior chamber depth obtained by UBM (Tomey Biometer Al-100) and keratometry on the Topcon KR 8800 autorefractometer. To adapt AL for new generation calculators - Barrett Universal II (BUII), Hill RBF ver. 3.0 (RBF), Kane and Ladas Super Formula (LSF) - the retinal thickness (0.20 mm) was added to the axial length determined by UBM, and then the optical power of the artificial lens was calculated. The mean error and its modulus value were used as criteria for the accuracy of IOL calculation. A significant difference (p=0.008) in the mean IOL calculation error was found between the formulas. Pairwise analysis revealed differences between SRK/T (-0.32±0.58 D) and other formulas - BUII (-0.16±0.52 D; p=0.014), RBF (-0.17±0.51 D; p=0.024), Kane (-0.17±0.52 D; p=0.029), but not with the LSF calculator (-0.19±0.53 D; p=0.071). No significant differences between the formulas were found in terms of mean error modulus (p=0.238). New generation calculators showed a more frequent success in hitting target refraction (within ±1.00 D in more than 95% of cases) than the SRK/T formula (86%). The proposed method of adding 0.20 mm to the AL determined by UBM allows using this parameter in modern IOL calculation formulas and improving the refractive results of PE, especially in eyes with non-standard anterior segment structure.

Case series of spontaneous bilateral absorbed cataracts running in a family

There are only a handful of case reports and studies available regarding spontaneously absorbed cataracts and their management, including the surgical techniques and results following the management. In our study, on retrospective analysis, after a thorough search of the concerned literature, we encountered a series of cases of bilateral spontaneous absorbed cataracts running in a family with no such documentation. This retrospective study included 11 patients (aged between 3 and 65 years and of either sex) of the same family having bilateral absorbed cataracts. All patients underwent best-corrected visual acuity (BCVA); a thorough eye examination; rubella titer estimation; intraocular lens (IOL) power calculation; lens aspiration with or without posterior capsulotomy, anterior vitrectomy (AV), or IOL implantation; and visual rehabilitation. All patients had bilateral absorbed cataracts, which were acquired in an autosomal dominant pattern. Preoperative BCVA distance: 22 eyes had either counting fingers close to the face or counting fingers at 1–2 feet. The presence of high-frequency mixed bilateral nystagmus was noted in four patients. Anterior continuous curvilinear capsulorhexis was possible. Cortical aspiration was uneventful. In the capsular bag, implantation was possible in the majority of cases. No postoperative inflammation was noted, and the IOL was well-centered in all patients. To the best of our knowledge, this is the first study to report a case series of bilateral absorbed cataracts running in an Indian family with no syndromic association, no history of mental retardation, or infection. Anatomic disorganization of the absorbed lens makes surgery in such cases challenging. By using appropriate surgical methods and good visual rehabilitation, satisfactory surgical and visual outcomes can be achieved.

Refractive error of canine cataract patients following implantation with three types of intraocular lenses.

To evaluate refractive state outcomes following phacoemulsification and implantation of 3 different intraocular lenses (IOLs). A prospective, randomized, controlled study was conducted on 43 client-owned dogs undergoing phacoemulsification with IOL implantation. Eyes were randomized to receive either an-vision Fo-X (n = 26), an-vision MD8 (18), or I-MED I-LENS (24) IOL. Refraction was measured 1 week, 1 month, and 3 months postoperatively using streak retinoscopy by 2 examiners masked to each other's results. Postoperative refractive outcomes were highly correlated and not significantly different between 2 examiners for all time points (r = 0.97, 0.98, and 1.00; P = .76, .94, and .98, respectively). One week postoperatively, the refractive errors (mean ± SD) for Fo-X, MD8, and I-LENS were -0.14 ± 2.02 diopters (D), 0.97 ± 2.01 D, and 0.15 ± 2.55 D, respectively. One month postoperatively, the refractive errors were 0.35 ± 2.04 D, 0.06 ± 2.41 D, and -0.82 ± 2.20 D, respectively. Three months postoperatively, the refractive errors were -0.16 ± 2.67 D, 1.60 ± 2.99 D, and 0.59 ± 1.51 D, respectively. There were no significant differences in refractive error outcomes between Fo-X, MD8, and I-LENS at 1 week, 1 month, and 3 months postoperatively (P = .16; F(df=2,66)- = 1.89). However, the Fo-X was the only IOL to yield nearly emmetropic outcomes (±0.50 D) at all 3 time points. The postoperative refractive states of dogs were not statistically different when comparing 3 types of IOLs at 3 postoperative time points, though the Fo-X was the only IOL to yield nearly emmetropic outcomes at all 3 time points.

Surgical management of bilateral isolated ectopia lentis – A case report

A 28-year-old female presented with diplopia for 3 years. The patient was a high myope with best corrected visual acuity (BCVA) of 6/18, N6 in the right eye (RE) and 5/60, N36 in the left eye (LE). RE showed mild inferotemporal ectopia lentis with zonular dialysis of 2 clock hours and LE showed moderate temporal ectopia lentis with zonular dialysis of 6 clock hours, with cataractous changes in both eyes. Systemic examination was unremarkable with no trauma history. Patient underwent phacoemulsification with intraocular lens (IOL) implantation with capsular tension ring in RE and lensectomy with pars plana vitrectomy and secondary IOL implantation (CM T-Flex IOL) in LE.

Analysis of visual quality improvement after implantation of PanOptix trifocal intraocular lens in cataract patients with different axial lengths.

To assess the visual quality, both subjective and objective, of cataract patients with varying axial lengths (AL) after PanOptix trifocal intraocular lens (IOL) implantation and investigated the lens tilt and its correlation with visual outcomes. From July 2020 to June 2022, 70 patients (140 eyes) diagnosed with age-related cataracts and undergoing PanOptix implantation at Chongqing Eye and Vision Care Hospital, Aier Eye Hospital Group, were included. Patients were assigned to either the observation group (35 cases, 70 eyes with PanOptix trifocal IOL) or the control group (35 cases, 70 eyes with bifocal IOL). Patients were further subdivided based on AL into AL < 24 mm (observation group: 23 eyes; control group: 26 eyes) and AL ≥ 24 mm (observation group: 47 eyes; control group: 44 eyes). Postoperative follow-up lasted three months. Visual acuity (distant, intermediate, near), objective visual quality (Strehl ratio: SR, total eye modulation transfer function (MTF)), and visual aberrations were measured preoperatively and at 3 months post-operation. Postoperatively, all groups saw significant improvements in uncorrected distance visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), and uncorrected near visual acuity (UCNVA) compared to preoperative values (T0) (all P < 0.05). Notably, UCIVA was significantly better in the observation group than in the control group (P < 0.05). At three months (T1), reductions in total high-order aberration (tHOA), internal high-order aberration (iHOA), coma, and trefoil aberrations were observed in both groups compared to baseline, with more significant decreases in the observation group (all P < 0.05). Both SR and MTF cutoff showed marked improvement from T0 to T1, with the observation group experiencing greater enhancements (both P < 0.05). The defocus curve of the observation group showed a gentle slope between +0.5 D and -3.0 D, maintaining superior visual acuity compared to the control group (P < 0.05). Subjective visual quality scores at T1 were significantly higher than at T0 for both groups (P < 0.05), with patients in the observation group scoring higher than those in the control group across all AL categories (P < 0.05). Spearman correlation analysis indicated that the tilt after PanOptix trifocal IOL implantation was associated with tHOA (r = 0.273, P = 0.022), iHOA (r = 0.433, P < 0.001), Trefoil (r = 0.360, P = 0.002) and coma (r = 0.688, P < 0.001). PanOptix trifocal IOL implantation in cataract patients across different AL significantly enhances visual quality compared to bifocal IOLs, suggesting a strong case for its clinical adoption.

Comparison of Optical Biometry and Scheimpflug Device Keratometric Readings Accuracy in Predicting Intraocular Lens Power in Cataract Surgery

Abstract Background: A correct preoperative intraocular lens (IOL) power measurement in cataract surgery depends on accurate assessment of axial length (AL), anterior segment parameters, and using the suitable formula for the calculation of the power. Objectives: To determine the accuracy of IOL power calculations using keratometric measurements of the IOL Master compared to the Pentacam and to determine whether the results obtained can be used interchangeably in clinical practice in calculating IOL power in routine cataract surgery. Patients and Methods: In this prospective study, the biometric data including AL, keratometric readings, and anterior chamber depth (ACD) were obtained by both the IOL Master 500 and Pentacam Scheimpflug devices added to these measures the white-to-white (WTW) distance by IOL Master and central corneal thickness by Pentacam and calculation of the IOL power using SRK/T formula for the enrolled patients who undergone uneventful cataract surgery with IOL implantation. Postoperatively, spherical equivalent refraction was measured and the mean arithmetic error and the mean absolute error (MAE) for both keratometric readings were calculated to compare the accuracy between them in calculating the IOL power. Results: The study evaluated 57 eyes of 57 patient, the mean K value for the IOL Master was 43.92 (D) ± 1.5 (standard deviation [SD]) and the mean K value for the Pentacam was 43.77 (D) ± 1.7 (SD) (P = 0.62), ACD values between the two groups, was 3.19 ± 0.44 mm measure by IOL Master compared to 3.22 ± 0.48 mm in Pentacam (P = 0.769), with a very strong positive correlation between the two values (r = 0.995, P &lt; 0.001). MAE for the IOL Master was 0.230 (D) ± 0.187 (SD), while for the Pentacam was 0.255 (D) ± 0.204 (SD), with no statistically significant differences between two devices’ values (P = 0.54). Conclusions: Pentacam Scheimpflug measured keratometric and ACD data had good correlation with IOL Master data with good interchangeability between two devices readings in measuring the IOL power in routine cases of cataract surgeries.

First experience of implantation of extended depth of focus intraocular lenses in patients with glaucoma

This study evaluates the effectiveness of implantation of extended depth of focus (EDOF) intraocular lenses (IOL) in patients with cataract and glaucoma. The study included 13 patients (16 eyes) who underwent implantation of the Lentis Comfort EDOF IOL (Teleon Surgical BV, Netherlands). Standard phacoemulsification cataract surgery with IOL implantation was performed in a planned manner after the hypotensive surgery stage in two eyes; a combined procedure was performed in 14 cases. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), near visual acuity, and intraocular pressure (IOP) measured with a Maklakov tonometer were assessed preoperatively, on the first day, and 3-6 months after surgery. Computer perimetry using the 30-2 program and spatial contrast sensitivity (SCS) assessment were also performed preoperatively and at the same follow-up time points. On the first day after surgery, UCVA was 0.53±0.65, BCVA was 0.85±0.45. Near UCVA (at 40 cm) was 0.5±0.14 on the first day after surgery and 0.56±0.18 at 3-6 months. According to computer perimetry data, retinal light sensitivity values increased in all patients in the long-term (-3.1±2.9 dB). SCS values increased for objects of all sizes compared to preoperative values. Implantation of EDOF IOL contributes to improved vision without reducing contrast sensitivity and retinal light sensitivity in patients with concomitant cataract and glaucoma.

Interchangeability of bilateral anterior chamber depth in intraocular lens power calculation and its application in unilateral lens subluxation

Aims/Purpose: To assess the interchangeability of bilateral anterior chamber depth (ACD) in intraocular lens (IOL) power calculation, and to evaluate whether using the unaffected fellow eye's ACD can enhance refractive results in unilateral lens subluxation.Methods: Axial length (AL), keratometry (K) and ACD were obtained by IOLMaster 700. In cataract surgery candidates (Group 1), the virtual implantation of the same IOL model was used. The predictive results closest to the Plano of the Kane formula, using the right eye's biometry (AL, K and ACD), served as a benchmark. The results of the corresponding IOL power were further calculated by substituting the left eye's ACD for the right eye's one and compared with the benchmark. Eyes with unilateral lens subluxation (Group 2) underwent in‐the‐bag IOL placement after the capsular hook(s) implantation, with refraction conducted at least 1 month post‐operatively. Prediction errors (PE) of the Kane formula with or without the unaffected fellow eye's ACD were compared.Results: 392 eyes of 196 patients were analysed, including 173 candidates and 23 patients with unilateral subluxated lenses. In Group 1, there was no significant difference in bilateral ACD (p = 0.30). The predictive refraction using the right eye's ACD was −0.16 ± 0.10 diopter (D), and that obtained by the left eye's one was −0.16 ± 0.11 D (p = 0.64), with an absolute difference of 0.03 ± 0.03 D. In Group 2, the ACD was 2.89 ± 0.86 mm of the affected eye and 3.14 ± 0.37 mm of the fellow eye (p = 0.17). The median absolute PE, mean absolute PE and the percentage of PEs within ±0.50 D using the affected eye's ACD were 0.50 D, 0.59 D and 52.17%. Using the unaffected eye's ACD improved the outcomes to 0.45D, 0.52 D and 60.87%.Conclusions: Bilateral ACD values are interchangeable in routine IOL power calculation, and using the unaffected fellow eye's ACD can improve its accuracy in cases of unilateral lens subluxation undergoing in‐the‐bag IOL implantation.

Prospective clinical study of a new intraocular lens with extended depth of focus: ISOPURE, 1 year follow‐up

Aims/Purpose: Monofocal lenses are currently the most frequently implanted intraocular lenses (IOL). New implants with enhanced depth of focus (EDOF) could improve intermediate and near visions with uncompromised far visual acuity and limited dysphotopsia. The objective of this study is to compare Group 1 – a bilateral implantation of an EDOF IOL‐ Isopure® versus Group 2 – a bilateral monofocal IOL – Micropure® – (BVI, Belgium).Methods: Eligible patients with bilateral cataracts were randomly assigned to two groups. Monocular, binocular, corrected, uncorrected, near, intermediate and far visions were measured before, 1 month and 1 year after surgery using ETDRS charts. A pre‐ and post‐operative questionnaire was realized to assess the impact of their vision on daily routine.Results: One year after the surgery near median visions were respectively 0.22 ± 0.18 and 0.44 ± 0.10 LogMar (p‐value = 0.0515) while intermediate visions were −0.02 ± 0.12 and 0.14 ± 0.07 LogMar (p‐value = 0.0595). No significant difference was demonstrated in the binocular distance visual acuities, respectively −0.09 ± 0.14 and −0.12 ± 0.15 (p‐value = 1.00). The study revealed no significant difference regarding sensitivity of contrast and the defocus curve had a larger curve plate of good visual acuity in the Isopure® group. The questionnaire's analysis showed no significant difference between the groups.Conclusions: Although no significant difference was demonstrated, this study suggests that with a larger patient sample, the Isopure® implant may provide better near and intermediate visual activity, since our p‐values are close to 0.05, with the same distance vision and no deterioration of the contrast sensitivity. This implant provides a daily visual comfort and the patients reported a better satisfaction, fewer dysphotopsias, less difficulties with daily activities and less dependence on their glasses.