Monocular UDVA Research Articles

Primary sulcus implantation of a diffractive multifocal pseudophakic piggyback intraocular lens

To evaluate the efficacy and safety of the combined implantation of a monofocal intraocular lens (IOL) in the capsular bag with a diffractive multifocal IOL designed for sulcus placement (Reverso). Purpan Hospital, Toulouse, and Helios Clinic, Saint-Jean-de-Luz, France. Prospective case series. The multifocal IOL piggyback IOL was implanted in the sulcus during cataract surgery. Visual acuity, defocus curve, contrast sensitivity, IOL positioning, and patient satisfaction were assessed with 1-year follow-ups. Fifty-four eyes of 27 patients were included. At 1-month, monocular uncorrected distance (UDVA) and near (UNVA) visual acuities were 0.13 logarithm of the minimum angle of resolution (logMAR)±0.18 (SD) and 0.20±0.16 logMAR, respectively. Binocular UDVA and UNVA were 0.03±0.06 and 0.12±0.08 logMAR, respectively. At 1year, the mean monocular logMAR UDVA, corrected distance visual acuity, UNVA, and corrected near visual acuity were 0.10±0.11, 0.02±0.06, 0.18±0.12, and 0.13±0.08, respectively. The defocus curve and contrast sensitivity values were comparable to those obtained with other multifocal IOLs. On Scheimpflug imaging, the mean distance between the sulcus multifocal IOL and the monofocal IOL was 517±141μm. At 1year, ultrasound biomicroscopy showed an annular fibrosis of the anterior capsule in 94.4% of the eyes. Complications included 1 posttraumatic IOL decentration and 1 slight corectopia. Eighty-nine percent of patients reported satisfaction. The piggyback implantation of this multifocal IOL seemed to be safe and effective. It might provide similar resultsas a primary in-the-bag multifocal IOL, with the advantage of reversibility that might extend primary or secondary implantation.

Objective and subjective results following implantation of the FineVision trifocal intraocular lens in Mexican patients.

To evaluate objective and subjective results after bilateral implantation of a diffractive trifocal intraocular lens (IOL) in a Mexican population. Prospective, interventional case series involved 15 cataract surgery patients who underwent bilateral implantation of the trifocal Micro F lens FineVision IOL (PhysIOL, Liège, Belgium). Objective analysis involved assessment of monocular uncorrected distance (UDVA), near (UNVA) at 30 and 40cm, and intermediate visual acuity (UIVA) at 50, 60, and 70cm, preoperatively, and at postoperative months 1, 3, and 6. Higher-order aberrations were assessed via aberrometry. Contrast sensitivity was determined via modulation transfer function. Subjective outcomes were assessed using the National Eye Institute Visual Functioning Questionnaire-25 (VFQ-25). At postoperative month 6, mean monocular UDVA was 0.06±0.11 logMAR, and UNVA was 0.03±0.04 logMAR at 30cm and 0.05±0.08 logMAR at 40cm. Mean UIVA at 50, 60, and 70cm was 0.12±0.06, 0.13±0.08, and 0.04±0.08 logMAR, respectively. Spherical equivalent at postoperative month 3 was 0.23±0.4 diopters (D). Aberrometry revealed a mean RMS of 0.18 microm and PSF of 0.19 (Strehl ratio). VFQ-25 questionnaire results showed a mean score of 93.64±4.19 points (maximum 100 points). Vision during distance and near activities was reported as "excellent." Adverse events were reported as occurring "never to occasionally." Implantation of a diffractive trifocal IOL in a Mexican population appears safe and effective, both objectively and subjectively. Good uncorrected visual acuity outcomes were achieved at far, near, and intermediate distances. Overall patient satisfaction was excellent.

Visual quality and performance comparison between 2 refractive rotationally asymmetric multifocal intraocular lenses

To compare the 12-month postoperative quality of vision and visual performance of 2 different refractive rotationally asymmetric multifocal intraocular lenses (IOLs). Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom. Retrospective case series. Refractive lens exchange (RLE) patients were divided into 2 groups. Group A comprised eyes receiving a Lentis Mplus LS-312 MF30 IOL and Group B, eyes receiving a Lenstec SBL-3 IOL. Refraction, uncorrected (UDVA) and corrected distance visual acuities, uncorrected intermediate (UIVA) and near (UNVA) visual acuities, distance-corrected intermediate and near (DCNVA) visual acuities, and quality of vision were evaluated preoperatively and up to 12months postoperatively. Each group comprised 90 eyes. Both groups had a high level of quality of vision 12months postoperatively with no significant difference between the 2 groups (P=.919). There was no significant between-group difference in mean monocular and binocular UDVA, monocular UIVA, or monocular UNVA. Group B had statistically significantly better mean monocular DCNVA (P=.049), binocular UNVA (P=.011), and binocular DCNVA (P=.035). Group B had a higher percentage of complete spectacle independence. Both refractive rotationally asymmetric multifocal IOLs provided an excellent level of quality of vision 12months postoperatively. Both IOL models restored distance, intermediate, and near visual function; however the IOLs in Group B provided better near visual performance.

Visual outcomes and patient satisfaction 3 and 12 months after implantation of a refractive rotationally asymmetric multifocal intraocular lens

To assess the 3-month and 12-month postoperative visual performance and subjective patient satisfaction after refractive lens exchange (RLE) with implantation of a rotationally asymmetric multifocal intraocular lens (IOL). Cathedral Eye Clinic, Belfast, United Kingdom. Prospective case series. The refraction, uncorrected (UDVA) and corrected distance visual acuities, uncorrected intermediate (UIVA) and near (UNVA) visual acuities, distance-corrected intermediate and near visual acuities, and a quality of vision (QoV) questionnaire were evaluated 3months and 12months after implantation of an SBL-3 IOL. The study enrolled 100 eyes of 50 patients. The mean monocular UDVA was -0.02 logarithm of minimum angle of resolution (logMAR)±0.12 (SD) 3months postoperatively and -0.01±0.10 logMAR at 12months (P=.393). The mean monocular UIVA was 0.39±0.11 logMAR and 0.41±0.12 logMAR, respectively (P=.06). The mean monocular UNVA was 0.12±0.13 logMAR and 0.14±0.12 logMAR, respectively (P=.077). The mean QoV score was 8.26±1.16 at 3months with a significant improvement at 12months, at which time the mean QoV score was 8.84±1.08 (P≤.001). This asymmetric multifocal IOL provided excellent unaided vision with no significant difference in near, intermediate, and distance vision 3months and 12months postoperatively. However, there was a significant improvement in subjective outcomesat the second postoperative assessment, during which patients reported a significantly better QoV score and less blurred vision.

Long-term rotational stability and visual outcomes of a single-piece hydrophilic acrylic toric IOL: a 1.5-year follow-up.

To evaluate the rotational stability and visual outcomes of a single-piece hydrophilic acrylic toric intraocular lenses (IOL) over a 1.5-year follow-up period. Data from the 6-month follow-up study have been previously reported. Forty eyes of 26 cataract patients (mean age: 72.8±7.9y) with pre-existing corneal astigmatism of 1.0 to 2.6 D were enrolled in the study. Mean axial length was 23.17±0.88 mm. Main outcome measures after implantation of the Torica-aA IOL (HumanOptics) were IOL rotational stability, subjective refraction, astigmatism correction, uncorrected and corrected distance visual acuity (UDVA, CDVA). There was no significant change in the parameters evaluated between the 6-month and 1.5-year follow-ups. At last visit, mean absolute IOL rotation (objective method) was 1.81°±1.87° (range 0.00° to 7.20°) with 78.6% of eyes having IOL rotation <3°, 92.9% of eyes <5° and 100% of eyes <8°. No patient required secondary IOL repositioning during the course of the study. Mean residual refractive cylinder was -0.60±0.40 D. There was a significant reduction in the magnitude of the J0 vector postoperatively (P<0.0001) with a mean absolute change of 0.76±0.40 D. The mean J45 vector was close to zero preoperatively and postoperatively and didn't change significantly (P=0.28). Mean monocular UDVA and CDVA was 0.09±0.12 logMAR and -0.01±0.12 logMAR, respectively. No treatment with Nd:YAG laser was required. The Torica-aA IOL shows good and stable visual performance and rotational stability over a 1.5-year follow-up period.

The Small-Aperture IC-8 Intraocular Lens: A New Concept for Added Depth of Focus in Cataract Patients

To evaluate visual performance of subjects implanted monocularly with a small-aperture hydrophobic intraocular lens (IC-8 IOL). A prospective, noncomparative, multicenter case series. A series of 12 patients, presenting for cataract surgery, were implanted monocularly with a single-piece hydrophobic acrylic intraocular with a centrally located opaque annular mask measuring 3.23mm in total diameter with a 1.36mm central aperture. Uncorrected distance, intermediate, and near visual acuities (UDVA, UIVA, and UNVA); depth of focus; and subjective symptoms were evaluated for 12months after implantation. Mean ± standard deviation visual acuity is reported in logMAR. The mean monocular UDVA, UIVA, and UNVA improved significantly from 0.42 ± 0.18, 0.52 ± 0.22 and 0.66 ± 0.23 preoperatively to 0.06 ± 0.08 (P < .0001), 0.07 ± 0.11 (P < .0001), and 0.11 ± 0.15 (P < .0001) at 1month, respectively, and remained stable until 12months. At 12months, 100%, 100%, and 92% of patients achieved 20/32 or better binocularly for UDVA, UIVA, and UNVA, respectively. One hundred percent of eyes maintained 20/40 or better visual acuity over a range of+0.50 diopter to-1.50 diopters of defocus. Subjects implanted with the IC-8 IOL perceived a small magnitude of visual symptoms and rated their symptoms on the lower end of the severity scale. Early results demonstrate that monocular IC-8 intraocular lens implantation provides a continuous, broad range of vision and excellent acuity across allfocal distances.

Safety and efficacy of wavefront-guided myopic laser in situ keratomileusis using a new wavefront sensor technology: First 100 cases

To evaluate the safety and efficacy of wavefront-guided laser in situ keratomileusis (LASIK) for the correction of low to high myopia and myopic astigmatism using data derived from a new-generation Hartmann-Shack aberrometer. Refractive Surgery Unit, Bordeaux Hospital University, France. Retrospective case series. This retrospective study analyzed the initial group of eyes treated with wavefront-guided LASIK for myopia and myopic astigmatism using the Visx S4IR excimer laser and wavefront data derived from a new Hartmann-Shack aberrometer (iDesign Advanced Wavescan aberrometer). Refractive (refraction and refractive accuracy) and visual outcomes (uncorrected [UDVA] and corrected [CDVA] distance visual acuities) were recorded 3 months postoperatively. The study included 100 eyes of 50 consecutively treated patients. The mean decimal UDVA improved from 0.1 ± 0.1 (SD) preoperatively to 1.1 ± 0.15 postoperatively (P < .01). A monocular UDVA of 20/16, 20/20, and 20/25 were achieved in 76.6%, 94.4%, and 96.6% of eyes, respectively. The postoperative manifest spherical equivalent was within ±0.5 diopter in all eyes. No eye lost 2 or more lines of CDVA, and 29.2% of the eyes gained 1 or more lines of CDVA. Wavefront-guided LASIK performed using data derived from the new Hartmann-Shack aberrometer was safe, effective, and predictable for treating myopia and myopic astigmatism. No author has a financial or proprietary interest in any material or method mentioned.

Comparison of Intracorneal Inlay for Presbyopia Correction: Hydrogel and Small-Aperture Inlays with a Six- Months Follow-Up

Purpose: To study the safety and efficacy of corneal reshaping and small-aperture inlays and compare the clinical results. Methods: From February 2014 to November 2014, 22 corneal reshaping inlays were inserted at Asan Medical Center and from October 2012 to March 2013, 26 small-aperture inlay surgeries were performed: 6 eyes at Asan Medical Center and 20 eyes at Samsung Medical Center. The preoperative and postoperative parameters were reviewed retrospectively and included monocular uncorrected distance visual acuity (UDVA; log MAR), uncorrected near visual acuity (UNVA; log MAR), refraction and corneal curvature based on automated refractor keratometry, reading distance and patient satisfaction. Results: In the hydrogel inlay group, preoperative mean monocular UNVA was 0.83 ± 0.05 and monocular UDVA 0.07 ± 0.03. At 6 months, mean monocular UNVA was 0.23 ± 0.05 and UDVA 0.05 ± 0.02. The most preferred mean reading distance in the hydrogel inlay group was 39.38 ± 3.18 cm. In the small-aperture inlay group, preoperative mean monocular UNVA was 0.4 ± 0.06 and monocular uncorrected visual acuity 0.27 ± 0.04. At 6 months, mean monocular UNVA was 0.11 ± 0.02 and UDVA 0.09 ± 0.05 and the most preferred mean reading distance was 44.23 ± 5.17 cm. Although 85% of patients in the corneal reshaping inlay group were satisfied or very satisfied, only 20% of patients in the small-aperture inlay group were satisfied. Conclusions: Both inlays are considered good options for correcting presbyopia. However, postoperative satisfaction score was higher and less glare symptoms were reported in the hydrogel inlay group. J Korean Ophthalmol Soc 2015;56(12):1840-1847

Clinical Outcomes with a New Trifocal Intraocular Lens

To evaluate visual and refractive outcomes, contrast sensitivity, and quality of vision after cataract surgery with the implantation of a new modality of trifocal intraocular lens (IOL). This case series comprised 30 patients who had bilateral implantation of the AT.LISA tri 839 MP trifocal IOL after phacoemulsification for either cataract or refractive lens exchange surgery. Uncorrected (UDVA) and corrected monocular distance visual acuity (CDVA) using a logMAR chart, binocular uncorrected (UNVA) and corrected near visual acuity (CNVA) (40 cm and patients' preferred distance) using the Radner Reading Charts, distance-corrected intermediate visual acuity (DCIVA) (70 cm), a binocular defocus curve, contrast sensitivity (CS) with the Pelli-Robson test, and subjective quality of vision by a short questionnaire were evaluated at 1, 3, and 6 months postoperatively. At 6 months, mean values of 0.05 ± 0.07 and -0.02 ± 0.05 logMAR were obtained for monocular UDVA and CDVA, respectively. Mean values of 0.16 ± 0.07, 0.12 ± 0.07, and 0.16 ± 0.07 logRAD were obtained for binocular UNVA, CNVA, and DCIVA, respectively. Significant changes were only detected in monocular CDVA (p<0.01) and UDVA that improved between 3 and 6 months postoperatively (p = 0.01). A visual acuity level of 0.2 logRAD could be seen in binocular defocus curves between +1.00 and -3.00 D. At 6 months, mean photopic and mesopic CS were 1.52 ± 0.11 and 1.54 ± 0.11. Regarding the questionnaire, almost all patients were satisfied with their distance, intermediate, and near vision. Difficulties associated with photic phenomena decreased significantly over time. The AT.LISA trifocal IOL provides excellent uncorrected distance, intermediate, and near visual outcomes.

Outcomes and complications of a multifocal toric intraocular lens with a surface-embedded near section

To evaluate the refractive outcomes and rotational stability after implantation ofa multifocal toric intraocular lens (IOL) with a surface-embedded near section. Private center, London, United Kingdom. Case series. This study evaluated eyes with more than 1.50 diopters (D) of preexisting corneal astigmatism. After phacoemulsification, Lentis Mplus toric IOLs were implanted in all cases. The main outcome measures were refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected near visual acuity (UNVA), keratometry, and IOL position. Three-month postoperative data are presented. The study enrolled 89 eyes (58 patients). The mean monocular postoperative UDVA and UNVA were 0.03 logMAR ± 0.11 (SD) and 0.17 ± 0.14 logMAR, respectively. The mean refractive cylinder decreased from 2.90 ± 1.31 D preoperatively to 0.50 ± 0.39 D postoperatively (P<.001). The mean difference between the planned axis of implantation and the actual axis postoperatively was 2.53 ± 2.27 degrees. The multifocal toric IOL with a surface-embedded near section effectively corrected preexisting corneal astigmatism. The IOL was stable in the capsular bag, there were no visually significant complications, and there was no significant rotation out to 3 months postoperatively. Neither author has a financial or proprietary interest in any material or method mentioned.