Monofocal Group Research Articles

Improvements in visual function early after cataract surgery in eyes implanted with multifocal intraocular lenses.

To compare the improvements in all-distance visual acuity (VA) and contrast sensitivity early after cataract surgery among eyes implanted with multifocal and monofocal intraocular lenses (IOLs). Nonrandomized comparative study. Forty-two eyes with a trifocal IOL (Alcon, PanOptix®), 42 eyes with a combined bifocal and extended-depth-of-focus (EDF) IOL (Johnson & Johnson, Synergy®), and 84 eyes with a monofocal IOL were recruited. Uncorrected or corrected VA at various distances, and photopia and mesopic contrast VA were examined at 1day and 3 months postoperatively. Improvements in these VAs were compared between time points and among groups. Mean uncorrected as well as corrected VA improved significantly between 1day and 3 months postoperatively at almost all distances in the trifocal and combined bifocal + EDF groups (P ≤ 0.018), and at the intermediate distance of 1.0m and far distances in the monofocal group (P ≤ 0.031). Mean improvements in near uncorrected VA at 0.3m, intermediate VA at 0.5m, and far VA at 2.0, 3.0, and 5.0m were significantly greater in the multifocal groups than in the monofocal group (P ≤ 0.032). Improvements in photopic and mesopic contrast VA at most contrasts were significantly better in the multifocal groups (P ≤ 0.021). Mean uncorrected or corrected VA at almost all distances and contrast sensitivity at most contrasts improved significantly early after surgery in eyes implanted with multifocal IOLs, and the improvements in VA at most distances and in contrast sensitivity were better with multifocal IOLs than with monofocal IOLs.

Visual Outcomes and Patient Satisfaction of Enhanced Monofocal Intraocular Lens in Phacovitrectomy for Idiopathic Epiretinal Membrane.

To evaluate the clinical outcomes and patient satisfaction after implantation of an enhanced monofocal intraocular lens (TECNIS Eyhance ICB00) in patients with idiopathic epiretinal membrane (ERM) who underwent cataract surgery with pars plana vitrectomy (PPV). This is a single-center, retrospective, comparative study. In total, 61 eyes of 61 patients with idiopathic ERM and cataracts were included. We measured the uncorrected near and intermediate visual acuity (UNVA and UIVA), uncorrected and corrected distance visual acuity (UDVA and CDVA), central macular thickness, defocus curves, and contrast sensitivity 3-6 months after the surgery. Overall patient satisfaction was assessed using a questionnaire at the 1-month follow-up visit. The ICB00 group showed better near and intermediate visual acuity than the monofocal group (TECNIS ZCB00); however, no statistically significant differences were found between the groups. The ICB00 group exhibited wider defocus curves at near to far distances (-3.0 to +2.0 D) than the ZCB00 group. There were no significant differences in the results of the contrast sensitivity test, dysphotopsia, spectacle dependence, or patient satisfaction between the two groups. In combined PPV and cataract surgery for ERM patients, ICB00 resulted in good visual acuity with a smoother defocus curve compared to the ZCB00 group.

Effects of different types of intraocular lens implantation on patient's visual quality and function after phacoemulsification

Objective: To explore the effects of different types of intraocular lens (IOL) implantation on patient's visual quality and function after phacoemulsification. Methods: The clinical data of patients with monocular cataract who underwent phacoemulsification in the Department of Ophthalmology, People's Hospital Affiliated to Shandong First Medical University between December 2021 and May 2023 were retrospectively analyzed. According to the types of IOL, the patients were divided into monofocal group, bifocal group and depth of focus extension group. Three months later, uncorrected distance visual acuity (UCDVA), best corrected distance visual acuity (BCDVA), uncorrected intermediate visual acuity (UCIVA), best corrected intermediate visual acuity (BCIVA), uncorrected near visual acuity (UCNVA) and best corrected near visual acuity (BCNVA) were detected. Contrast sensitivity and total wavefront aberration were measured by visual function analyzer. Satisfaction with visual quality was evaluated by hospital-made satisfaction questionnaire. Results: A total of 92 patients were included, with 31 males and 61 females, and their age was (61.8±5.2) years. There were 43, 28 and 21 cases in monofocal group, bifocal group and depth of focus extension group, respectively. No statistically significant difference was found in clinical baseline data among the three groups. UCIVA, UCDVA, BCIVA and BCDVA in depth of focus extension group were 1.01±0.13, 0.92±0.18, 1.21±0.19 and 1.20±0.23, respectively, which were higher than those in monofocal group (0.62±0.12, 0.74±0.13, 1.02±0.17, 1.07±0.19, respectively) and bifocal group (0.67±0.15, 0.78±0.14, 1.01±0.16, 1.01±0.18, respectively), while absolute value of spherical equivalent [(-0.42±0.07) D] was lower than that in the other two groups [ (-0.49±0.05) D and (-0.45±0.08) D] (both P<0.05). UCNVA and BCNVA in bifocal group were 0.91±0.18 and 1.25±0.18, which were higher than those in depth of focus extension group (0.63±0.24 and 1.19±0.17) (both P<0.05). There were no significant differences in contrast sensitivity among the three groups under day vision or between monofocal group and bifocal group under night vision (all P>0.05), but the contrast sensitivity was higher in depth of focus extension group under night vision (3.0, 6.0, 12.0 c/d) than other two groups (all P<0.05). The score of ocular discomfort was the highest in bifocal group, followed by depth of focus extension group and monofocal group (both P<0.05). The score of visual interference in bifocal group was lower than that in monofocal group and depth of focus extension group (both P<0.05). The scores of subjective feeling in bifocal group and depth of focus extension group were higher than that in monofocal group (both P<0.05). The reading score was the highest in bifocal group, followed by depth of focus extension group and monofocal group (both P<0.05). There was no significant difference in total low-order aberration among the three groups (P=0.472). The total aberration and higher-order aberration [(0.74±0.35) μm and (0.41±0.12) μm] were the highest in monofocal group, followed by bifocal group [(0.61±0.21) μm and (0.22±0.09) μm] and depth of focus extension group [(0.46±0.13) μm and (0.06±0.09) μm] (all P<0.05). Conclusions: IOL implantation with depth of focus extension can enhance visual range, night vision and contrast sensitivity, and thus effectively improve postoperative visual quality and function in cataract patients. The bifocal IOL can better improve the patient's UCNVA and BCNVA, resulting in high satisfaction with visual quality.

Enhanced Monofocal Intraocular Lenses in Fuchs' Endothelial Dystrophy Patients: Results from Triple Descemet Membrane Endothelial Keratoplasty Procedure.

Descemet membrane endothelial keratoplasty (DMEK) is currently regarded as the most effective surgical procedure for addressing Fuchs Endothelial Corneal Dystrophy (FECD), frequently performed in conjunction with cataract surgery. In this retrospective study, we present a comparison of visual performance, clinical outcomes, and optical quality between two types of monofocal Intraocular Lenses (IOLs): one standard and one enhanced intermediate vision model, implanted in patients who underwent combined phacoemulsification and DMEK surgery. This single center comparative retrospective study was conducted at the Eye Clinic of the University of Florence (Italy) and included a total of 48 eyes of 48 patients affected by FECD and cataract. All patients underwent combined DMEK with phacoemulsification procedures. The patients' data were analyzed and divided into two groups: one group (standard group) consisted of 24 eyes that underwent phaco-DMEK with implantation of a monofocal IOL, and the second group (enhanced monofocal group) included 24 eyes that underwent phaco-DMEK with implantation of an enhanced monofocal IOL. In both groups, the following monocular visual outcomes were evaluated 6 months after surgery: Uncorrected Distance Visual Acuity (UDVA) and Best-Corrected Distance Visual Acuity (BCDVA) at 4 mts; Uncorrected Intermediate Visual Acuity (UIVA), Distance-Corrected Intermediate Visual Acuity (DCIVA) at 66 cm; Uncorrected Near Visual Acuity (UNVA) and Best Corrected Near Visual Acuity (BCNVA). Monocular defocus curves were also assessed. Furthermore, optical quality in terms of Contrast Sensitivity (CS) in photopic conditions, Higher-Order Aberrations (HOAs) at a pupil size of 5 mm. Modulation Transfer Function (MTF), Objective Scatter Index (OSI), and Strehl ratio, were also analyzed. A Patient-Reported Spectacle Independence Questionnaire was revised to evaluate spectacle independence outcomes. the two groups did not exhibit statistically significant differences in terms of UDVA, BCDVA, UNVA and BCNVA, photopic CS, HOAs, OSI, Strehl ratio, and MTF. However, in the phaco-DMEK enhanced monofocal IOL group, significantly better results were observed in terms of UIVA and DCIVA as well as a different defocus curve profile at 1.50 D, providing better defocus results at intermediate distance compared with the ZCB00 IOL. In our study, we found that enhanced monofocal lens performed favorable visual outcomes, even in cases of FECD, compared to standard monofocal IOLs. Comparable optical quality observed in the Eyhance group could allow surgeons to consider these lenses as a viable option for selected patients with FECD.

The effect of trifocal and extended-depth-of-focus intraocular lenses on optical coherence tomography parameters.

Optical properties of commonly used multifocal and extended-depth-of-focus (EDOF) intraocular lenses (IOLs) can induce artifacts or changes in optical coherence tomography (OCT) measurements. Our purpose was to investigate the possible effects of different IOLs on peripapillary and macular OCT parameters. The preoperative and postoperative third-month peripapillary OCT and ganglion cell analysis (GCA) parameters of patients having monofocal (Alcon IQ), multifocal (PanOptix), or EDOF (Vivity) IOL implanted during cataract surgery were compared. Sixty-four eyes of 64 patients were included (21 monofocal, 24 multifocal, and 19 EDOF). Although all OCT image qualities increased postoperatively, only GCA image quality changes in the monofocal and multifocal groups reached statistical significance. Most peripapillary retinal nerve fiber layer (RNFL) and GCA parameters were similar preoperatively and postoperatively. The superior RNFL thickness in the monofocal group and the temporal RNFL thickness in the EDOF group were higher postoperatively ( P = 0.04 and P = 0.02, respectively). Most GCA and RNFL value changes between preoperative and postoperative measurements were similar between groups. In the parameters that changed, postoperative values were higher in the monofocal group ( P = 0.02 for minimum ganglion cell layer and inner plexiform layer, P = 0.04 for average RNFL). Trifocal and EDOF IOLs do not seem to have a negative effect on OCT parameters.

Trifocal versus monofocal intraocular lens implantation in eyes previously treated with laser in situ keratomileusis (LASIK) for myopia.

To assess visual and refractive outcomes of trifocal intraocular lens (IOL) implantation in eyes that had previously undergone laser in situ keratomileusis (LASIK) for myopia and to compare them with those recorded after implantation of a monofocal IOL. Retrospective comparative cases series. This study evaluated uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), safety, and efficacy after the implantation of two comparable trifocal IOL models and one monofocal IOL model in patients who had previously undergone myopic LASIK. Patients were classified according to the implanted IOL (monofocal or trifocal). A total of 211 eyes from 170 patients received a monofocal IOL, and 211 eyes from 161 patients received a trifocal IOL. At the end of the study, after lensectomy, there was a higher myopic residual spherical equivalent in the monofocal group because some eyes had been targeted for slight myopia to achieve monovision; therefore, UDVA was better in the trifocal group. CDVA was comparable in both groups. As expected, both monocular and binocular UNVA were significantly better in the trifocal group. Although the percentage of eyes that lost ≥1 line of CDVA did not differ between the groups, the safety index was slightly better in the monofocal group. Although implantation of monofocal and trifocal IOLs after myopic LASIK yielded excellent distance visual outcomes, UNVA was significantly better for the trifocal IOL, with a minimally worse safety profile. Trifocal IOLs can be considered after previous LASIK for myopia, with an appropriate patient selection.

Assessment of Safety, Efficacy and Predictability of a Trifocal Intraocular Lens. Performance of PanOptix Trifocal Versus Monofocal IOL

Purpose. To evaluate the performance and the visual outcomes of Acrysof PanOptix trifocal IOL in terms of safety, efficacy, predictability and assessment of the quality of vision after implantation as regards; contrast sensitivity and ocular aberrations. Methods. A prospective interventional non randomized study that included forty eyes of twenty one patients with senile cataract. All surgeries were carried out between September 2019 and January 2020. Patients underwent phacoemulsification for cataract removal with IOL implantation. They were divided into two groups; group(A) included twenty eyes of eleven patients who were implanted with AcrySof IQ PanOptix trifocal IOL Model TFNT00. While group (B) included twenty eyes of ten patients who were implanted with monofocal AcrySof IOLs as a control group. Results. There were 21 subjects enrolled in our study. Mean age was 56.6 ± 6.9 years in group (A) and 62.8 ± 7.1 years in group (B),(range 50–70).We found statistical significant difference between both groups with group A showing better post operative uncorrected distance, intermediate, near, and best corrected near visual acuity . Group (B) showed statistically significant better post operative contrast sensitivity compared to group (A). Conclusion: In this study, Acrysof PanOptix trifocal IOL showed excellent safety, efficacy, predictability and spectacle independence at all distances, This prospective interventional non-randomized study showed excellent safety, efficacy and predictability of the PanOptix IOL with higher spectacle independence, slightly impaired contrast sensitivity without affecting daily activities. However, contrast sensitivity was compromised in comparison to the monofocal group and high order aberrations (coma, trefoil) were noted to be higher affecting the quality of vision but not the daily activities of the patient.

Опыт имплантации мультифокальных и монофокальных интраокулярных линз отечественного производства

The article considers the primary factors affecting patients’ rehabilitation after implantation of different multifocal intraocular lens models, made in russia, during cataract surgeries. Implantation of multifocal intraocular lens provides patients with visual independence, however, at the same time some optical phenomena associated with the inner structure of multifocal Iols may appear, which negatively affect functional results of cataract surgery. therefore, comparison of patients’ visual functions after multifocal intraocular lens and monofocal intraocular lenses seems topical. Purpose. To compare visual functions of cataract patients after implantation of bifocal, trifocal and monofocal intraocular lenses. Materials and methods. 150 patients (150 eyes) were included in this study. They were divided into three groups depending on the type of implanted lens: bifocal Iol (45 patients), trifocal Iol (45 patients), monofocal Iol (control group, 60 patients). For one eye of each patient, an ultrasound cataract phacoemulsification was performed, and Iol was implanted. patients were tested for visual acuity at different distances and for contrast sensitivity function. Subjective satisfaction was evaluated using a questionnaire. Results. Improved distance visual acuity was noted in all research groups, near visual acuity was better for implanted bifocal and trifocal Iols in comparison with monofocal, intermediate visual acuity was better for trifocal Iols. contrast sensitivity function was higher in the monofocal Iol group. Subjective satisfaction was better for multifocal Iols compared to monofocal Iols. negative optical phenomena appeared more often after implanting trifocal Iols. Eyeglass independence were higher by patients of the multifoal Iol. Conclusion. Implanting multifocal Iols compared to monofocal Iols provides better pseudoaccommodation function and good degrees of visual independence and subjective satisfaction. this is offset by a higher frequency of optical phenomena negatively affecting the received functional results. Keywords: multifocal intraocular lens (IOL), bifocal IOL, trifocal IOL, cataract surgery, visual acuity, contrast sensitivity

Improved Intermediate Visual Function with New Monofocal Intraocular Lens in Combined Cataract and Vitrectomy Surgery for Retinal Disease.

To evaluate the usefulness of a newly generated monofocal intraocular lens (IOL) in patients with various retinal diseases who underwent combined cataract and pars plana vitrectomy surgery. This prospective observational study included 33 patients with various retinal diseases. Monocular best-corrected distance visual acuity (BCDVA), uncorrected distance visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA), and contrast sensitivity were measured and compared with 40 age-matched patients in the standard monofocal IOL. The Eyhance IOL group demonstrated significantly better UCIVA at 6 months follow-up compared to the standard monofocal IOL group. No significant differences were observed between the two groups in contrast sensitivity, BCDVA, UCDVA, or UCNVA. The regression analysis showed a significant association between preoperative corrected distance visual acuity and improved UCIVA in the Eyhance IOL group. The Eyhance ICB00 IOL proved to be a valuable option for patients with retinal diseases undergoing combined cataract surgery and vitrectomy. It effectively improved intermediate vision without compromising contrast sensitivity or distance visual acuity.

Enhancing Intermediate Vision in Patients Affected by Epiretinal Membrane Treated by Phaco-Vitrectomy.

The aim of this research was to see if a refractive enhanced monofocal IOL (Eyhance IOL, IOL Abbott Medical Optics, Inc., Santa Ana, CA, USA) can provide better intermediate vision in patients undergoing phaco-vitrectomy due to cataract and epiretinal macular membrane (ERM). A nonrandomized prospective observational comparative study enrolled patients affected by cataract and ERM undergoing phaco-vitrectomy. A follow up of 6 months was established. Corrected and uncorrected visual acuity of both monocular and binocular types were assessed regarding intermediate and far distances. The CATQUEST 9-SF questionnaire was administered preoperatively and at the last follow-up. Twenty-three eyes of twenty-three patients were enrolled, with 11 in the enhanced monofocal group. The uncorrected and corrected distance visual acuity after 6 months was not statistically different. Both monocular and binocular uncorrected intermediate visual acuity after 6 months were higher in the enhanced monofocal group (p < 0.001). The corrected intermediate visual acuity after 6 months was higher in the enhanced monofocal group (p = 0.01). The CATQUEST-9SF questionnaire showed significant differences in the variation between the preoperative condition and six-month postoperative results (p < 0.001). This refractive enhanced monofocal IOL can provide better intermediate vision compared to a standard monofocal IOL in patients undergoing phaco-vitrectomy due to cataracts and ERM. Further studies are necessary to confirm these results.

Work Intensity of Postoperative Care Following Implantation of Presbyopia-Correcting versus Monofocal Intraocular Lenses.

To compare the work intensity of postoperative care following implantation of presbyopia-correcting intraocular lenses (IOLs) to that of standard monofocal IOLs. This open-label, multicenter, comparative study retrospectively reviewed the case records of cataract surgery patients who underwent bilateral implantation of either presbyopia-correcting IOLs (presby-IOL group; N=177) or standard monofocal IOLs (monofocal group; N=177). Outcome measures included the total time the patient spent in the office, number of visits, mean duration of visits, and the number of procedures and diagnostic tests during the first postoperative year. Outcome measures were compared between the first 90 days and days 91-365 after surgery. Mean (±SD) time spent in the office during the first postoperative year was 5:50 ± 3:35 hours (H:MM) over 6.6 ± 2.9 visits in the presby-IOL group, compared to 3:38 ± 1:36 hours over 4.9 ± 1.6 visits in the monofocal IOL group (p <0.001). During the first 90 days, a presby-IOL patient spent 40 minutes longer in the office than a monofocal IOL patient (3:39 ± 1:38 hours vs 2.59 ± 1:13 hours) (p <0.001). During days 91-365, time in the office was 1:32 hours longer (p <0.001), and the mean visit duration was 8 minutes longer for the presby-IOL patients (p=0.002) than those with monofocal IOL. In addition, the presby-IOL patients underwent more procedures and diagnostic tests (p ≤0.001) as compared with standard monofocal cataract surgery patients. Patients implanted with presbyopia-correcting IOLs require significantly more clinic time, diagnostic testing, and procedures postoperatively as compared with standard monofocal cataract surgery patients.

Influence of isofocal intraocular lenses on objective refraction based on autorefraction and aberrometry.

To evaluate and compare the objective refractions obtained by autorefraction and aberrometry under different lighting conditions with an isofocal intraocular lens (Isopure, BVI medical, Liége, Belgium) compared to a monofocal control lens (Micropure, BVI medical, Liége, Belgium) with the same platform and material. Prospective, comparative and randomized study on patients undergoing cataract surgery and bilateral isofocal or monofocal IOL implantation. A total of 44 subjects were randomly assigned to either the isofocal group (n = 22) or the Micropure (n = 22). Manifest refraction (MR) was always performed under the same lighting conditions for all the patients. For objective refraction the autorefractor KR8800 and the aberrometer OPD-Scan III (Nidek Inc., Tokyo, Japan.) were used. For each eye included in the study, six result sets were collected: MR, AR (autorefraction measured with the autorefractor), WF-P and WF-M (Zernike-coefficients-based objective refraction, photopic and mesopic pupil size), OPD-C and OPD-M (autorefraction measured with the aberrometer in photopic and mesopic conditions). The mean sphere for MR was 0.03 ± 0.32D for the Isopure group and 0.24 ± 0.22D for the monofocal group (p = 0.013). For the Isopure group, Friedman analysis showed statistically significant differences for sphere measured with WF-P (p = 0.035), WF-M (p = 0.018) and OPD-M (p = 0.000), and SE measured with OPD-M (p = 0.004). In the Micropure lens group, the Friedman analysis showed differences for all values studied (p < 0.05). Correlation coefficients showed that AR is the objective method with the strongest correlation values for all components of refraction for both groups. The modification of the surfaces of the isofocal lens does not have a negative impact on the refraction obtained by AR compared to a standard monofocal intraocular lens.

Visual Outcomes, Spectacle Independence, and Patient-Reported Satisfaction of the Vivity Extended Range of Vision Intraocular Lens in Patients with Early Glaucoma: An Observational Comparative Study.

This study aimed to evaluate and compare visual outcomes, spectacle independence, and patient satisfaction on bilaterally implanted Vivity extended depth-of-focus (EDOF) or monofocal intraocular lenses (IOLs) after cataract surgery in patients with early glaucoma. In this retrospective, non-randomized, interventional cohort study, patients with early glaucoma undergoing cataract surgery received bilateral implantation of either EDOF (AcrySof IQ Vivity; Alcon) or monofocal (Clareon/SN6ATx/SN60WF; Alcon) IOLs. The primary outcome was monocular uncorrected intermediate visual acuity (UIVA). The secondary outcomes were monocular uncorrected distance (UDVA) and near (UNVA) visual acuity, spectacle independence, patient satisfaction, and photic phenomena. Fifty-eight eyes from 29 patients, including 32 eyes in the EDOF group and 26 eyes in the monofocal group, were included in the study. UIVA (0.06 ± 0.16 versus 0.39 ± 0.10 LogMAR; P < 0.001) and UNVA outcomes (0.29 ± 0.10 versus 0.55 ± 0.18 LogMAR; P < 0.001) were significantly better in the EDOF group than in the monofocal group, respectively. There was no difference in UDVA and corrected distance visual acuity outcomes between the groups (P > 0.05), but both spectacle independence and patient satisfaction scores were significantly higher in the EDOF group (P < 0.001 and P < 0.05, respectively). There was no difference in self-reported photic phenomena. Bilaterally implanted EDOF IOLs provided excellent distance vision and better intermediate and near vision than monofocal IOLs in patients with early glaucoma. Spectacle independence and patient satisfaction were significantly higher in patients who received EDOF IOLs. Photic phenomena were rare and seldom bothersome.

Comparison of visual performances of enhanced monofocal versus standard monofocal IOLs in a mini-monovision approach

PurposeTo compare visual performance and quality of life in patients who received either monofocal intraocular lenses (IOLs) or an enhanced monofocal IOL in a mini-monovision target approach.BackgroundMonofocal lenses are the most common intraocular IOLs employed during cataract surgery because of their relatively low cost and good performance for distance sight. However, these lenses, generally, do not exonerate patients from spectacle use for near or intermediate tasks. On the other hand, enhanced monofocal IOLs (e.g., Tecnis Eyhance®) feature optical properties providing patients with good intermediate visual outcomes. Satisfactory near visual acuity results, regardless of IOL type, may be achieved through mini-monovision. We assessed visual performance outcomes between these IOLs, in a mini-monovision approach.MethodsRetrospective case series of patients who underwent bilateral cataract surgery at our institution with implantation of Alcon SN60WF, J&J Tecnis DCB00 or J&J Tecnis Eyhance® DIB00 with a pre-operative mini-monovision target. The postoperative spherical equivalent was measured by a Nidek® auto-refractometer. Best-uncorrected binocular visual acuity (BUBVA) at far (3 m), intermediate (66 cm), and near (40 cm) distance and binocular contrast sensitivity (100%, 25%, and 5%, all at 1 m) were measured using Snellen and Pelli-Robson charts, respectively. Visual performance in daily life was evaluated with the Cataract VF-14 quality of life survey.Results71 patients (35 in the monofocal IOL and 37 enhanced IOL group) were enrolled. Patients implanted with enhanced IOL exhibited statistically significant better BUBVA results at 66 cm and 40 cm distances compared to patients in the monofocal group. Additionally, patients in the enhanced IOL group presented a better contrast sensitivity in lower contrast conditions (5%) than patients with monofocal IOL. The quality of life survey showed statistically significant higher scores in daily activities without spectacles for patients with enhanced IOL.ConclusionEnhanced monofocal IOLs, combined with a mini-monovision approach, provided patients with good visual performance at all tested distances, with superiority of enhanced monofocal IOLs at near and intermediate distances.

Outcomes of Laser Retinopexy for Retinal Tears in Pseudophakic Eyes with Multifocal Versus Monofocal Intraocular Lenses: A Matched Cohort Study

Purpose Performing laser retinopexy through multifocal intraocular lenses may be challenging due to aberrations of the peripheral retinal view. This study investigated the influence of multifocal versus monofocal intraocular lenses on outcomes of laser retinopexy for retinal tears. Methods Pseudophakic eyes (multifocal and monofocal intraocular lenses) that underwent in-office laser retinopexy for retinal tears, with a minimum follow-up of 3 months, were retrospectively analyzed. Eyes with multifocal intraocular lenses were matched to controls with monofocal intraocular lenses in a 1:2 ratio for age, gender, number, and location of retinal tears. The main outcome measure was the rate of complications. Results We included 168 eyes in the study. Fifty-six eyes (51 patients) with multifocal intraocular lenses were matched with 112 eyes (112 patients) with monofocal intraocular lenses. The mean follow-up was 26 months. Baseline characteristics were similar between two groups. No significant differences were noted in the rate of successful laser retinopexy without additional procedures (91% vs. 86% at 3 months and 79% vs. 74% during follow-up, in the multifocal intraocular lens and monofocal intraocular lens group, respectively). No significant differences were observed in the rate of subsequent rhegmatogenous retinal detachment (multifocal, 4% vs. monofocal, 6%, p=.716) or need for additional laser retinopexy for new tears (14% vs. 15%; p=.939). The surgery rates for vitreous hemorrhage (0% vs. 3%; p=.537), epiretinal membrane (2% vs. 2%; p=.553), and vitreous floaters (5% vs. 2%, p=.422) were not significantly different. Visual outcomes were also similar. Conclusion Multifocal intraocular lenses did not appear to negatively impact the outcomes of in-office laser retinopexy for retinal tears.

Comparative Study Between Non-Diffractive Extended Depth of Focus and Monofocal Intraocular Lenses.

To evaluate the visual acuity and quality of vision in bilaterally implanted ZCBOO/ZCTx monofocal (Johnson & Johnson Vision) intraocular lens (IOL) and bilaterally implanted DATx15 extended depth of focus (EDOF) IOL (Alcon Vision, LLC). A single site, non-interventional study comparing ZCBOO/ZCTx monofocal IOL patients implanted with DATx15 IOL toric or non-toric versions in both eyes. A total of 30 patients (60 eyes) completed the study in the monofocal group, 32 (64 eyes) in the EDOF group, and all were targeted for emmetropia. Binocular uncorrected distance, intermediate (66cm), and near (40cm) visual acuities and distance corrected distance, intermediate (66cm) and near (40cm) visual acuities were assessed. Binocular distance corrected defocus curve testing was from -3.5 D to +3 D. Patient reported visual disturbances (QUVID) and IOL satisfaction (IOLSAT) questionnaires were administered. The DATx15 group mean uncorrected visual acuity was 0.15 ± 0.10 logMAR at 66cm and 0.36 ± 0.14 logMAR at 40cm, compared to 0.24 ± 0.15 logMAR and 0.59 ± 0.17 logMAR respectively for the ZCBOO/ZCTx group. The DATx15 group (23 respondents, 74%) also reported significantly more spectacle independence at near with the IOLSAT (p < 0.01), compared to the ZCBOO/ZCTx group (13 respondents, 43%). Glare, halos, starbursts, and blur reported on the QUVID questionnaire were similar in the two groups. The DATx15 group had improved near and intermediate vision and increased spectacle independence compared to the ZCBOO/ZCTx group.

Assessment of Safety, Efficacy and Predictability of a Trifocal Intraocular Lens

Purpose: To evaluate the performance and the visual outcomes of Acrysof PanOptix trifocal IOL in terms of safety, efficacy, predictability and assessment of the quality of vision after implantation as regards; contrast sensitivity and ocular aberrations. Study Design: Quasi experimental study. Place and Duration of Study: Dar el Ouyon hospital and Rowad Correction Center, Egypt, from September 2019 and January 2020. Methods: Forty eyes of twenty-one patients with senile cataract were included by convenient sampling. All eyes underwent phacoemulsification with IOL implantation. They were divided into two groups; group A included twenty eyes of eleven patients who were implanted AcrySof IQ PanOptix trifocal IOL Model TFNT00. Group B included twenty eyes of ten patients who were implanted monofocal AcrySof IOLs as a control group. A questionnaire was given to every patient after explaining to him\her the questions in Arabic, and clarifying the aim of evaluation. Results: Mean age was 56.6 ± 6.9 years in group A and 62.8 ± 7.1 years in group B, range 50 – 70 (P = 0.861). We found statistical significant difference between both groups with group A showing better post operative uncorrected distance, intermediate, near, and best corrected near visual acuity (P values were 0.001, 0.556, 0.001, 0.177, 0.001, 0.001 respectively). Group B showed statistically significant better post operative contrast sensitivity compared to group A. Conclusion: In this study, Acrysof PanOptix trifocal IOL showed excellent safety, efficacy, predictability and spectacle independence at all distances, However, contrast sensitivity was compromised in comparison to the monofocal group.

Clinical outcome of diffractive multifocal lens versus monofocal lens in post-laser in situ keratomileusis patients: A retrospective, comparative study.

To compare the clinical outcomes of diffractive multifocal and monofocal lenses in post-laser in situ keratomileusis (LASIK) patients who underwent cataract surgery. This was a retrospective, comparative study of clinical outcomes that was conducted at a referral medical center. Post-LASIK patients who underwent uncomplicated cataract surgery and received either diffractive multifocal or monofocal lens were studied. Visual acuities were compared at baseline and postoperatively. The intraocular lens (IOL) power was calculated with Barrett True-K Formula only. At baseline, both groups had comparable age, gender, and an equal distribution hyperopic and myopic LASIK. A significantly higher percentage of patients receiving diffractive lenses achieved uncorrected distance visual acuity (UCDVA) of 20/25 or better (80 of 93 eyes, 86% vs. 36 of 82 eyes, 43.9%, P = 1.0 x 105) and uncorrected near vision of J1 or better (63% vs. 0) compared to the monofocal group. The residual refractive error had no significant difference (0.37 ± 0.39 vs. 0.44 ± 0.39, respectively, P = 0.16) in these two groups. However, more eyes in the diffractive group achieved UCDVA of 20/25 or better with residual refractive error of 0.25-0.5 D (36 of 42 eyes, 86% vs. 15 of 24 eyes, 63%, P = 0.032) or 0.75-1.5 D (15 of 21 eyes, 23% vs. 0 of 22 eyes, P = 1.0 x 10-5) compared to the monofocal group. This pilot study shows that patients with a history of LASIK who undergo cataract surgery with a diffractive multifocal lens are not inferior to those who receive monofocal lens. Post-LASIK patients with diffractive lens are more likely to achieve not only excellent near vision, but also potentially better UCDVA, regardless of the residual refractive error.

Comparison of dynamic defocus curve on cataract patients implanting extended depth of focus and monofocal intraocular lens

BackgroundThe aim of the study was to compare the dynamic defocus curve on patients post-implantation of the extended depth-of-focus (EDOF) and monofocal intraocular lens (IOL).MethodsA total of 62 age-related cataract patients receiving phacoemulsification with implantation of TECNIS Symfony (ZXR00) or monofocal IOLs were enrolled. The binocular static and dynamic defocus curves with corrected distance visual acuity were evaluated at one month postoperatively.ResultsThe ZXR00 group achieved significantly better intermediate (P = 0.044) and near (P = 0.017) visual acuity (VA) than the monofocal group. Two groups had similar uncorrected and corrected distance VA (P > 0.05, respectively). The dynamic defocus curve revealed a smoother decline from 0.0 D to − 2.0 D in the ZXR00 group. Defocused dynamic VA in the ZXR00 group was significantly better (P < 0.05) except at 0.0 D (P = 0.724) and − 0.5 D (P = 0.176). The area under the curve (P = 0.002) and corrected dynamic vision accommodation (P = 0.001) derived from the dynamic defocus curves were better in the ZXR00 group. A positive correlation was observed between defocused dynamic and static VA in both groups (P < 0.001). Multiple linear regression analysis indicated that defocused static VA and corrected dynamic vision accommodation were significant influential factors for the defocused dynamic VA from − 1.0 D to − 3.0 D (P < 0.05).ConclusionsThe EDOF IOL provided similar distance vision, better intermediate and near vision, and a better overall dynamic defocus curve than the monofocal IOL. The dynamic defocus curve may be comprehensively applied to evaluate the all-distance dynamic visual performance post-cataract surgery.

Visual satisfaction and spectacle independence with monofocal intraocular lens with enhanced intermediate vision and trifocal intraocular lenses in the prepresbyopic age group patients with cataracts.

This aims to study visual satisfaction and spectacle independence in prepresbyopic age patients with cataracts after the implantation of either monofocal intraocular lens (IOL) with enhanced intermediate vision or trifocal IOL. Private practice. This prospective, observational case study was conducted on patients in the prepresbyopic age group with cataracts. Patients were allocated to one of the two groups. Thirteen patients (26 eyes) received monofocal IOL with enhanced intermediate vision (intermediate vision group), and 12 patients (24 eyes) received diffractive multifocal IOLs (trifocal group). Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity, Uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA) values, defocus curves, and contrast sensitivities (CS) of the two groups were compared 3 months' postsurgery. Their spectacle independence and visual satisfaction were also assessed. The study patients were aged 35-45 years and comprised 14 males and 11 females. No significant difference was observed in UDVA (intermediate vision group: 0.02 ± 0.01, trifocal group: 0.02 ± 0.01; P = 0.22) and UIVA (intermediate vision group: 0.20 ± 0.10, trifocal group: 0.19 ± 0.10; P = 0.12). However, a statistically significant difference was observed between the groups in terms of UNVA (intermediate vision group: 0.32 ± 0.10, trifocal group: 0.80 ± 0.10; P = 0.01). The mean CS in monofocal IOL with enhanced intermediate vision and trifocal groups were 1.577 ± 0.3 and 1.550 ± 0.2, respectively (P = 0.40). None of the patients experienced photic phenomena. In total, 10 of 13 patients in the monofocal IOL with enhanced intermediate vision group required spectacle correction for near visual acuity in the range of +1.00 to +2.00 D. This study found that there was no significant difference in distance and intermediate vision between the two groups. However, the trifocal group had better uncorrected near vision compared to the monofocal group that had enhanced intermediate vision. The conclusion is that using trifocal IOLs for both eyes provided complete independence from wearing glasses. In addition, no visual disturbances were observed after implanting the new-generation trifocal IOLs.