Multifocal Intraocular Lens Research Articles

TIMELY REFRACTIVE LANCESECTOMY SHOULD BE CONSIDERED AS A PROPHYLACTIC TREATMENT FOR OPENCLOSURE GLAUCOMA IN PATIENTS WITH MULTIPLE CYSTS OF THE IRIDOCILIARY PROCESSES

This article presents a clinical case of bilateral ophthalmic hypertensin a patient at the presbyopic age with cysts of iridocyliary processes. A bilateral lentectomy was carried out with the implant of multifocal IOLs for refractive purposes. To evaluate the сlinico-functional performance of the treatment, an ultrasound biopsy of the anterior segment of the eye was performed and a hydrodynamic assessment was carried out before and after the operation. The remote results of the treatment allow to conclude that timely extraction of native lens can significantly reduce the risk of open-closure glaucoma in patients with cysts of iridocyliary processes.

Clinical outcomes with a new diffractive multifocal intraocular lens optimized by the dynamic light utilization algorithm.

To evaluate the refractive outcomes, optical performance, and the quality of vision in patients implanted with a new diffractive intraocular lens (IOL), the Intensity Hanita. This observational, prospective, longitudinal study included 64 eyes underwent bilateral cataract surgery with the Intensity IOL (Hanita Israel) implantation. Main outcome measures after 6 months were the following visual acuities (VAs) of uncorrected and corrected distance (UDVA and CDVA), uncorrected and distance corrected intermediate VAs (UIVA and DCIVA), uncorrected and distance corrected near (UNVA and DCNVA), refraction, slitlamp biomicroscopy, defocus curve (DFC),high ocular aberrations (HOA), contrast sensitivity (CS), optical quality, subjective quality of vision (QoV) and near activity visual questionnaires (NAVQ). Sixty-six percent of eyes having UDVA 0.10 logMAR or better. DFC showed maximum vision at distance (0.02 ± 0.07 LogMAR at 0.0 D), with flat decline through intermediate and near vision (0.11 ± 0.08 LogMAR at -1.5 D and 0.12 ± 0.12 at -2.5 D). No significant changes in CS were found (all spatial frequencies, p ≥ 0.06). The RMS of HOA, coma, trefoil, and SA were 0.21 ± 0.10, 0.10 ± 0.06, 0.11 ± 0.07, and 0.00 ± 0.04 μm and the Strehl ratio was 0.12 ± .04 at 6 months. Subjective symptoms (halos and glare) were reported mild but well tolerated, not causing significant disturbance in daily activities. The NAVQ showed high levels of satisfaction performing daily near-vision tasks. The Hanita Intensity diffractive IOL successfully restores all distances of vision. The flat profile of the monocular defocus curve confirms the five-foci distribution principle that provides vision at all ranges while increasing the depth of focus.

Correlation of angle kappa and angle alpha on visual outcomes in eyes implanted with three types of multifocal intraocular lenses.

To evaluate the correlation between preoperative, postoperative, and change in angle kappa and alpha to visual outcomes following implantation of three multifocal intraocular lenses. This is a retrospective study which included 122 eyes of 61 patients. There were 38 eyes in the Synergy (Johnson & Johnson, USA) group and 42 eyes each from both the Panoptix (Alcon Laboratories, USA) and FineVision (Physiol BVI, Belgium) groups. Visual outcome parameters (uncorrected distance, intermediate, near vision, halo and starburst) and angle kappa and alpha were recorded preoperatively and at three months postoperatively. The preoperative, postoperative and the amount of change in angle kappa and alpha were correlated to visual outcomes and photic phenomena among the three different diffractive trifocal IOLs. There were no significant differences in the preoperative and postoperative magnitude of angle kappa and alpha among the Synergy, Panoptix, and FineVision groups. There was no significant correlation between the preoperative and postoperative magnitude, and change in angle kappa and alpha with the postoperative uncorrected distance, intermediate and near visual acuity, and halo and starburst scores of the three different diffractive IOLs. The frequency of eyes with greater than 0.5mm angle kappa and alpha values were low. Visual outcomes can be good even in eyes in which the angle kappa and alpha were greater than 0.5mm. The newer diffractive multifocal IOLs were observed to be more tolerant to low and intermediate levels of angle kappa and alpha.

Comparison of visual outcomes in patients with cataracts and high myopia after implantation of a zonal refractive multifocal or diffractive bifocal intraocular lens

This study compares the optical quality of zonal refractive multifocal and diffractive bifocal intraocular lenses (IOLs) and visual outcomes after implantation in 93 patients(93 eyes) with cataracts and high myopia. A retrospective analysis was conducted to measure visual acuity at far, intermediate, and near distances, defocus curves, wavefront aberrations, modulation transfer function (MTF), a Quality of Vision questionnaire (QoV) and visual quality self-evaluation were examined at 3 months. The results demonstrated the ZMB group showed better uncorrected near visual acuity (P < 0.01), and the MF15 group showed better uncorrected intermediate visual acuity (P < 0.001). The ZMB group provided better MTF than the MF15 group (P < 0.01) but demonstrated a worse QoV score, especially for the severity of glare, halo, and starburst (P < 0.05). The satisfaction score and spectacle independence rate in the ZMB group were higher than in the MF15 group (P < 0.01). LS-313MF15 and TecnisZMB00 offered excellent visual restoration, stable distance visual acuity, and good subjective visual function.

Reading Performance Following Contralateral Implantation of an Extended Depth of Focus (EDOF) IOL and a Hybrid EDOF Multifocal IOL.

To assess objective reading performance at intermediate and near distances using the Salzberg Reading Desk (SRD) (SRD Vision) in patients with cataract who underwent the implantation of a diffractive extended depth of focus intraocular lens (EDOF IOL) in the dominant eye and a hybrid multifocal EDOF IOL in the non-dominant eye. This prospective, non-comparative, interventional study included 46 eyes of 23 patients with cataract who underwent bilateral cataract surgery with implantation of the DFR00V Tecnis Synergy IOL (Johnson & Johnson Surgical Vision) in the non-dominant eye and the DXR00V Tecnis Symfony OptiBlue IOL (Johnson & Johnson Surgical Vision) in the dominant eye. At postoperative 6 months, the Salzburg Reading Desk was used to assess distance-corrected reading performance at near and intermediate distances. Although the monocular reading acuity at the preferred intermediate distance was statistically significantly better in the eyes implanted with the DXR00V IOL, it was better with the DFR00V IOL at preferred near distances. The mean binocular distance-corrected preferred intermediate and near reading acuity was 0.07 ± 0.09 (20/23) and 0.13 ± 0.09 (20/27) logarithm of the minimum angle of resolution, respectively. Other parameters of reading performance, such as reading speed, reading distance, reading time, and smallest scale log print size, were similar between the two IOL groups when assessed monocularly. Implanting a DFR00V IOL in the non-dominant eye and a diffractive DXR00V IOL in the dominant eye resulted in excellent binocular reading acuity and speed at intermediate and near distances. [J Refract Surg. 2024;40(11):e778-e782.].

Evaluation of Long-term Rotational Stability and Functional Performance of Two Toric Multifocal IOL Models Beyond 5 Years.

To assess visual outcomes and stability of lens alignment more than 3 years after implanting either the AT Lisa Tri Toric (Carl Zeiss Meditec) or the Acrysof IQ Restor Toric (Alcon Laboratories, Inc) intraocular lens (IOL). Patients who had received either the AT Lisa Tri Toric or the Acrysof IQ Restor Toric IOL were included in the study. The average follow-up period was 5.4 years for the AT Lisa Tri Toric group and 7.9 years for the Acrysof IQ Restor group. The examinations covered included: subjective refraction, monocular and binocular corrected and uncorrected visual acuity at far (4 m), intermediate (75 cm), and near (40 cm) distances, binocular best-corrected defocus curve analysis (4 m), contrast sensitivity evaluation, assessment of IOL axial position, and presence of positive dysphotopsia. A total of 42 eyes were evaluated. Both groups exhibited good long-term lens axial stability. The AT Lisa Tri Toric group had a mean misalignment of 4.8 ± 3.2° from the preoperatively determined axis, whereas the Acrysof IQ Restor Toric group had an average misalignment of 5.4 ± 4.5° (no statistically significant difference, P = .578). Mean achieved spherical equivalent was -0.19 ± 0.36 diopters (D) for the AT Lisa Tri Toric group and 0.15 ± 0.39 D for the Acrysof IQ Restor Toric group. In the AT Lisa Tri Toric group, 18 eyes (72%) achieved an uncorrected distance visual acuity of 0.10 logarithm of the minimum angle of resolution (20/25 Snellen) or better, compared to 15 eyes (88%) in the Acrysof IQ Restor Toric group. Overall, 21 eyes (84%) in the AT Lisa Tri Toric group and 14 eyes (83%) in the Acrysof IQ Restor Toric group achieved a postoperative spherical equivalent refraction between -0.50 and +0.50 D. Both the AT Lisa Tri Toric and the Acrysof IQ Restor Toric IOLs showed good long-term stability and functional outcomes. They proved to be effective options for restoring vision at far, intermediate, and near distances, providing a viable solution for presbyopia correction even several years after implantation. [J Refract Surg. 2024;40(11):e845-e853.].

Intraocular lens simulator using computational holographic display for cataract patients.

To develop and validate a holography based vision simulator for the demonstration of expected postoperative vision corresponding to monofocal and multifocal intraocular lenses (IOL) to cataract patients before surgery. An artificial eye model is used to measure the optical performance of different IOL types. The resultant aberrations and degradations are then modeled using phase holograms and shown to subjects on a holographic display. We measure the contrast and resolution loss, halos around the light sources, and point spread function (PSF) corresponding to three different IOLs. We tested the holography based vision simulator on 13 healthy subjects and 6 cataract patients. Monofocal, bifocal, and trifocal IOLs exhibited a contrast decrease of 5%, 42%, and 45% and a resolution limit of 4.49, 4.00, and 4.00 lp/mm (using 0.05 MTF criteria), respectively. Monofocal IOLs have the best resolution and contrast at the optimal focus distance, and multifocal lenses offer extended depth-of-field but exhibit prominent halos and reduced contrast/resolution. We confirmed that the visual functions of IOLs could be successfully modeled using phase holograms and simulated using a holographic display without using a physical IOL. Patients can experience the effects of different IOL options prior to surgery, which helps with IOL selection, expectation management, and patient satisfaction.

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.

Подходы в совершенствовании нормативной базы в отношении применения мультифокальных интраокулярных линз при хирургическом лечении катаракты

Ultrasound phacoemulsification with intraocular lens (IOL) implantation is the “gold standard” for cataract treatment. Considering the existing requirements for the quality of vision after surgery, there is an increasing demand from patients for IOL implantation, which provides comfortable vision not only at a long distance, but also at a short one without the use of reading glasses (IOL with multifocal properties). The analysis of the existing regulatory framework regarding the possibility and obligation of using this medical product in the provision of specialized medical care – surgical treatment of cataract within the framework of the state guarantee program shows the possibility of using this consumable material without the obligation of the medical organization to consider the wishes of the patient. The change in the structure of the payment tariff for medical care for patients with cataract in 2023, the reduction in the tariff for providing specialized medical care to patients with uncomplicated forms affected the availability of multifocal IOL for patients without specifying the way to obtain this type of service, which makes it relevant to analyze approaches to improving the regulatory framework regarding the use of multifocal intraocular lenses in cataract surgical treatment. There are unsettled clinical, organizational, and economic issues regarding the use of multifocal intraocular lenses (artificial lenses) in the surgical treatment of cataract. There are various approaches (clinical-organizational, economic, legal, information) to improving the regulatory framework, but the approach of decision makers should be complex based on a comprehensive assessment of the economic, clinical, and technological components. Approaches are only a means to achieve a goal: the development of a multifunctional system of state guarantees in the provision of medical services, rational use of available resources.

Visual and patient reported outcomes provided by a refractive multifocal intraocular lens based on continuous transitional focus

PurposeTo analyze the quality of vision of patients implanted bilaterally with the multifocal Precizon Presbyopic intraocular lens (IOL), as well as to evaluate the visual performance provided by the lens.SettingVissum Miranza Alicante.DesignProspective multicenter study.Methods56 patients (mean age 65.0 ± 8.7 years old) underwent bilateral implantation with multifocal Precizon Presbyopic IOL. The quality of vision was assessed by a quality of vision questionnaire at 6 months after the implantation procedure, a complete eye examination was also performed including visual and refractive measurements, defocus curve and contrast sensitivity assessment. Visual and refractive variables were compared in preoperative, 3-month postoperative and 6-month postoperative visits by Wilcoxon test.ResultsThe quality of vision analysis showed the absence of severe glare and severe haloes in all evaluated patients. Likewise, non-symptoms of glare, haloes and starbursts were seen in 75%, 68%, and 55% of subjects, respectively. Efficacy and safety index was 1.26 and 1.42, respectively. The 6-month postoperative binocular uncorrected distance visual acuity and near uncorrected visual acuity were 0.00 ± 0.09 and 0.20 ± 0.13 logMAR, respectively. Mean spherical equivalent was 0.29 ± 0.45 D.ConclusionsThe Precizon Presbyopic NVA IOL (OPHTEC BV) provides a suitable quality of vision with a low rate of disturbance photic phenomena induction, as well as an excellent visual performance at main distances of sight accomplishing the visual demands of the majority of patients.

Ten-year trends of delayed sequential bilateral cataract surgery (DSBCS) in Sweden: a register-based study.

To study the trend of delayed sequential bilateral cataract surgery (DSBCS) in Sweden in the past decade. This register-based cohort study utilized data from the Swedish National Cataract Register (NCR) from 2010 through 2019. Register files from patients who underwent cataract surgery in both eyes during the study period were linked using their social security numbers. Bilateral surgeries on different days were classified as DSBCS. The study investigated the association between DSBCS within 3months and several variables with stratification and multivariate logistic regression. The following variables were used: operation year, region, private or public unit, age, sex, indication for surgery, type of intraocular lens (IOL), preoperative visual acuity, ocular comorbidity, posterior capsule rupture and perioperative difficulties. During the study period, 368,106 patients underwent DSBCS, of which 62.6% (n = 230,331) had bilateral surgery within 3months. The median time between the surgeries was 61days (interquartile range 26-161days), showing regional variations. Better visual acuity in the fellow eye, presence of ocular comorbidity, various perioperative events and complications were associated with longer time to surgery of the second eye. Conversely, cataract surgery in more recent years, private clinic, increasing age, anisometropia and multifocal IOL were associated with shorter timespan between surgeries. The majority of DSBCS were conducted within a 3-month timeframe, with the interval between surgeries decreasing throughout the study period. Several rational factors were associated with the time difference, in addition to regional variations. Many patients would probably benefit from less time between the surgeries, and we encourage a clinical practice taking the whole patient's visual function into account.

Efficacy and comfort following the implantation of extended depth of focus, multifocal, and monofocal intraocular lenses in cataract patients

BackgroundExtended depth of focus (EDOF) and multifocal (Multi) intraocular lenses (IOL) can provide a fixed distance of near vision, which may result in some discomfort for patients who prefer different near distances. The aim of this study was to compare the vision, comfortable near distance (CND) and visual comfort in patients who underwent implantation of EDOF, Multi, and monofocal (Mono) IOLs.MethodsA total of 100 eyes were implanted with Tecnis ZXR00, ZMB00 or ZCB00 IOLs. Uncorrected distance, intermediate, and near visual acuity (UDVA, UIVA, and UNVA, respectively), corrected distance visual acuity (CDVA), the fluctuations of CND, the ability to see at comfortable or standard near distance and visual comfort were evaluated at 3-month postoperative.ResultsAt 3 months postoperative, the EDOF and Multi groups showed non-inferiority compared to the Mono group in the UDVA (P > 0.05) and CDVA (P > 0.05) but superiority in the UNVA (P < 0.001). The UIVA was better in the EDOF group, with comparable results for the Multi and Mono groups. There was no difference in preoperative and postoperative CND in the three groups. The CND visual acuity (CNDVA) was lower than the UNVA in the three groups, especially in the EDOF and Multi groups (P < 0.05). The CND effectively improved patients’ near visual comfort and visual clarity, except for one patient in the Multi group who complained of severe fatigue and was unable to tolerate the experience at month 3.ConclusionThe EDOF and Multi IOLs achieved excellent visual quality and superior UNVA compared to the Mono IOL, but the CNDVA was significantly inferior to the UNVA. Patients’ near visual experience can be effectively improved at their CND.

Clinical Outcomes after Implantation of a Novel Binocular Complementary Extended Depth-of-Focus Intraocular Lens Compared to Bilateral Low Near-Add Multifocal Intraocular Lenses

Introduction: Nowadays, patients expect to be less spectacle dependent at all distances after cataract surgery. However, all intraocular lens (IOL) models that currently offer this function can also have negative visual effects. Aim of this study was therefore to compare the visual function performance of a novel and a conventional IOL solution for multifocality. Methods: Patients scheduled for bilateral cataract surgery were randomized to receive one of two different IOL combinations: either a binocular complementary extended depth-of-focus IOL set or a low near-add MIOL. Patients had visual acuity (VA) assessment at distance, intermediate, and near as well as evaluation of contrast sensitivity, halometry, and reading performance. Results: In total, 56 eyes of 28 patients were enrolled. At 6 months, there were no statistically significant differences in binocular VA between the ARTIS SYMBIOSE and the AT LARA. Contrast sensitivity, measured binocularly, at 1.5 cycles per degree under photopic conditions without glare was 1.54 logCS with the ARTIS SYMBIOSE and 1.43 logCS with the AT LARA (p = 0.046), under mesopic conditions with glare at 1.5 and 3 cycles per degree 1.31 logCS and 1.28 logCS with the ARTIS SYMBIOSE, respectively, compared to 0.58 logCS and 0.51 logCS with the AT LARA (p = 0.002; p = 0.006). Binocular halos and reading performance between both groups were similar. Conclusion: There were no significant differences between both groups in VA at different distances, reading ability, or halometry. The contrast sensitivity at low spatial frequencies was better in the ARTIS SYMBIOSE group under photopic conditions without glare as well as mesopic conditions with glare, which could potentially improve quality of vision with these IOLs, especially under mesopic conditions.

Objective quantification of posterior capsule opacification using swept-source anterior segment optical coherence tomography.

To objectively quantify posterior capsule opacification (PCO) using swept-source anterior segment optical coherence tomography (SS-ASOCT) in pseudophakic eyes. Zhongshan Ophthalmic Center, Guangzhou, China. Prospective cross-sectional study. One hundred and eighty eyes with PCO (37 multifocal intraocular lenses [MfIOLs] and 143 monofocal intraocular lenses [MoIOLs]) were enrolled. The PCO Irregular Degree (PID), defined to evaluate the surface irregularity of PCO, the average and maximum thickness of PCO (AT-PCO, MT-PCO) were applied to quantify PCO based on SS-ASOCT (CASIA2) images. Corrected distance visual acuity (CDVA), high order aberrations (HOAs), modulation transfer function (MTF) and Strehl ratio were recorded. The associations between SS-ASOCT parameters and visual function parameters were assessed by Spearman's correlation analysis. PID, AT-PCO and MT-PCO showed significant correlations with CDVA, Strehl ratio and HOAs (CDVA: r = 0.702, 0.741, 0.736; Strehl ratio: r = -0.746, -0.719, -0.740; HOAs: r = 0.762, 0.734, 0.752). The correlations of these three parameters with Strehl ratio and HOAs were significantly higher than those of clinical PCO grading with Strehl ratio and HOAs (all P < 0.05). Particularly, PID demonstrated notable correlations with Strehl ratio and HOAs. In addition, patients with MfIOLs presented worse Strehl ratio and HOAs than those with MoIOLs after matching age, PID, AT-PCO and MT-PCO. This study provides a novel method for objectively quantifying PCO using successive cross-sectional SS-ASOCT images. AT-PCO, MT-PCO and PID are presented as new indicators to document PCO severity, with PID offering a unique perspective by considering the irregularity aspect of PCO.

Stereopsis Following Implantation of Presbyopia-Correcting Intraocular Lenses: A Narrative Review.

Recent advancements in cataract surgery have broadened its scope from mere vision restoration to include correction of refractive errors and presbyopia. This evolution has introduced multifocal and extended depth-of-focus (EDOF) intraocular lenses (IOLs), allowing enhanced vision across multiple distances. However, the influence of these advanced IOLs on stereopsis remains controversial. Factors influencing stereopsis after surgery include visual acuity, interocular differences, residual astigmatism, and the type of IOL, etc. Binocular vision integration and neuroadaptation further affect stereopsis, especially in cases of presbyopia-correcting IOLs. It is widely acknowledged that bilateral implantation of presbyopia-correcting IOLs yield superior stereopsis compared to unilateral implantation. However, there remains no consensus on whether binocular implantation of multifocal or monofocal IOLs provides superior stereopsis. Most studies suggest no significant difference in stereopsis between these two types of implants. Among different types of multifocal IOLs, refractive multifocal IOLs may offer better stereopsis than diffractive multifocal IOLs when implanted bilaterally. Emerging EDOF and hybrid multifocal-EDOF IOLs also demonstrate promising postoperative stereopsis. Additionally, a mix-and-match strategy with different types of IOLs implanted in each eye may result in interocular differences in visual acuity at certain distances, potentially affecting stereopsis. Nevertheless, with appropriate selection, most patients can achieve satisfactory postoperative stereopsis. This review synthesizes current literature on the effects of presbyopia-correcting IOLs on postoperative stereopsis recovery following cataract surgery. Studies on stereopsis outcomes with different IOLs have yielded mixed results, urging further investigation for optimized surgical strategies and patient outcomes.

A Multi Comparison of 8 Different Intraocular Lens Biometry Formulae, Including a Machine Learning Thin Lens Formula (MM) and an Inbuilt Anterior Segment Optical Coherence Tomography Ray Tracing Formula.

A comparison of the accuracy of intraocular lens (IOL) power calculation formulae, including SRK/T, HofferQ, Holladay 1, Haigis, MM, Barrett Universal II (BUII), Emmetropia Verifying Optical (EVO), and AS-OCT ray tracing, was performed. One hundred eyes implanted with either the Rayone EMV RAO200E (Rayner Intraocular Lenses Limited, Worthing, UK) or the Artis Symbiose (Cristalens Industrie, Lannion, France) IOL were included. Biometry was obtained using IOLMaster 700 (Carl Zeiss Meditec AG, Jena, Germany) and MS-39 AS-OCT (CSO, Firenze, Italy). Mean (MAE) and median (MedAE) absolute errors and percentage of eyes within ±0.25D, ±0.50D, ±0.75D, and ±1.00D of the target were compared, with ±0.75D considered a key metric. The highest percentage within ±0.75D was found with MM (96%) followed by the Haigis (94%) for the enhanced monofocal IOL. SRK/T (94%) had the highest percentage within ±0.75D, followed by Holladay 1, MM, BUII, and ray tracing (all 90%) for the multifocal IOL. No statistically significant difference in MAE was found with both IOLs. EVO showed the lowest MAE for the enhanced monofocal and ray tracing for the multifocal IOL. EVO and ray tracing showed the lowest MedAE for the two respective IOLs. A similar performance with high accuracy across formulae was found. MM and ray tracing appear to have similar accuracy to the well-established formulae and displayed a high percentage of eyes within ±0.75D.

Application of objective optical quality analysis system in guiding early posterior capsule opacification laser treatment: An observational study.

In the present study, we aimed to demonstrate the objective guiding role of objective scatter index (OSI) in patients with early stage posterior capsule opacification (PCO), especially in patients with multifocal intraocular lens (IOL) implantation. A prospective randomized case analysis was conducted on elderly patients experiencing PCO, exhibiting best-corrected visual acuity (BCVA) below 0.2 LogMAR. Exclusion criteria comprised patients with diabetes, glaucoma, high myopia, trauma, endothelial dystrophy, maculopathy or prior eye surgery affecting visual acuity. The main observational indicators were patient gender, age, post-cataract surgery duration, BCVA (LogMAR), and OSI values. For patients undergoing laser posterior capsulotomy, meticulous documentation of pre-laser OSI values and post-laser OSI values was undertaken. Subjective visual quality was then compared using the Chinese version visual function index-14 (VF-14-CN). The study comprised 65 eyes from 56 patients. PCO developed, on average, 2.06 ± 0.94 years (ranging from 0.5 to 4 years) after the initial surgery, with the OSI consistently exceeding 3.0. Among these cases, only 40 eyes underwent laser posterior capsulotomy using Nd:YAG laser, including 26 eyes implanted with monofocal IOLs and 14 eyes implanted with multifocal IOLs. Following laser posterior capsulotomy for early-stage secondary cataracts, there was a significant decrease in OSI values compared to the presurgery state, coupled with a notable increase in VF-14-CN scores. Among the 14 cases with multifocal IOL implantation, pre-laser VF-14-CN scores were lower compared to those with monofocal IOLs. Post-laser posterior capsulotomy, patients reported a marked improvement in self-perceived symptoms. The OQAS functioned as an objective assessment metric for the laser treatment of early stage PCO. In cases involving multifocal IOL implantation, the visual disturbance caused by PCO was more pronounced, underscoring the significance of OSI as a valuable guide for laser treatment in these patients.

Outcomes of Rhegmatogenous Retinal Detachment Repair in Pseudophakic Eyes With Multifocal vs Monofocal Intraocular Lenses

Outcomes of Rhegmatogenous Retinal Detachment Repair in Pseudophakic Eyes With Multifocal vs Monofocal Intraocular Lenses

Functional Outcomes After Refractive Lens Exchange With Implantation of a Glistening-Free Diffractive Trifocal Intraocular Lens

PurposeTo evaluate visual outcomes and patient-reported results after bilateral femtosecond-laser assisted refractive lens exchange (RLE) with the implantation of a diffractive trifocal intraocular lens (IOL). DesignProspective interventional case series MethodsA study of 27 patients (54 eyes) implanted with the Clareon PanOptix (Alcon) multifocal IOL during femtosecond laser assisted RLE in a university hospital setting. The uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuity at 60cm, uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity at 40cm and 33cm were evaluated at three months postoperatively and compared with the preoperative values. In addition, we assessed the postoperative defocus curve, mesopic and photopic contrast sensitivity, and patient-reported spectacle independence. ResultsThe mean postoperative binocular UDVA was -0.02±0.06 logMAR and CDVA was -0.11±0.05 logMAR. The UIVA was -0.07±0.05 logMAR and DCIVA was -0.07±0.07 logMAR. The UNVA at 40cm was 0.03±0.09 logMAR and DCNVA was -0.02±0.06 logMAR; and, at 33cm UNVA was 0.14±0.10 logMAR and DCNVA was 0.11±0.08 logMAR. In comparison to the preoperative binocular CDVA (-0.12±0.08 logMAR), no statistically significant change was observed (p=1.0), while all the other binocular visual acuities improved (p<0.01). In the mean binocular defocus curve, the visual acuity was better than 0.10 logMAR in the range between +0.5 D and -3.0 D. The mean contrast sensitivity was within the normal range, and most patients reported complete spectacle independence. ConclusionThe RLE surgery improved uncorrected visual acuity at far, intermediate and near distances without negatively affecting the CDVA. Patients achieved a high level of spectacle independence.

Evaluation of visual and optical quality following phacoemulsification cataract surgery with diffractive multifocal intraocular lens implantation: An observational study.

The assessment of patient satisfaction following cataract surgery is heavily reliant on the evaluation of visual quality, specifically after the placement of diffractive multifocal intraocular lenses (MIOLs) under varying pupil conditions. The objective of this study was to examine the visual and optical clarity following cataract phacoemulsification and the use of Tecnis ZMB00 MIOL for implantation. The study involved 116 individuals (135 eyes) who received cataract phacoemulsification and underwent Tecnis ZMB00 MIOL implantation. Assessments were conducted 1 week and 3 months after the surgery. These assessments involved measuring uncorrected and corrected visual acuity for distant, intermediate, and near vision. Additionally, scatter light values and wavefront aberrations were measured under different aperture settings of 3 and 5 mm. There was no noticeable disparity in visual acuity between 1 week and 3 months after the surgery. After 3 months of surgery, there was a considerable decrease in scatter light values and spherical aberrations compared to the values observed 1 week after surgery, under the setting of a 5 mm aperture. Moreover, the modulation transfer function values showed a significant rise after 3 months following the surgery, particularly under the 5 mm aperture condition. The most substantial increase was observed at the intermediate spatial frequency of 20 cycles per degree (cpd), in comparison to the values obtained 1 week after the operation. The combination of cataract phacoemulsification and Tecnis ZMB00 MIOL implantation yielded favorable visual acuity at various distances for patients. Furthermore, enhancements in the measurements of scattered light, higher-order aberrations, and modulation transfer function values were noted 3 months after the surgical procedure, specifically under the condition of a 5 mm pupil. These findings suggest an increase in visual clarity and night vision to a certain degree.