Traditional Intraocular Lens Research Articles

Accuracy of Modern and Traditional Intraocular Lens Power Calculation Formulas in Pediatric Cataract Surgery.

To compare the accuracy of modern intraocular lens (IOL) power calculation formulas with that of older formulas, such as SRK/T and Hoffer Q, in pediatric cataract surgery. This retrospective study included 100 eyes of 100 children who underwent routine cataract surgery with primary IOL implantation in a bag. This study used four IOLMaster 700 integrated formulas: SRK/T, Hoffer Q, Haigis, and Barrett Universal II (BUII). In addition, the following formulas were used: EVO 2.0, Hill RBF 3.0, Hoffer QST, Kane, and PEARL DGS, which are available online. There was a statistically significant difference between SRK/T and most other formulas, except for Hoffer Q, Hoffer QST, and BUII (p < 0.05). SRK/T yielded the lowest median absolute error (MedAE) of 0.63 D. This was followed by the BUII (0.66 D), Hoffer Q, and Hoffer QST (0.68 D). SRK/T also yielded the highest percentage of cases within ± 0.50 D (43% of the cases). For patients aged 2 to 5 years, SRK/T formula yielded statistically significantly better results than all other included formulas (p < 0.05) with MedAE = 0.44 D, 58.33% and 87.50% of the cases were within ± 0.50 D and ± 1.0 D of intended refraction, respectively. The SRK/T formula showed the best IOL power calculation results in pediatric cataract surgery, followed by BUII, Hoffer Q, and Hoffer QST. In children aged 2-5 years, the SRK/T formula outperformed all other formulas, followed by the BUII and Hoffer QST formulas. In children older than 5 years, there was no statistically significant difference between the different formulas (p > 0.05); Hoffer Q and SRK/T showed slightly better MedAE in this age group (5-10 years).

Premium multifocal intraocular lens: Pearls and practices

Cataract surgery has gradually evolved from being a visual restoration surgery to a refractive surgery. Patients are gradually shifting from traditional intraocular lens (IOL) to high end premium IOL which provide reduced spectacle dependence and in turn greater patient satisfaction. However, these premium lenses are not without cons and calls for meticulous pre-operative calculation, realistic counseling, and perfect surgical technique. This in-depth review provides insight into the varieties of multifocal IOL, selection criteria, pre-operative planning and calculation, surgical technique, and comprehensive post-operative complication management.

Evolution of Scleral Fixation, Haptic Externalization and Tucking Techniques

Phakic rehabilitation poses challenges for patients without capsular support, making traditional intraocular lens (IOL) implantation difficult. In such cases, an Anterior Chamber (AC) IOL or a scleral-fixated posterior chamber IOL (SF-PC IOL) can be considered as options. To ensure a well-centered IOL, haptics should be away from the ciliary processes, iris, and oraserrata, with sufficient distance from the iris to prevent capture. Delayed IOL dislocation can occur due to suture breakage, but it can be prevented by proper IOL size and snugly opposing the stitched haptics into the ciliary sulcus.

Accuracy of new-generation intraocular lens calculation formulas in eyes with variations in predicted refraction.

To investigate the characteristics of eyes with large variations in predicted refraction using four traditional intraocular lens (IOL) formulas and evaluate the accuracy of new-generation intraocular lens power calculation formulas. Eyes that had variationin predicted refraction (≥ 0.75 D) using four traditional formulas (SRK/T, Holladay 1, Hoffer Q, and Haigis formulas) were included. Axial length (AL), anterior chamber depth (ACD), average keratometry (AK), and the ratio of axial length to corneal radius (AL/CR) were measured. New-generation formulas (Barrett Universal II, Emmetropia Verifying Optical2.0, Kane, and Pearl-DGS formulas) and traditional formulas were compared. The median absolute error (MedAE) was the main parameter to evaluate the accuracy of formulas. A total of 79 participants (79 eyes) who had variation in predicted refraction of (≥ 0.75 D) using four traditional formulas out of 510 eyes (510 patients) underwent uncomplicated cataract surgeries. The Barrett Universal II (0.29 D), EVO 2.0 (0.31 D), Kane (0.30 D), and Pearl-DGS (0.33 D) formulas produced significantly lower median absolute errors (MedAEs) than the Hoffer Q (0.61 D) and Holladay 1 (0.59 D) formulas (P < 0.01). The Wang-Koch (WK) adjustment significantly improved the accuracy of the Holladay 1 formula in long eyes (P < 0.001). Abnormal AL, ACD, and AK are more likely to lead to prediction errors using traditional formulas. New-generation formulas and traditional formulas with WK adjustment showed satisfactory prediction accuracy.

Vision-related Quality of Life after Bilateral Implantation of Monofocal and Multifocal Intraocular Lenses.

PurposeTo evaluate vision-related quality of life in two sets of patients after routine cataract surgery implanting with traditional versus multifocal intraocular lens (IOLs).MethodsIn a cross-sectional prospective study, 58 and 33 candidates for cataract surgery were divided into traditional (Acrysof SN60WF, Alcon Laboratories, Inc) and multifocal IOL (AcrySof IQ PanOptix IOL TFNT00, Alcon Laboratories, Inc.) groups, respectively. The primary outcome was VFQ-25 scores. The secondary outcomes were making comparisons between the two IOL types in the near vision and the driving items.Resultsmean patients' age in traditional and multifocal IOL groups was 60.85 7.40 (55% female) and 59.85 8.95 (36% female) years, respectively. The mean VFQ-25 total scores in traditional and multifocal IOL groups before and after surgery were 63.69 4.95 and 72.15 9.66, and 98.08 0.70 and 95.70 1.30, respectively (P = 0.001 & 0.001). The mean scores of night driving in traditional and multifocal IOL groups were 38.79 20.50 and 44.35 21.12 (P = 0.1) before surgery which improved to 97.41 7.68 and 56.45 11.12 after surgery, respectively (P = 0.001). The mean scores of near vision in traditional and multifocal IOL groups were 46.83 10.56 and 50.53 8.58 (P = 0.2) before surgery which improved to 89.94 4.87 and 100.00 0.00 after surgery, respectively (P = 0.001).ConclusionVision-related quality of life after cataract surgery with either type of traditional or multifocal (PanOptix) IOLs improved to an excellent level. Traditional IOLs provided more satisfaction in nighttime driving while multifocal IOLs provided increased satisfaction in near and intermediate vision.

A systematic review and meta-analysis on intraocular lens implantation with different performances for the treatment of cataract.

Cataract is one of the common eye diseases. At present, Phacoemulsification combined with traditional intraocular lens (IOL) implantation can achieve satisfactory rejuvenation effects. However, the correction of corneal astigmatism is limited, while Toric IOL implantation can provide good astigmatism correction treatment. We retrieved randomized controlled trials (RCTs) on the treatment of cataracts published in the PubMed, EBSCO, MEDLINE, EMBASE, Science Direct, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases. Professional journals were searched manually to avoid omissions. The research subject search terms included cataract, astigmatism, IOL, and intraocular lens. The observation indicators search terms included uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BDVA), residual corneal astigmatism, and cataract cure rate. A total of 12 articles were included. The articles were tested for heterogeneity of UDVA measured using the Logarithm of Mininal Angle Resolution (LogMAR) visual acuity chart, and the results showed that Chi-squared test (Chi2) =75.21, degree of freedom (df) =11, and I2=85%>50%, so the random effects model (REM) was adopted for analysis. The results indicated that the differences between the Toric and Non-Toric IOL groups statistically significant, and the Toric IOL group had a significant therapeutic effect [Z =2.18, mean difference (MD) =-0.05, 95% confidential interval (CI): -0.09, -0.00, P=0.03]. The fixed effects model (FEM) was adopted to analyze the determination of BDVA by LogMAR visual acuity chart in 6 articles. The results suggested that the difference between the Toric IOL and non-Toric IOL groups was not statistically significant (Z =0.29, MD =-0.00, 95% CI: -0.02, 0.01, P=0.77). Heterogeneity analysis was performed on three articles in terms of residual corneal astigmatism, which showed that Chi2=75.55, df =3, I2=96%>50%, and P<0.00001. The REM analysis results revealed that the difference between the two groups was not statistically significant, and the Toric IOL group had low residual corneal astigmatism (Z =1.35, MD =-0.34, 95% CI: -0.83, 0.15, P=0.18). The meta-analysis results confirmed that Toric IOL implantation showed obvious advantages in improving UDVA and corneal residual astigmatism in cataract patients.

Accuracy of new-generation intraocular lens calculation formulas in eyes undergoing combined silicone oil removal and cataract surgery.

To compare the performance of new-generation and traditional intraocular lens (IOL) calculation formulas in eyes undergoing combined silicone oil (SO) removal and cataract surgery and to evaluate the prediction accuracy of Wang-Koch (WK) adjustment in SO-filled long eyes. Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. Retrospective consecutive case-series study. New-generation formulas (Barrett Universal II, Emmetropia Verifying Optical, Kane, and Ladas Super formulas) and traditional formulas (Haigis, Hoffer Q, Holladay 1, and SRK/T formulas) were compared. The performance of WK adjustment was assessed in eyes with axial length more than 26 mm. The median absolute error (MedAE) was the main parameter to evaluate the accuracy of formulas. A total of 211 participants (211 eyes) who underwent combined SO removal and phacoemulsification with IOL implantation were included. Four new-generation formulas displayed statistically significant lower MedAE (0.32 to 0.35 diopter [D]) and higher percentage of eyes within ±1.00 D of prediction error (85.31% to 87.20%) compared with those of the traditional formulas (MedAE: 0.39 to 0.50 D; ±1.00 D: 81.04% to 81.99%, P < .05). For SO-filled long eyes, all traditional formulas showed hyperopic bias (0.36 to 0.65 D, P < .05), except for Haigis formula (0.28 D, P = .083), and this bias could be corrected by WK adjustment (P > .05). EVO formula displayed the lowest MedAE both in total (0.32 D) and in long eyes (0.33 D). New-generation formulas and traditional formulas with WK adjustment showed satisfactory prediction accuracy in eyes undergoing combined SO removal and cataract surgery. EVO formula displayed the highest accuracy.

Development and Evaluation of Clinical Efficacy of Intraocular Lens Fixation after Cataract Phacoemulsification, Complicated by Capsular Lenticular Disruption

Рurpose.Evaluation of the clinical efficacy of the original procedure for fixing the posterior chamber intraocular lens (IOL) after phacoemulsification of cataracts (FEC), complicated by the violation of capsular lens support.Patients and Methods. 194 patients were examined after FEC, complicated by a capsular lenticular impairment. They were divided into 3 groups. In the main group (OG, 64 eyes) the IOL was sutured with an original technique, fundamentally different method, there nodes formed at the ends of the filaments were fixed in the layers of the cornea. In 2 controls groups, there the traditional IOL under the scleral flap (K1, 68 eyes) was performed and the IOL was attached to the iris (K2, 62 eyes). A comprehensive examination of the patients’ vision state included an evaluation of clinical, functional and subjective indicators.Results.The lowest total probability of postoperative complications development was noted in OG (6.4%) compared to K2 and K1 (16.0–17.7%). The overall probability of changing the positions of the IOL in the exhaust gas is 6.4%, which is significantly lower than in the K2 (9.6%) and K1 (14.6%) groups. The developed method in comparison with the traditional methods of fixation provides a higher level of patient’s quality of life (by 10.2–11.7%, p &lt; 0.05) and functional indicators associated with the brightness and contrast sensitivity of the eye.The conclusion.The developed technique provides, in comparison with the traditional, a higher level of safety and functionality of IOL fixation.