Monofocal Intraocular Lens Implantation Research Articles

Comparison of the axial growth with multifocal and monofocal intraocular lenses in unilateral pediatric cataract surgery.

To compare axial growth in pediatric cataract patients who underwent multifocal intraocular lens (IOL) implantation without anterior vitrectomy (AV) with that in pediatric patients who underwent monofocal IOL implantation with or without AV. Patients who had unilateral pediatric cataracts and underwent surgery at 3-6years of age from June 6, 2019, to June 30, 2020, at our institution were prospectively analyzed. The patients were categorized into Group A: multifocal IOL implantation with optic capture in Berger's space without AV; Group B: monofocal IOL implantation with optic capture in Berger's space without AV; and Group C: bag-in-the-lens monofocal IOL implantation with AV. Groups A', B' and C' consisted of the fellow eyes from the respective groups. Axial growth and monthly growth rates were compared among the 3 treatment groups, as well as between the treated eyes and the fellow eyes. Thirty-one, 23, and 14 children fulfilling the inclusion criteria, respectively, were included in the final analysis. There were no significant differences in patient age at the time of surgery or preoperative axial length (P > 0.05). After a mean follow-up of 35.57 ± 3.78months, significant differences in the axial growth and the monthly growth rate were observed (P < 0.05), and Group A had the least axial elongation. Comparing treated eyes with fellow eyes, the amount and rate of axial growth were lower in Group A than in Group A' (P < 0.05), no significant differences were found in Group B (P > 0.05), and Group C had greater growth than did Group C' (P < 0.05). The implanting multifocal intraocular lenses and maintenance of vitreous body integrity may be protective factors against excessive axial growth in pediatric cataract patients. Clinical trial registration (prospective study): chiCRT1900023155; 2019-05-14.

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.

Analysis of intraocular lens decentration and tilt after femtosecond laser-assisted cataract surgery using swept-source anterior optical coherence tomography

ObjectiveTo evaluate and compare the magnitude of intraocular lens (IOL) decentration and tilt following conventional and femtosecond laser-assisted cataract surgery (FLACS) using swept-source anterior optical coherence tomography (SS-OCT). MethodsIn this retrospective observational study, we enrolled patients who underwent conventional cataract surgery or FLACS with the implantation of hydrophobic 1-piece monofocal IOL. The magnitude of IOL decentration and tilt were measured using SS-OCT. Visual acuity, intraocular pressure, spherical equivalent, axial length, contrast sensitivity, and satisfaction questionnaire were evaluated before and one-month post-surgery. Additionally, postoperative internal cylinder measurements were obtained using a wavefront aberrometer. Correlation factors between each parameter and IOL decentration or tilt were analyzed. ResultsThis study included 100 eyes from 100 patients. Mean IOL decentration and tilt were 0.21 ± 0.13 mm and 5.01 ± 1.49°, respectively. Conventional cataract surgery (versus FLACS, P = 0.001) and male sex (versus female, P = 0.047) were significantly correlated with higher postoperative decentration. Preoperative lens diameter (P < 0.001), preoperative lens tilt (P = 0.007), and preoperative intraocular pressure (P = 0.027) were correlated with higher postoperative tilt. Fifty eyes that underwent FLACS demonstrated mean postoperative decentration of 0.21 ± 0.13 mm and tilt of 4.64 ± 1.48°. Compared with the conventional surgery group, the FLACS group significantly differed in postoperative decentration (0.30 ± 0.12 mm, P < 0.001) but not in tilt (5.03 ± 1.35°, P = 0.173). Postoperative visual acuity did not significantly differ between the two groups. ConclusionPatients who underwent FLACS demonstrated better IOL decentration and tilt than those who underwent conventional cataract surgery one-month post-surgery. However, differences in IOL decentration and tilt did not affect postoperative visual acuity.

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.

Comparative Evaluation of Visual Outcomes in Combined Cataract and Vitrectomy for Idiopathic Epiretinal Membrane with an Advanced or Conventional Intraocular Lens

Introduction: The aim of this study was to investigate the efficacy of new monofocal intraocular lens (IOL) in comparison with conventional monofocal IOL in patients undergoing combined cataract and vitrectomy surgery for epiretinal membrane (ERM). Methods: This prospective non-randomized comparative study included 65 eyes of 65 patients who underwent combined cataract and vitrectomy for ERM with implantation of advanced monofocal IOL (Eyhance ICB00, 33 patients) and standard monofocal IOL (Tecnis ZCB00, 32 patients). Monocular visual acuities were measured 6 months post-operatively, including corrected and uncorrected distance visual acuity (CDVA, UCDVA), uncorrected intermediate visual acuity (UCIVA), and uncorrected near visual acuity (UCNVA). Furthermore, contrast sensitivity and metamorphopsia were measured. Results: There was no significant difference between two groups regarding operation time, post-operative CDVA, UCDVA, UCNVA, and spherical equivalent (p > 0.05). Monocular UCIVA was significantly higher in the Eyhance IOL group than in the Tecnis IOL group (p = 0.005). The photopic and mesopic contrast sensitivities were comparable between each group for any spatial frequency (p > 0.05). The correlation coefficients from correlations between retinal wrinkling ratio and M score did not differ significantly between groups (p = 0.877), and the degree of metamorphopsia was not significantly related to the type of IOL (p = 0.969). Conclusions: In combined cataract and vitrectomy for ERM, Eyhance IOL provided significant better visual performance at intermediate distance than standard monofocal IOL without compromising operation time, distance vision, contrast sensitivity, and evaluating metamorphopsia. Eyhance IOL can be a useful option for both surgeons and patients.

Effect of Low Myopia on Near and Distance Vision in Astigmatic Pseudophakic Eyes

Purpose: To investigate the effect of the postoperative spherical equivalent (SE) and astigmatism on the uncorrected near/distance visual acuity (UNVA/UDVA) in monofocal intraocular lens (IOL)-implanted pseudophakic eyes.Methods: Of the eyes that underwent successful cataract surgery and monofocal IOL implantation from January 2020 to September 2021 by a single surgeon, eyes with postoperative astigmatism ≤ 1.5 diopters (D) and -0.75 D ≤ SE &lt; +0.25 D were included. Eyes implanted with a toric IOL or with a best corrected visual acuity under 20/25 were excluded. This was a cross-sectional study, and the correlation of SE/astigmatism and UNVA/UDVA at 1 month postoperatively was analyzed retrospectively. The eyes were divided into mini-myopia (-0.75 D ≤ SE &lt; -0.25 D) and emmetropia (-0.25 D ≤ SE &lt; 0.25 D) groups according to the SE.Results: This study included 118 eyes (86 patients). The UNVA was significantly better in the mini-myopia group than in the emmetropia group (&lt;i&gt;p&lt;/i&gt; = 0.009), without a significant difference in UDVA (&lt;i&gt;p&lt;/i&gt; = 0.412). Dividing the range into 0.5 D units according to the degree of astigmatism, no significant difference was observed in UNVA/UDVA between the mini-myopia and emmetropia groups in eyes with astigmatism ≤ 1.0 D. However, the mini-myopia group had a significantly better UNVA (&lt;i&gt;p&lt;/i&gt; = 0.03), without a significant difference in UDVA (&lt;i&gt;p&lt;/i&gt; = 0.879) in eyes with astigmatism &gt; 1.0 D or ≤ 1.5 D.Conclusions: In non-toric monofocal IOL-implanted pseudophakic eyes with postoperative residual astigmatism of ≤ 1.5 D, especially in eyes with astigmatism &gt; 1.0 D and ≤ 1.5 D, the mini-myopia group had a significantly better UNVA compared to the emmetropia group, without a significant difference in UDVA.

Migraine is a risk factor for pseudophakic positive dysphotopsia following monofocal lens implantation

ObjectiveTo identify neuroadaptation-related risk factors for persistent positive dysphotopsia (>6 months) following monofocal lens implantation. DesignRetrospective cohort study. ParticipantsPatients of an academic institution and a private practice in Saint Louis, Missouri. Inclusion criteria were adults with cataract extraction between January 2010 and April 2021 with monofocal intraocular lens implantation. Exclusion criteria included dementia, <20/40 acuity, visual pathway damage, visual field loss, and significant pathology causing photopsia. MethodsParticipants were surveyed via telephone. ResultsThere were 385 participants (385 eyes), of whom 66 had persistent dysphotopsia (58 positive), 298 had none, and 21 had nonpersistent dysphotopsia. Among the 58 who had positive persistent dysphotopsia, mean Pseudophakic Dysphotopsia Questionnaire 6 (PDQ-6) score was 14.11 (SD, 8.46). There were no significant differences in sex or race. Migraine prevalence was greater among those with dysphotopsia (21.2%) than among those without (11.4%; p = 0.054). History of migraine was associated with an increase in PDQ-6 score of 2.76 points (p = 0.006). Six people in each group had Visual Aura Rating Scale (VARS) scores greater than zero. Mean VARS score was 0.48 for those with dysphotopsia and 0.14 for those without (p = 0.03). History of migraine or increased VARS score, younger age, and female sex were associated with lower satisfaction. ConclusionHistory of migraine was associated with increased dysphotopsia severity and decreased patient satisfaction. Although further study with a larger sample size is warranted, these preliminary results highlight the potential of simple questions to individualize lens choice, reduce the risk of dysphotopsia, and improve patient satisfaction.

MONOVISION VERSUS MULTIFOCAL INTRAOCULAR LENS IMPLANTATION IN CATARACT PATIENTS:A SYSTEMATIC REVIEW AND META-ANALYSIS

Objective: With the aim to increase spectacle independence, recent approaches to repair cataracts include the implantation of premium intraocular lenses (IOLs), such as multifocals. Another approach is monovision techniques achieved by monofocal IOL implantation, which is more cost-effective, although it has the same good outcome as multifocal IOLs. This meta-analysis aimed to compare monovision versus multifocal IOL implantation in cataract patients.&#x0D; Method: Systematic search was performed in April 2023 on six databases (Medline, SCOPUS, Proquest, EBSCO, Embase, and PubMed). Studies were extracted for the following outcome of interest: monovision, multifocal intraocular lens, spectacles independence, visual acuity. All studies published up to April 2023 were reviewed. Cochrane risk of bias tool (RoB 2) and The Risk Of Bias In Non-randomized Studies – of Interventions (ROBINS-I) was used to screen studies for risk of bias where appropriate. A meta-analysis was done to quantify any reported quantitative data.&#x0D; Result: Ten studies satisfying the inclusion criteria were included. Pooling analysis for BCVA and BNVA showed no difference between monovision vs multifocal IOL (95% CI at -0,10 to 0,73; I2=79% (p=0,14) and 95% CI at -0,27 to 1,37; I2=94% (p=0,19), respectively). Spectacle independence showed monovision was inferior to multifocal IOL (RR 0,53; 95% CI at 0,34 to 0,82; I² 83% (p=0,004)).&#x0D; Conclusion: Current evidence showed monovision was comparable to multifocal IOL in terms of visual acuity. While multifocal IOL achieved more spectacle-free patients than monovision, many patients in the monovision group also achieved spectacle-free condition.&#x0D; Keywords: cataract, monovision, multifocal intraocular lens, visual acuity, spectacle independence.

Monovision versus multifocal intraocular lens implantation in cataract patients: a systematic review and meta-analysis

Abstract&#x0D; Introduction &amp; Objectives : Modern cataract surgery technique entails replacing the crystalline lens with an artificial intraocular lens (IOL). While the standard monofocal IOL implantation with monovision technique has been cost- effective and provided patients with good visual acuity, multifocal IOLs present the prospect of spectacle-free vision despite various adverse outcomes. It remained contentious whether multifocal IOLs were superior to monovision. Our review provide an up-to-date assessment of monovision vs. multifocal IOL implantation's visual acuity and spectacle independence following cataract surgery.&#x0D; Methods : A systematic search was performed in April 2023 on six databases (Medline, SCOPUS, Proquest, EBSCO, Embase, and PubMed). Studies were extracted for the following outcome of interest: monovision, multifocal intraocular lens, spectacle independence, and visual acuity. All studies published up to April 2023 were reviewed. Cochrane risk of bias tool (RoB 2) was used to screen studies for risk of bias where appropriate. A meta-analysis was done to quantify any reported quantitative data.&#x0D; Results : Ten studies were identified. Pooling analysis for uncorrected binocular distance visual acuity and binocular uncorrected near visual acuity showed no difference between monovision vs. multifocal IOL (SMD 0,31; 95% CI -0,21 to 0,82 and SMD 0,41; 95% CI -0,58 to 1,40, respectively). Spectacle independence showed monovision was inferior to multifocal IOL (OR 0,22; 95% CI 0,08 to 0,61; heterogeneity I2=75%).&#x0D; Conclusion : Current evidence showed that multifocal IOL had comparable visual acuity to monovision with slightly higher likelihood of being spectacle-free. Despite that, monovision can be an efficacious and affordable option to be implemented in countries with high cataract burden.

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.

Clinical outcomes after implantation of a new monofocal intraocular lens with enhanced intermediate function in patients with preperimetric glaucoma.

We evaluated the clinical outcomes after implantation of a new monofocal intraocular lens (IOL) with enhanced intermediate function in patients with preperimetric glaucoma and compared those with patients without retinal nerve fiber layer (RNFL) defects. All patients were implanted bilaterally a new monofocal IOL with enhanced intermediate function. Patients with bilateral RNFL defects and no glaucomatous visual field defects were classified as the preperimetric glaucoma group. A total of 60 eyes of 30 patients with preperimetric glaucoma were compared with 60 eyes of 30 patients without RNFL defects. Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), defocus curve, contrast sensitivity, and questionnaire were evaluated 1 month and 3 months after surgery. No difference in binocular UDVA, UIVA, and UNVA was evident between the two groups at 1 and 3 months postoperatively. Additionally, there were no significant differences between the two groups regarding the proportion of severe or very severe photic phenomena, such as glare and halos, or the overall satisfaction. Bilateral implantation of a new monofocal IOL with enhanced intermediate function in patients with preperimetric glaucoma demonstrated commensurate clinical outcomes and could be considered a feasible alternative.

Refractive Predictability between Standard and Total Keratometry during the Femtosecond Laser-Assisted Cataract Surgery with Monofocal Intraocular Lens with Enhanced Intermediate Function.

We aimed to compare the accuracy of the intraocular lens (IOL) calculation formula using the standard keratometry (K) and total K (TK) during the femtosecond laser-assisted cataract surgery (FLACS) with a monofocal IOL with enhanced intermediate function using currently used formulas. A retrospective review of 125 eyes from 125 patients who had undergone FLACS with implantation of monofocal IOL with enhanced intermediate function was conducted. The predicted refractive power was calculated using an optical biometer (IOLmaster 700) according to the K and TK in the Barrett Universal II, SRK/T, Haigis, and Holladay 2 formulas. Absolute prediction error (APE) obtained from the actual postoperative refractive outcomes and the refractive error predicted in each formula was compared one month after surgery. Mean APE ranged between 0.29 and 0.39 diopters (D) regardless of the calculation formula and the method of measuring corneal curvature. Significant differences were observed in the APE from the four formulas and the two keratometric measurements (p = 0.014). In a total of 125 eyes from 125 patients, the mean APE was lowest with the Barrett Universal II formula. Across all formulas, both the mean APE and the median APE tended to be lower for K than for TK, although there was no significant difference. Approximately 70% to 80% of the patients were included within 0.5 D of the refractive error across all formulas. The percentage of eyes within 0.5 D of APE outcomes was not statistically different between the K and TK data when using each formula. Keratometric measurements considering the poster corneal curvature did not show any additional advantages when implanting the monofocal IOL with enhanced intermediate function during the FLACS.

Simulations of Multifocal Vision in Patients With Previous Monofocal Intraocular Lens Implantation

Purpose: To evaluate the effectiveness and patient acceptance of multifocal vision simulation in patients with previous monofocal intraocular lens (IOL) implantation, and to explore their willingness-to-pay (WTP) and willingness-to-accept (WTA) based on the perceived advantages and disadvantages of multifocal vision. Methods: Seventeen patients with previous monofocal IOL implantation participated in this cross-sectional study. The SimVis Gekko device (2EyesVision SL) was used to simulate monofocal (Evaluation B) and multifocal (Evaluation C) visual experiences, compared to their existing vision (Evaluation A). Visual acuity at three distances and defocus curves were measured. Patients responded to inquiries about visual quality in each evaluation, bothersomeness of photic phenomena, probability to select the visual experience, and the monetary value they associated with enhanced WTP or diminished WTA visual quality. Results: The simulations underestimated the visual acuity reported for the IOL in existing literature by one or two lines, depending on the testing distance. This underestimation was more pronounced in defocus curves. However, 70.6% of patients were likely or very likely to opt for multifocal vision, indicating they perceived the benefits of multifocality. The WTP for multifocal vision was twice that of monofocal vision, and the WTP/WTA ratio exceeded 1, suggesting the perceived vision benefits outweighed potential drawbacks. Conclusions: Despite underestimating the expected postoperative visual performance, the multifocal simulation enabled patients to perceive the benefits of multifocal vision to some extent. This system could be beneficial in avoiding potential postoperative complaints, but the possible rise in false-positive results should be considered and evaluated in future research. [ J Refract Surg . 2023;39(12):831–839.]

The accuracy of intraocular lens power calculation formulas based on artificial intelligence in highly myopic eyes: a systematic review and network meta-analysis.

To systematically compare and rank the accuracy of AI-based intraocular lens (IOL) power calculation formulas and traditional IOL formulas in highly myopic eyes. We screened PubMed, Web of Science, Embase, and Cochrane Library databases for studies published from inception to April 2023. The following outcome data were collected: mean absolute error (MAE), percentage of eyes with a refractive prediction error (PE) within ±0.25, ±0.50, and ±1.00 diopters (D), and median absolute error (MedAE). The network meta-analysis was conducted by R 4.3.0 and STATA 17.0. Twelve studies involving 2,430 adult myopic eyes (with axial lengths >26.0 mm) that underwent uncomplicated cataract surgery with mono-focal IOL implantation were included. The network meta-analysis of 21 formulas showed that the top three AI-based formulas, as per the surface under the cumulative ranking curve (SUCRA) values, were XGBoost, Hill-RBF, and Kane. The three formulas had the lowest MedAE and were more accurate than traditional vergence formulas, such as SRK/T, Holladay 1, Holladay 2, Haigis, and Hoffer Q regarding MAE, percentage of eyes with PE within ±0.25, ±0.50, and ±1.00 D. The top AI-based formulas for calculating IOL power in highly myopic eyes were XGBoost, Hill-RBF, and Kane. They were significantly more accurate than traditional vergence formulas and ranked better than formulas with Wang-Koch AL modifications or newer generations of formulas such as Barrett and Olsen. https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022335969.

Katlanabilir Göz İçi Lens İmplantasyonunda Viskoimplantasyon ve Hidroimplantasyon Tekniklerinin Anatomik ve Fonksiyonel Sonuçlarının Karşılaştırılması

Objective: The aim of this study was to compare the anatomical and functional results of viscoimplantation and hydroimplantation techniques in monofocal foldable intraocular lens implantation.&#x0D; Materials and Methods: The study included 387 patients older than 50 years who underwent surgery for senile cataract. They were divided into two subgroups as hydroimplantation (group 1) and viscoimplantation (group 2).&#x0D; Results: The mean implantation time was 397.5±44.3 s in group 1 and 580±105.1 s in group 2. During the follow-up period (12 months), 4 (2.1%) patients in group 1 and 28 (14.6%) patients in group 2 developed posterior capsular opacification. The implantation time was shorter and the rate of posterior capsular opacification was lower in group 1 compared to group 2 (p

Short-term clinical outcomes after implantation of monofocal intraocular lens with enhanced intermediate function in eyes with epiretinal membrane

Our study evaluated the clinical outcomes after implantation of a monofocal intraocular lens (IOL) with enhanced intermediate function in eyes with epiretinal membrane (ERM). Patients with preexisting ERM who underwent cataract surgery with implantation of monofocal IOL with enhanced intermediate function were included retrospectively. According to the ERM grade and central subfield thickness (CST) obtained from preoperative optical coherence tomography, patients were divided into non-fovea-involving and fovea-involving ERM groups. At 1 month after surgery, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), contrast sensitivity, defocus curve, and satisfaction questionnaire were evaluated. Postoperative clinical findings were compared with age-matched controls without ERM. A total of 50 patients’ eyes (28 and 22 in the non-fovea-involving and fovea-involving ERM groups, respectively) were compared with 42 control eyes. One month post-surgery, significant differences in UDVA, CDVA, and CST (corrected P was < 0.001, = 0.001, and < 0.001, respectively) were observed between the fovea-involving ERM and control group; however, no significant differences in UIVA and UNVA were observed between the two groups. Contrast sensitivity showed inferior results in the fovea-involving group without significance. Photic phenomena were reported less in the fovea-involving group than in the non-fovea-involving group. More than 70% of patients in both ERM groups were satisfied. Implantation of monofocal IOL with enhanced intermediate function could be a good option for patients with ERM that need intermediate vision.

Residual astigmatism calculation method in implantation of a monofocal non-toric intraocular lens

BACKGROUND: Nowadays, phacoemulsification with monofocal non-toric intraocular lens (IOL) implantation is a most common procedure in cataract surgery. Residual astigmatism has an important impact on uncorrected visual acuity. Therefore, development of residual astigmatism assessment method is relevant and may expand indications for toric IOL implantation.&#x0D; AIM: To develop a method for calculating residual astigmatism in cases when non-toric monofocal IOL is implanted.&#x0D; MATERIALS AND METHODS: The study included 351 patients (391 eyes, 105 men and 246 women, mean age 75.3 8.5 years) who underwent phacoemulsification with non-toric monofocal IOL implantation. Biometry was performed by IOL-Master 500, postoperative refraction was assessed by autorefractometer Topcon-8800.&#x0D; RESULTS: Using regression analysis, where the depended variable was residual astigmatism, and preoperative corneal astigmatism and steep corneal meridian axis location served as covariates, we revealed a significant relation (p 0.001) with medium strength (R2 = 0.51) between these parameters, which formed residual astigmatism calculation formula for monofocal non-toric IOL implantation: Ast = KAst 0.71 0.62 sinKax + 0.73.&#x0D; CONCLUSIONS: This formula may allow to evaluate the residual astigmatism and justify a decision on the advisability of toric IOL implantation.

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

IRIS® Registry (Intelligent Research In Sight) Analysis of the Incidence of Monovision in Cataract Patients with Bilateral Monofocal Intraocular Lens Implantation.

To determine the incidence of pseudophakic monovision among patients bilaterally implanted with monofocal intraocular lenses (IOLs) and to characterize the distribution of myopic offsets achieved. This retrospective database study included data on patients receiving care from ophthalmologists who contributed to the Academy IRIS® (Intelligent Research In Sight) Registry. Anonymized data were collected, including patient age, ethnicity, procedure data (CPT code, date, laterality), and postoperative manifest refractive spherical equivalent (MRSE) in both eyes implanted with monofocal or monofocal toric IOLs. No data regarding IOL manufacturer, model, or power were collected. One primary outcome measure was the percentage of patients achieving monovision (defined as emmetropia within ±0.25 diopters [D] in one eye and a myopic offset of ≥0.50 D in the fellow eye) among all patients receiving bilateral monofocal IOLs at the time of cataract surgery between January 1, 2016, and September 1, 2019, with at least 90 days of follow-up. Other primary outcomes included the distribution and frequency of myopic offsets (anisometropia) between eyes. Of the 16,765 people receiving bilateral monofocal IOLs within the study period, 4796 (28.6%) achieved emmetropia in at least one eye, as defined by an MRSE within ± 0.25 D. The incidence of monovision among these patients was 34.2% (1638/4796). One-quarter (24.7%; 405/1638) of patients who achieved monovision had a myopic offset between 0.50 and 0.74 D, with more than one-third (35.2%; 576/1638) falling within 0.75-1.24 D and 18.0% within 1.25-1.74 D. A myopic offset ≥1.75 D was observed in 22.1% (362/1638) of patients who achieved monovision. Pseudophakic monovision for presbyopia correction was achieved in ~34% of patients in the IRIS Registry bilaterally implanted with monofocal IOLs, with myopic offsets typically ranging from 0.5 to 1.24 D.

Accuracy of refractive outcomes using standard or total keratometry for intraocular lens power formulas in conventional cataract surgery

PurposeTo evaluate if total keratometry (TK) is better than standard keratometry (K) for predicting an accurate intraocular lens (IOL) refractive outcome in virgin eyes using four IOL power calculation formulas.Methods447 eyes that underwent monofocal intraocular lens implantation were enrolled in this study. IOLMaster 700 (Carl Zeiss Meditech, Jena, Germany) was used for optical biometry. Prediction error (PE), mean absolute prediction error (MAE), median absolute prediction error (MedAE), proportions of eyes within ± 0.25 diopters (D), ± 0.50 D, ± 0.75 D, ± 1.00 D, ± 2.00 D prediction error, and formula performance index (FPI) were calculated for each K- and TK-based formula.ResultsOverall, the accuracy of each TK and K formula was comparable. The MAEs and MedAEs showed no difference between most of the K-based and the TK-based formula; only the MAE of TK was significantly higher than that of K using the Haigis. The percent of eyes within ± 0.25 D PE for TK was not significantly different from that for K. The analysis of PE across various optical dimensions revealed that TK had no effect on the refractive results in eyes with different preoperative axial length, anterior chamber depth, keratometry, and lens thickness. The K-based Barrett Universal II formula performed excellently, showed the leading FPI score, and had the best refractive prediction outcomes among the four formulas.ConclusionTK and K can be used for IOL power calculation in monofocal IOL implantation cataract surgery in virgin eyes, as both are comparable. In all investigated formulas, the predictive accuracy of TK-based formulas is not superior to that of standard K-based formulas.