Types Of Intraocular Lenses Research Articles

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.

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.

Assessment of intraocular lens tilt and decentration after femtosecond laser-assisted and conventional cataract surgery at 12 months and beyond

PurposeTo compare long-term intraocular lens (IOL) decentration and tilt following femtosecond laser-assisted cataract surgery (FLACS) and conventional surgery using swept-source anterior segment ocular coherence tomography (SS-ASOCT).MethodsIn this retrospective cross-sectional study, all patients underwent FLACS or conventional cataract surgery. Those with a minimum of 12-months follow-up since surgery were included. Patients with surgical complications were excluded. Demographics, preoperative ocular measurements (axial length, anterior chamber depth), and postoperative measurements [corrected distance visual acuity (CDVA), autorefraction, keratometry, IOL type] were collected. Postoperative IOL tilt and decentration were compared using SS-ASOCT between patients with FLACS and conventional cataract surgery. Subgroup analysis was conducted to analyze tilt and decentration by haptic type (single-piece vs. three-piece).ResultsA total of 188 eyes were included [110 (58.5%) in the FLACS group and 78 (41.5%) in the conventional group]. No differences were observed between the FLACS and conventional groups regarding preoperative parameters. FLACS resulted in less IOL decentration compared to conventional cataract surgery (170 μm vs. 240 μm, p = 0.002). No statistically significant differences were observed between the FLACS and conventional groups in the magnitude and axis of IOL tilt. Both groups had a trend of IOL tilt toward the inferotemporal aspects. Moreover, no difference regarding postoperative CDVA, spherical equivalent, and keratometric astigmatism was observed.ConclusionsFLACS resulted in significantly better long-term IOL centration than conventional surgery with manual capsulotomy. No significant difference in IOL tilt or postoperative CDVA was observed between FLACS and conventional cataract surgery.

Cornea Endothelial Cell Loss Before and After Explantation of Artisan and Artiflex Iris-Fixated Phakic Intraocular Lenses

PurposeTo investigate the risk factors for corneal endothelial cell density (ECD) loss of two types of iris-fixated phakic intraocular lenses (pIOL) and indicate the cutoff values for preventing irreversible ECD loss after explantation. DesignThe retrospective, comparative, clinical cohort study MethodsTotal 114 eyes of 61 patients were included in this study. Fifty-five eyes with Artisan pIOL and 59 eyes with Artiflex pIOL had undergone explantation of pIOLs due to continuous ECD loss. Correlation analysis was performed to assess the ocular parameters associated with ECD loss. Receiver operating characteristic (ROC) curve was performed to set cutoff values of ocular parameters to prevent ECD loss after explantation. ResultThe mean ECD before explantation was 1637 cells/mm2 in Artisan group and 1769 cells/mm2 in Artiflex group. The distance of cornea endothelium to IOL center and edges were all significantly higher in Artisan group (p <0.05). The risk factor of decreased ECD in Artisan group were small anterior chamber angle (ACA), and distance of nasal edge of IOL to endothelium and iris fixation to nasal limbus distance, and differences of fixation length. In Artiflex group, ACA, distance of nasal edge of IOL to endothelium, both limbus to IOL fixation length, fixation length, iris pigmentation grading were the risk factors. At 1 year after the pIOL removal, the population demonstrating ΔECD >10% were significantly higher in Artisan group than Artiflex group (p <0.05). In ROC curve analysis, the cutoff value of preoperative ECD to prevent significant post-explantation ECD loss was 1683.5 cells/mm2 in Artisan group and 1648 cells/mm2 in Artiflex group. ConclusionThis study examined the existing explantation guidelines for these lenses. In analyzing the longterm prognosis of cornea ECD with Iris-fixated phakic intraocular lens, it is important to identify the relevant anatomical factors. Small ACA, and short distances from IOL to endothelium and from limbus to iris fixation especially in the nasaSSSl region were significant risk factors to continuous ECD loss in both lenses. To minimize irreversible ECD loss after explantation, it is important to determine the optimal period of explantation by observing both ECD and structural changes.

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.

Intraocular aphakia correction in patients with prior keratorefractive surgery: literature review. Part 1

Introduction. An increasing number of patients with a history of keratorefractive surgeries are presenting to ophthalmologists with complaints of vision loss due to cataracts. Treating this group poses surgeons with a range of unique challenges: high demands for vision quality, complexities in selecting the appropriate intraocular lens (IOL) power calculation formula and IOL model, target refraction, as well as the need to modify cataract extraction techniques and address specific postoperative considerations. Despite advancements in the development of new IOL designs and calculation formulas, clinical and functional outcomes in this group remain inferior to those in patients without prior keratorefractive procedures. A paradigm shift is emerging, advocating for a personalized approach in the diagnosis and management of cataracts in these patients. However, discussing all aspects within a single review proved impractical, leading us to divide it into two parts. The objective of the first part of this study is to assess the specific considerations for aphakia correction in patients who have undergone keratorefractive procedures, based on literature data, while taking into account the long-term complications of refractive surgery. Additionally, this part will address the fundamental principles of the design and functionality of pseudoaccommodating intraocular lenses (IOLs). Materials and methods. A selection of over 200 peer-reviewed publications from resources such as PubMed, eLibrary, CyberLeninka, Science Direct, and Google Scholar over the past 30 years was conducted. The first part of the review includes 49 publications. This work represents an analysis of contemporary literature, reflecting the impact of keratorefractive surgeries on the successful performance of phacoemulsification with IOL implantation. Results. The findings from the first part of the analysis indicate that a detailed medical history of previously performed keratorefractive corrections – specifically their type and potential long-term complications – play a significant role in determining the surgical treatment strategy. Standard examination methods do not always fully reflect the optical characteristics of the cornea in these patients. Extended preoperative assessments, including specialized techniques such as keratotopography and keratotomography, are crucial for identifying corneal irregularities and for the subsequent selection of the type of intraocular lens (IOL) for aphakia correction in patients who have undergone keratorefractive surgeries. Studies show high effectiveness not only in using monofocal lenses but also in the potential application of pseudoaccommodating IOLs, including those with extended depth of focus and multifocal lenses. The selection of optimal formulas for IOL calculation, as well as the clinical aspects influencing refraction in the postoperative period, will be addressed in the second part of the literature review. Conclusion. The increase in the number of refractive surgeries has led to a growing population of patients with cataracts following ametropia correction. This has spurred the development of new IOL variants with extended depth of focus. However, literature data on their effectiveness in patients who have undergone keratorefractive procedures remain limited. Multicenter prospective studies are needed to evaluate new IOL models and to determine the optimal surgical strategies for this category of patients.

Effect of Monofocal, Wavefront-Shaped, and Diffractive Trifocal Intraocular Lenses on Scanning-Slit Automated Refraction

PurposeTo compare scanning-slit retinoscopy automated refraction spherical equivalent (ARSE) to subjective manifest refraction spherical equivalent (MRSE) in normal eyes with four different types of intraocular lenses (IOLs). DesignRetrospective cross-sectional study Methods279 pseudophakic eyes that underwent lens extraction at a private center with implantation of either a wavefront shaped IOL (Acrysof® Vivity, DFT015), a nonapodized diffractive trifocal IOL (Acrysof® Panoptix), or a monofocal IOL with negative spherical aberration (Tecnis ZCBOO) or aberration-free (Envista Mx60E). Patients who had an automated refraction measurement with retinoscopy refractometer and aberrometer (NIDEK OPD Scan III, Nidek Technologies) and subjective refraction data 1-2 months postoperatively were included in the study. Main outcome measured was the difference between automated refraction and subjective refraction. ResultsSixty-one eyes implanted with a DFT015 IOL, 78 eyes with a TFNT00 IOL, 40 with a ZCBOO IOL and 100 with a Mx60E IOL were enrolled in this study. Statistically significant myopic results were observed when using ARSE compared to MRSE in the DFT015 (-0.95±0.64, -0.33±0.65, p < .001), TFNT00 (-0.43±0.36, -0.2±0.35, p <.001), ZCBOO (-0.81±0.63, -0.4±0.69, p = .008) and Mx60E (-0.75±0.65, -0.45±0.52; p <0.05) IOL groups. The absolute difference between the 2 methods was statistically significant in the DFT015 IOL group (0.65±0.49; p< 0.05). ConclusionAutomated refraction yields myopic results in pseudophakic eyes with monofocal and presbyopia correcting IOLs and may be used with caution. Manifest refraction “push-plus” technique should be used in all pseudophakic eyes to avoid over-minus prescriptions, especially in patient with residual refractive error following cataract surgery.

Comparison of Near-Distance Reading Speed Based on the Intraocular Lens Type Using a Korean Reading Speed Measurement Application

Comparison of Near-Distance Reading Speed Based on the Intraocular Lens Type Using a Korean Reading Speed Measurement Application

Организационно-финансовые аспекты выбора интраокулярных линз при хирургии катаракты в условиях ценностно-ориентированной системы здравоохранения.

Relevance. In modern conditions, value-based healthcare provides for the provision by medical organizations of medical care of appropriate quality with mandatory control of its cost. Treatment outcomes that are important to the patient become no less significant than clinical performance indicators and payment for medical services, regardless of the profile of medical care. The gradual change in paradigms of healthcare systems from a paternalistic to a person-centric model required changes in organizational, legislative and financial approaches when introducing health-saving healthcare technologies. Purpose of the study: analysis of the current organizational, legal, financial and clinical models of surgical treatment of patients with age-related cataracts, astigmatism and development of proposals for the implementation of the patient’s right to choose intraocular lenses, taking into account his modern expectations from the results of treatment. Materials and methods. Statistical and analytical methods were used (content analysis methods, expert assessment methods, analysis and synthesis methods). Results. An analysis of the legislation in organizing the provision and financing of medical care to the adult population in the field of ophthalmology is presented, and state guarantees for the use of medical products – types of intraocular lenses implanted into the human body for the surgical treatment of senile cataracts and astigmatism – are considered. Clinical models of the disease are systematized, taking into account the frequency and frequency of provision of medical services and the list of medical devices implanted into the human body, professional, medico-economic, medico-legal and reputational risks are described when exercising the patient’s right to choose intraocular lenses in the treatment of ophthalmological pathology. Proposals have been developed to change clinical recommendations, standards of medical care for senile cataracts and astigmatism, and improve payment for ophthalmological care. Conclusions. The transition to value-based healthcare requires the consolidation of the efforts of all structures of the healthcare industry to achieve the best results in the treatment of ophthalmic diseases and increase the clinical effectiveness associated with the choice of intraocular lenses in the surgical treatment of adults in the field of ophthalmology.

A survey of intraocular lens preferences of UK refractive surgeons for cataract surgery and refractive lens exchange

BackgroundTo explore intraocular lens (IOL) preferences of United Kingdom-based (UK) refractive surgeons in cataract and refractive lens exchange (RLE) surgery.MethodsAn online survey on IOL preferences (and reasons for their choice) in cataract and RLE surgery was distributed. It also enquired about implementing mini-monovision with extended depth of field (EDoF) IOLs, about utilising IOL mix-and-match (different IOL types in each eye), and at what level of corneal astigmatism they prefer toric lenses.ResultsFollowing an 81.6% response rate, thirty responses were analysed; median years of refractive surgery experience was 12.5. The most popular IOL choices for cataract surgery were EDoF lenses (30%), monofocals (20%), and trifocals (20%). The most cited reason for each was better overall visual outcomes (88.9%), fewer unwanted symptoms (66.7%) and best spectacle independence (66.7%), respectively.For RLE, EDoF remained most popular (36.7%), followed by trifocals (30%), and multifocals (16.7%) with the same reasons for choice cited above.Mini-monovision with EDoF lenses was well-regarded (83% recommend for most/select patients), unlike utilising IOL mix-and-match (60% did not recommend). 40% prefer toric IOLs for astigmatism of 1 dioptre (D) or higher, whilst 30% opt for them at < 1D.ConclusionsExperienced UK refractive surgeons prefer newer IOLs with enhanced optics; ≥50% of respondents favoured either EDoF or trifocals for a ‘typical’ cataract or RLE patient. Notably, respondents have a low corneal astigmatism threshold for toric lenses. Mini-monovision with EDoF IOLs was well-regarded, whilst mix-and-match of different IOL types was less recommended.

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.

Cross-Sectional Survey of Vitreoretinal Surgery Fellowship Training in Secondary Intraocular Lens Placement.

Purpose: To assess current trends in vitreoretinal surgical fellowship training for placement of secondary intraocular lenses (IOLs). Methods: A cross-sectional survey was administered to vitreoretinal surgical fellowship graduates who completed their program between 2019 and 2023. Results: Completed responses were obtained from 70 (22.5%) of 311 eligible recipients. Training settings included academic (80%), hybrid academic/private practice (15%), and private practice (5%). During their fellowship, the majority of respondents reported 10 or fewer cases using anterior chamber (AC) IOLs (69%), 5 to 50 cases using scleral-sutured IOLs (64%), and 5 to 25 cases using sutureless scleral-fixated IOLs (52%). Most fellows (79%) did not have exposure to iris-fixated IOL placement during fellowship training. The Akreos AO60 (78%) and Envista MX60 (10%) IOLs were the most common choice for scleral-sutured placement. Most fellows (67%) placed fewer than 10 secondary IOLs through scleral tunnels. Overall, scleral-sutured IOL placement (Akreos Gore-Tex [polytetrafluoroethylene] sutured, 49%) and scleral-fixated IOLs (modified Yamane, 45%) were the preferred and most comfortable surgical techniques for recent graduates after completing training. There was a significant association between surgical case volume during fellowship training and self-reported competency for each type of secondary IOL (P ≤ .005). Conclusions: The majority of vitreoretinal surgical fellows receive limited training in the placement of AC IOLs or construction of scleral tunnels during their fellowship. Aligned with their experience during fellowship, recent graduates generally prefer implanting scleral-fixated or scleral-sutured IOLs. Analysis of trainees' exposure to various techniques and postgraduate surgical preferences may identify areas for improvement in surgical education.

Implantation of phakic intraocular lenses in patients with stabilized keratoconus

To date, extensive experience has been accumulated in the correction of high myopia and myopic astigmatism through the implantation of additional negative lenses (phakic intraocular lenses). However, the use of this method in patients with anatomically altered corneas due to keratoconus remains unresolved.Purpose: to assess the effectiveness and safety of correcting high myopia combined with myopic astigmatism by implanting phakic intraocular lenses in patients with stabilized keratoconus at stages 1–2.Materials and methods. The study encompassed results from 27 surgeries involving the implantation of phakic intraocular lenses in patients with high myopia and myopic astigmatism (12.63 ± 4.25 D). These patients had thin corneas and were diagnosed with stage 1–2 keratoconus after undergoing corneal collagen crosslinking treatment – this constituted the main group. The control group comprised 35 surgeries performed on patients with subclinical non-progressive keratoconus (Forme Fruste). All participants underwent evaluations for visual acuity dynamics and refractive stability of spherical and cylindrical components before surgery, immediately post-surgery, and then at 1, 6, and 12 months after implantation. Additional assessments included intraocular pressure measurements, gonioscopy, ultrasonic echobiometry, ultrasonic ophthalmoscopy, biomicroscopy, ophthalmoscopy, endothelial microscopy, vision character and stereopsis determination, ultrasound biomicroscopy, anterior segment optical coherence tomography, electrophysiological studies, and statistical analysis. An IPCL (a type of phakic intraocular lenses made from hydrophilic acrylic) was implanted, capable of correcting myopia up to 30 D and astigmatism up to 10 D.Results. All patients achieved high uncorrected visual acuity 0.86 ± 0.11. Astigmatism correction was successful in 96% of cases. The average postoperative vault – the distance from the back surface of the phakic intraocular lenses to the anterior lens capsule – was 527.5 ± 40.27 μm (range 460–600 μm), and the intraocular pressure was 11.7 ± 2.08 mm Hg. There was a minor decrease in corneal endothelial cell count from 2599 ± 157.3 to 2375 ± 125.3 cells/mm² in the first group and from 2614 ± 104.8 to 2375 ± 43.3 cells/mm² in the second group respectively (p &gt; 0.05), which falls within the acceptable loss range of 4–7% from preoperative values for both groups. Throughout the observation period, there were no cases of cataract development, pigmentary glaucoma, pupillary block, or other vision-threatening complications.Conclusions. Implantation of phakic intraocular lenses in patients with early-stage stabilized keratoconus and subclinical non-progressive keratoconus provides an effective and practically safe means of correcting high myopia and astigmatism.

Effect of surface-modified intraocular lenses on long-term postoperative inhibition of posterior capsule opacification

We compared the posterior capsule opacification incidences at 5 years postoperatively and the neodymium–yttrium–aluminum–garnet capsulotomy rates at 10 years postoperatively for two types of intraocular lenses with different optical properties and shapes. This randomized, controlled, prospective, single-blinded study with intra-individual comparisons was conducted between July 21, 2009, and August 31, 2011, at the Dokkyo Medical University Hospital, Tochigi, Japan. Thirty patients (60 eyes) underwent bilateral cataract surgery and received a XY1 intraocular lens in one eye and a FY-60AD intraocular lens in the other. Both intraocular lenses are acrylic and manufactured by HOYA. The XY1 lens is a single-piece, tinted intraocular lens featuring an ultraviolet/ozone treatment on the posterior surface of the lens optic, aimed at enhancing posterior capsule adhesion to prevent posterior capsule opacification. Conversely, the FY-60AD is a tinted intraocular lens with modified polymethylmethacrylate C-loops and no ultraviolet/ozone treatment of the optic. Scheimpflug images were taken using EAS-1000 (NIDEK Co., Ltd., Aichi, Japan), and the scattered light intensity (computer compatible tape) on the posterior surface of the intraocular lens was calculated and evaluated as the posterior capsule opacification. The scattered light values of the XY1 and FY-60AD groups were 6.50 ± 5.69 and 11.64 ± 5.30 computer compatible tape, respectively, at 5 years postoperatively. The cumulative survival incidence after neodymium–yttrium–aluminum–garnet laser capsulotomy was 74.8 % in the XY1 group and 13.8 % in the FY-60AD group at 10 years postoperatively. The surface-modified intraocular lens XY1 reduced the incidence of posterior capsule opacification even 10 years after surgery. Surface modification to increase the adhesion between the intraocular lens and the capsule effectively prevents posterior capsule opacification.

Stereoacuity and Aniseikonia: Evaluation Before and After Bilateral Implantation of Three Types of Presbyopia-Correcting Intraocular Lenses in Uncomplicated Phacoemulsification with Due Consideration of Interocular Differences in Higher Order Aberrations, Axial Lengths, Refractive Errors, and Acuities

Stereoacuity and Aniseikonia: Evaluation Before and After Bilateral Implantation of Three Types of Presbyopia-Correcting Intraocular Lenses in Uncomplicated Phacoemulsification with Due Consideration of Interocular Differences in Higher Order Aberrations, Axial Lengths, Refractive Errors, and Acuities

Retrospective Analysis of Negative Dysphotopsia After Cataract Surgery

&amp;lt;i&amp;gt;Purpose&amp;lt;/i&amp;gt;: To describe the incidence and characteristics of negative dysphotopsia (ND) as well as the risk factors contributing to it. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: For this retrospective study, data from patients who underwent cataract surgery between January 2018 and December 2019 at our department (Department of Ophthalmology, Hietzing Hospital, Vienna, Austria) was analyzed. A total of 8122 eyes had cataract surgery performed. Three different intraocular lenses (IOLs) have been used (EyeCee® One by Bausch + Lomb, TECNIS® by Johnson &amp; Johnson, HOYA Vivienx ™ by HOYA). Data from patients who postoperatively complained about ND as well as data from a gender and age-matched control group (34 eyes in each) was further analyzed: pupil size, axial length, anterior chamber depth, angle kappa, IOL power and other biometrical factors. The scotomas were depicted on a Harms tangent screen. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: An incidence of 1.99% of ND was found, of which 1.58% was transient and 0.42% persistent. The average duration of the symptoms was 5.40 (±6.15) weeks in the transient ND group. In the total cohort of 8122 eyes, there was no difference in the distribution of implanted IOL types or IOL power; neither played the surgeon a significant role in the development of ND. There was no significant difference between ND and control eyes regarding pupil size, axial length, and angle kappa. The anterior chamber was significantly shallower in the ND group: 5.1±0.58mm vs. 5.41±0.61mm (p=0.03). &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: According to our findings, a shallower anterior chamber poses a risk to the development of ND.

A comparative study of two phakic posterior chamber implantable lenses.

This study aimed to compare the postimplantation clinical outcomes of 2 types of posterior chamber phakic intraocular lenses (IOLs): Visian™ implantable collamer lenses (ICL; EVO+ V5; Staar Surgical, Monrovia, CA) and an implantable phakic contact lens (IPCL) (IPCL V2.0, Care Group Sight Solution, India) to correct high myopia and myopic astigmatism. This retrospective study included patients who had undergone phakic IOL implantation performed by a single surgeon between March 2021 and March 2022. Preoperative assessments included slit-lamp examination, fundus examination, spherical equivalent, uncorrected distant visual acuity (UDVA), corrected distant visual acuity (CDVA), specular microscope parameters, and optical quality analysis system parameters. Postoperative assessments after 1 year included slit-lamp examination to detect adverse effects and spherical equivalent, UDVA, CDVA, specular microscope, optical quality analysis system, and anterior-segment optical coherence tomography. Eighty eyes from 42 patients (47 eyes from 24 patients in the ICL group and 33 eyes from 18 patients in the IPCL group) were included. No statistically significant differences were observed between the 2 groups regarding preoperative parameters. At 1-year postoperatively, the mean UDVA in the ICL and IPCL groups was 0.019 ± 0.040 logMAR and 0.019 ± 0.041 logMAR, respectively. The mean CDVA was 0.001 ± 0.008 logMAR and 0.001 ± 0.007 logMAR in the ICL and IPCL groups, respectively, showing no statistically significant differences. The postoperative parameters did not differ significantly between the 2 groups. The visual acuity and refractive results of both groups were excellent, and both groups exhibited similar efficacy and safety profiles.

VITREORETINAL OUTCOMES FOLLOWING SECONDARY INTRAOCULAR LENS IMPLANTATION WITH PARS PLANA VITRECTOMY.

Retrospective cohort study of 561 adult patients undergoing secondary intraocular lens (IOL) implantation by vitreoretinal surgeons at a single institution from April 2015 to December 2020. Patient historical factors, intraoperative/postoperative complications, and outcomes of IOL type (anterior chamber IOL versus scleral sutured IOL versus scleral fixated IOL versus. sulcus) were assessed. Primary outcomes were rates of postoperative retinal tears and rhegmatogenous retinal detachment. Secondary outcomes were rates of intraoperative endolaser, intraoperative retinal tear, and further IOL surgery. The incidence of intraoperative retinal tears was 7.3% and not significantly different between techniques. Rates of intraoperative endolaser use were 17.5% among all techniques and not significantly different between techniques. Rates of postoperative retinal tear were low (0%-2.7%). Rates of postoperative rhegmatogenous retinal detachment were not significantly different between techniques (anterior chamber IOL 9/198 [4.5%], SFIOL 1/54 [1.9%], scleral sutured IOL 14/274 [5.1%], sulcus 2/35 [5.7%], total 26/561 [4.6%], P = 0.79). Rates of repeat IOL surgery trended higher in sulcus lenses (anterior chamber IOL 5/198 [2.5%], SFIOL 4/54 [7.4%], scleral sutured IOL 16/274 [5.8%], sulcus 5/35 [14.3%], total 30/561 [5.3%], P = 0.12). Intraoperative endolaser use and intraoperative retinal tear are not uncommon in secondary IOL surgery and underscore the importance of careful vitreoretinal management among these patients.

The Effect of Blue-light Filtering Intraocular Lenses on the Development and Progression of Macular Atrophy in Eyes With Neovascular Age-related Macular Degeneration

PurposeTo assess the effect of blue-light filtering (BLF) intraocular lenses (IOLs) on the development and progression of macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD). DesignRetrospective clinical cohort study. MethodsnAMD patients with anti-vascular endothelial growth factor (VEGF) injections who underwent uneventful cataract surgery between 2007 and 2018 with follow-up until June 2023. Subsequent MA rates were compared between subjects who received a BLF IOL or a non-BLF IOL. All OCT scans were manually reviewed in a masked manner regarding patient baseline variables and IOL status by an experienced research technician. Using the Heidelberg software, the area of MA was manually evaluated and calculated (mm2) by the program. The overall risk of developing new-onset MA and the effect of IOL type on disease progression were assessed. Death was included as a censoring event. ResultsIncluded were 373 eyes of 373 patients (mean age 78.6±6.7 years at surgery, 67.4% females). 206 eyes were implanted with BLF IOLs and 167 with non-BLF IOLs with comparable follow-up times (3164±1420 days vs. 3180±1403 days, respectively, P=0.908), and other baseline parameters (age, gender, corrected distance visual acuity, macular thickness, cumulative number of anti-VEGF injections). Nine pre-existing and 77 new-onset MA cases were detected, with similar distribution between BLF and non-BLF eyes (P=0.598 and P=0.399, respectively). Both univariate Kaplan-Meier (P=0.366) and multivariate Cox regression analysis adjusted for age and gender showed that BLF-IOLs were comparable to non-BLF IOLs regarding hazard for new-onset MA (HR 1.236, 95% CI 0.784-1.949, P=0.363). Final MA area at the last visit was 5.14±4.71mm2 for BLF IOLs and 8.56±9.17mm2 for non-BLF IOLs (P=0.028), with the mean annual MA area increase of 0.78±0.84mm2 and 1.26±1.32mm2, respectively (P=0.042). ConclusionsBLF IOLs did not show added benefit over non-BLF IOLs in terms of MA-free survival but were associated with less progression over time in a cohort of nAMD patients.

In vitro optical assessment of three types of non-diffractive extended depth-of-focus intraocular lenses

Objective: To evaluate the in vitro optical performance of three types of non-diffractive extended depth-of-focus (EDoF) intraocular lenses (IOLs). Methods: Experimental study. Three Vivity IOLs, three Eyhance IOLs, and three ES60 IOLs were included. The professional optical bench OptiSpheric® IOL PRO 2 and an ISO-2 corneal model were applied. The through-focus modulation transfer function (MTF) and predicted visual acuity (logarithm of the minimum angle of resolution) of different spatial frequencies and different focuses under apertures of 3.0 mm and 4.5 mm were recorded. The aspheric monofocal (Tecnis ZCB00), diffractive EDoF (Tecnis Symfony), and trifocus (STF1) IOLs, as well as the lowest visual requirement criteria of EDoF IOLs of American Academy of Ophthalmology served as assessment controls. Results: For the 3.0-mm aperture, the peak value of the MTF was highest with ZCB00, followed by Eyhance, ES60, Vivity, Symfony, and STF1. All experimental non-diffractive EDoF IOLs had two MTF peaks, and the distance between both peaks was longest with Vivity (1.76 D), followed by ES60 (1.43 D) and Eyhance (1.36 D). Among the control IOLs, Symfony had two MTF peaks, and the peak MTF of the intermediate focus was highest. STF1 had three MTF peaks, and the peak MTF of the near focus was highest. For the 4.5-mm aperture, the ranking of the MTF peak of the six types of IOLs was the same as that for the 3.0-mm aperture. Vivity had an increased MTF peak of the distance focus, but a decreased intermediate focus MTF peak, while the MTF peaks of the distance, intermediate, and near focuses in the other IOLs decreased, compared to those for the 3.0-mm aperture. The predicted visual acuity of the distance focus of the three types of non-diffractive EDoF IOLs was all better than 0.0. The predicted visual acuity of the intermediate focus of the Vivity IOL and the ES60 IOL was 0.11 and 0.05 better than that of the Eyhance IOL, respectively. Based on the predicted visual acuity of 0.2, Vivity and ES60 had a depth of focus of at least 0.50 D exceeding ZCB00, while Eyhance had a depth of focus of 0.40 D exceeding ZCB00. Conclusion: In the experiments in vitro, the three types of non-diffractive EDoF IOLs exhibited varying degrees of intermediate to near focus optical performance while maintaining distance focus optical performance. The Eyhance IOL showed better distance focus optical performance than ES60 and Vivity IOL. The Vivity IOL and the ES60 IOL showed better depth of focus extensions than the Eyhance IOL and met the lowest visual requirement criteria of EDoF IOLs of American Academy of Ophthalmology.