Uncorrected Distance (UDVA), Intermediate Research Articles

Comparison of short-term clinical outcomes of a diffractive trifocal intraocular lens with phacoemulsification and femtosecond laser assisted cataract surgery

PurposeTo evaluate short-term visual and refractive outcomes after implantation of a diffractive trifocal intraocular lens (IOL) in cataract patients with phacoemulsification (PHACO) and femtosecond laser assisted cataract surgery (FLACS).SettingDepartment of Ophthalmology, Shanghai Aier Eye Hospital, China.DesignA retrospective, observational study.MethodsPatients who underwent cataract surgery combined with Acrysoft IQ PanOptix trifocal IOL implantation were enrolled and divided into three groups: PHACO group, LAstig-FLACS group (astigmatism less then 1D) and HAstig-FLACS group (astigmatism more than 1D). Logarithm of the minimum angle of resolution (logMAR) visual acuity of uncorrected distance (UDVA), intermediate (UIVA), near visual (UNVA), defocus curve, surgically induced astigmatism (SIA) were evaluated in 1 months postoperatively and wavefront aberrations were evaluated in 6 months.Results101 eyes of 60 patients were included with 31 eyes in PHACO group, 45 eyes in LAstig-FLACS group and 25 eyes in HAstig-FLACS group. Significant difference was found of internal Strehl Ratio (SR) between PHACO and LAstig-FLACS group (P = 0.026). In PHACO group, 79.31%, 86.21%, 72.41% of eyes gain visual acuity LogMAR 0.1 or more in UDVA, UIVA and UNVA, while 83.72%, 93.02%, 93.02% of those in LAstig-FLACS group and 92.00%, 84.00%, 76.00% in HAstig-FLACS group.ConclusionsPanoptix diffractive trifocal IOL provides satisfied visual outcome in no matter FLACS or PHACO. Besides, trifocal IOL implantation via FLACS can provide a better accumulative visual acuity outcome at all distance than PHACO in 1 month. Femtosecond laser assisted limbal relaxing incisions (FLLRIs) is an excellent way to reduce a patient’s corneal astigmatism.

Effect of larger corneal spherical aberration in improving the near visual acuity of eyes implanted with the TECNIS Symfony.

To explore the effect of corneal spherical aberration on the visual acuity and visual quality of eyes implanted with the TECNIS Symfony intraocular lens (IOL). A total of 43 patients with age-related cataract (60 eyes) undergoing phacoemulsification and TECNIS Symfony IOL implantation were enrolled in this study. The uncorrected distance (UDVA), intermediate (UIVA), near visual acuity (UNVA), corrected distance visual acuity (CDVA), contrast sensitivity, and ocular spherical aberration were recorded 3 months after surgery. Preoperative and postoperative corneal spherical aberration were also measured using the iTrace device. Objective scattering index (OSI), modulation transfer function cut-off frequency (MTF cut-off), and Strehl ratio (SR) were measured by the Optical Quality Analyzing System. Catquest-9SF questionnaire were applied too. Spearman's correlation analysis was used to evaluate the relationship between spherical aberration and visual quality parameters. Patients were satisfied with their postoperatively visual quality. And the postoperative logMAR UDVA, UIVA, UNVA, and CDVA was 0.05 ± 0.07, 0.04 ± 0.06, 0.15 ± 0.07, and 0.03 ± 0.05, respectively. The mean preoperative corneal spherical aberration was 0.24 ± 0.10 μm, which is the only factor influencing postoperatively UNVA, and it was negatively correlated with UNVA and glare contrast sensitivity under 18 cpd (cycle/degree, cpd) spatial frequency (r = -0.403, -0.300, -0.360; all P < 0.05). Additionally, the greater the residual spherical aberration of the cornea, the better the near vision after operation. The mean postoperative ocular spherical aberration was -0.03 ± 0.07 μm, it was not correlated with visual acuity, contrast sensitivity, and visual quality (all P > 0.05). Preoperative positive spherical aberration can benefit near vision while decrease contrast sensitivities at high spatial frequencies when implanted with the TECNIS Symfony IOL.

Comparative Visual Outcome Analysis of a Diffractive Multifocal Intraocular Lens and a New Diffractive Multifocal Lens with Extended Depth of Focus.

This study compares the visual and refractive performance of the TECNIS Synergy (DFR00V-DFW150-225-300-375) multifocal intraocular lens (IOL) and the AcrySof IQ PanOptix (TFAT00-30-40-50-60) multifocal IOL. Patients who underwent phacoemulsification and cataract extraction and received either a multifocal Synergy or PanOptix IOL were included. Monocular uncorrected distance (UDVA), intermediate (UIVA), near (UNVA), and corrected distance (CDVA) visual acuities were assessed at three and six months postoperatively. Secondary outcome measures of photic phenomena were also assessed. A total of 140 patients (224 eyes) were included in this study, with 69 patients (105 eyes) in the Synergy group and 71 patients (119 eyes) in the PanOptix group. There were no statistically significant differences in UIVA or CDVA measurements across all time points. When assessing UDVA, at three months postoperatively, there were more eyes in the PanOptix group with vision better than 20/40 (p = 0.04). At three and six months postoperatively, the average UNVA was superior in the Synergy group (p = 0.01, 0.002). While the Synergy group reported more night vision disturbances at one and three months (p = 0.01, 0.03), the PanOptix group had more night vision disturbances at six months (p = 0.02). Although not statistically significant, the AcrySof IQ PanOptix multifocal IOL demonstrated better UDVA and UIVA sooner postoperatively than the TECNIS Synergy multifocal IOL. The Synergy IOL provided statistically better UNVA compared to the PanOptix IOL at three and six months postoperatively. Synergy patients reported more early photic phenomena than PanOptix patients, which later diminished.

Early Outcomes of Two Treatment Modes of PresbyLASIK: Monocular vs. Micro-Monovision

To report the visual, refractive and subjective outcomes of presbyLASIK for the correction of presbyopia. Monocular (20 eyes) or micro-monovision (12 eyes) presbyLASIK was performed on a total of 32 eyes in 16 patients (50% female, average age 55±4.6 years) using the Zeiss VisuMax 400Hz femtosecond and Schwind Amaris 1050RS excimer laser platform. Predictability, safety and efficacy were assessed and compared at 4-6 weeks, 3 months and 6 months. Results were considered significant if P < 0.05. For monocular treatments, average postoperative spherical equivalent (SE) was 0.1±0.1 D and -0.86±0.5 D at 4-6 weeks postoperatively for distance and near eyes respectively; 90% eyes achieved SE ±1.0 D of the target. Postoperative binocular uncorrected distance (UDVA), intermediate (UIVA) and near visual acuity (UNVA) were -0.03±0.1 LogMAR (20/20), 0.09±0.26 LogMAR (N4) and 0.29±0.11 LogMAR (N6) respectively with 90% patients achieving binocular UDVA of 20/20 or better. For micro-monovision treatments, average postoperative SE was -0.33±0.51 D and -1.60±0.78 D at 4-6 weeks postoperatively for distance and near eyes respectively; 100% eyes achieved SE ±1.0 D of the target. Postoperative binocular UDVA, UIVA and UNVA were 0.05±0.16 LogMAR (20/20), -0.02±0.10 LogMAR (N3) and 0.23±0.08 LogMAR (N5) respectively with 67% patients achieving binocular UDVA of 20/20 or better. Monocular and micro-monovision presbyLASIK are both effective options for the treatment of presbyopia. Monocular treatments are more likely to be well tolerated by patients who prefer to preserve exceptional distance vision, while micro-monovision treatments may be better suited to patients who can tolerate compromises in distance vision in order to attain greater intermediate vision function.

Clinical outcomes after femtosecond laser assisted cataract surgery with implantation of the TECNIS Symfony intraocular lens

AIM: To evaluate the clinical outcomes in terms of vision across distances (near, intermediate, and far), contrast sensitivity and subjective patient satisfaction after femtosecond laser-assisted cataract surgery (FLACS) with implantation of an extended range of vision (ERV) intraocular lens (IOL). METHODS: Forty patients (55 eyes) undergoing bilateral or monocular FLACS with implantation of the ERV IOL TECNIS Symfony (Johnson &amp; Johnson Vision) were enrolled. Uncorrected distance (UDVA), intermediate (UIVA) and near visual acuities (UNVA) were evaluated at 3mo after surgery, as well the defocus curve, contrast sensitivity, patient satisfaction and spectacle independence. RESULTS: No severe complications occurred. All eyes showed a central position of the IOL in the capsular bag without tilting at 3mo after surgery. 3mo postoperative mean logMAR visual acuity at 5 m, 67 cm and 40 cm were -0.04 ±0.08, -0.17±0.22, 0.37±0.17, respectively. All patients obtained satisfactory UDVA and UIVA, as well as functional UNVA, meeting the needs of daily life. Spectacle independence rate was 94.55%. Contrast sensitivity results did not differ from those obtained with monofocal aspheric lenses. Likewise, no moderate and severe photic phenomena were reported. Mean patient satisfaction scores with distance, intermediate and near vision were 9.0, 9.0, and 7.0, respectively. CONCLUSION: FLACS with implantation of the ERV IOL TECNIS Symfony provides a successful visual restoration at far, intermediate distance and a functional-range near vision acuity, with minimal level of disturbing photic phenomena, and high rates of spectacle independence and patient satisfaction.

Surgical Curriculum for Presbyopia-Correcting Intraocular Lenses: Resident Experiences and Surgical Outcomes.

ObjectiveTo describe a stepwise surgical curriculum that was implemented to teach novice surgeons about currently available advanced technology intraocular lenses (ATIOLs) for correction of presbyopia and to report the experiences and surgical results of ATIOL surgery performed by residents who engaged in the curriculum.Design, Setting, and ParticipantsThird-year ophthalmology residents participated in a curriculum incorporating didactic lectures (with objective assessment and wet-lab practice) and observation of attending-performed ATIOL surgeries prior to performing ATIOL surgery as primary surgeon under direct supervision. Post-operative outcomes studied were best corrected distance visual acuity (BCDVA) and uncorrected distance (UDVA), intermediate (UIVA) near (UNVA) visual acuity and correction of astigmatism with at least 3 months of follow-up (POM3+). Residents were also given a survey to assess experiences with the surgical curriculum, preparedness for use of ATIOLs post-residency, and ATIOL practice pattern post-residency.ResultsA total of 12 residents from four consecutive classes completed the curriculum. Residents overall had a favorable opinion of the curriculum and felt well prepared to use ATIOLs after training. Graduates who currently perform cataract surgery felt comfortable using all available ATIOLs. A total of 100 eyes from 72 patients met the inclusion criteria for analysis in the study. At the POM3+ timepoint, 88% of eyes had UDVA of 20/30 or better, 93% had UIVA of 20/30 or better, and 71.2% had UNVA of 20/30 (J2) or better. Among eyes that received an astigmatism-correcting ATIOL, 91% had <1 diopter of astigmatism after surgery.ConclusionResident surgeons learned to perform ATIOL surgery (medical knowledge) and achieve strong surgical outcomes (patient care) with all currently available ATIOLs after completion of a stepwise curriculum. Educators may be encouraged to incorporate an ATIOL curriculum based on the results of this study. The curriculum presented is a prototype and may be further improved with future experiences and studies.

Clinical outcomes of cataract surgery with implantation of a continuous transitional focus intraocular lens

To evaluate the clinical outcomes obtained after cataract or crystalline lens surgery with implantation of a new continuous transitional focus intraocular lens (IOL). San Rafael Hospital, Madrid, Spain. Nonrandomized prospective case series. Uncomplicated phacoemulsification cataract surgery was performed with bilateral implantation of the continuous transitional focus IOL Precizon Presbyopic. Visual, refractive, and contrast sensitivity outcomes were evaluated during a 6-month follow-up. Likewise, the incidence of postoperative disturbing photic phenomena was recorded. Sixty-two eyes of 31 patients (mean age: 61.3 years) were enrolled. Mean 6-month postoperative binocular uncorrected distance (UDVA), intermediate (UIVA), and near visual acuity (UNVA) were 0.01 ± 0.03, 0.17 ± 0.04, and 0.02 ± 0.04 logarithm of the minimum angle of resolution (logMAR), respectively. A total of 98.4% (61) and 93.5% (58) of eyes achieved 20/25 monocular UDVA and UNVA or better, respectively, whereas all eyes (100%) achieved 20/30 UIVA or better. Mean corrected visual acuity of 0.14 ± 0.05, 0.15 ± 0.06, and 0.19 ± 0.02 logMAR were obtained for the defocus levels of -1.00, -1.50, and -2.00 diopters. Mean 6-month postoperative log contrast sensitivity was 1.22 ± 0.18 and 0.75 ± 0.10 for 12 and 18 cycles per degree, respectively. A total of 9.7% (3) and 6.5% (2) of patients reported disturbing halos and glare. This presbyopia-correcting IOL provided a complete visual rehabilitation after cataract surgery, maintaining excellent levels of visual quality. Specifically, the IOL generated a continuous range of functional vision from distance to near, with minimal levels of photic phenomena associated.

A novel standardized test system to evaluate dynamic visual acuity post trifocal or monofocal intraocular lens implantation: a multicenter study.

To compare the dynamic visual acuity (DVA) following implantation of trifocal with monofocal intraocular lenses (IOL) and using a novel test system. The present research was a retrospective, multicenter clinical study. Two hundred and ten eyes of 149 patients that underwent cataract phacoemulsification and IOL implantation were enrolled. One hundred and ten eyes of patients received trifocal (AT LISA tri839MP, Carl Zeiss Meditec, Germany) and 100 eyes received monofocal (Tecnis ZCB00, Abbott, United States) lenses and were evaluated 3 months after implantation. Outcome measures included monocular uncorrected distance (UDVA), intermediate (UIVA) and near (UNVA) visual acuity and best corrected distance visual acuity (BCDVA; logMAR units); contrast sensitivity under photopic, mesopic, with glare conditions; and dynamic visual acuity using a self-developed system. There was no statistically significant difference in baseline characteristics between groups. Monocular UDVA, UIVA, and UNVA were significantly better (all p < 0.001) in the trifocal IOL group, but not BCDVA. The trifocal IOL group showed better contrast sensitivity under photopic, mesopic, with or without glare conditions (p < 0.05) and statistically significantly better dynamic vision at 15, 30, 60, and 90 degrees per second (dps) compared with the monofocal group (all p < 0.001). The strength of positive association only between UIVA and dynamic visual acuity increased as the velocity increased, but not UDVA or UNVA. Diffractive trifocal IOL provides better postoperative full range vision acuity, contrast sensitivity, and dynamic vision compared with monofocal IOLs. And intermediate visual acuity is increasingly associated with DVA as the velocity increasing.

Visual results after implantation of a trifocal intraocular lens in high myopes

To report visual and refractive outcomes after implantation of a trifocal intraocular lens (IOL) in highly myopic patients. Department of Ophthalmology, Goethe University, Frankfurt, Germany. Retrospective case series. This study included eyes with previous phacoemulsification and implantation of a trifocal IOL (AT LISA tri 839MP or 939MP) with an IOL power between 0.0 diopter (D) and 10.0 D. Postoperative outcomes at 3months including uncorrected distance (UDVA), intermediate (UIVA), and near visual acuity (UNVA), corrected distance visual acuity, spherical equivalent, and refractive astigmatism were analyzed. Age-matched eyes after implantation of the same trifocal IOL with higher dioptric power (>10.0 D) served as controls. Thirty-six eyes of 19 patients were included: 18 eyes (10 patients) in the highly myopic group (IOL power 0.0 to 10.0 D) and 18 eyes (9 patients) in the age-matched control group (IOL power >10.0 D). Three months postoperatively, the mean UDVA, UIVA, and UNVA in the highly myopic group were 0.06 logarithm of the minimum angle of resolution (logMAR)±0.08 (SD), 0.13±0.09 logMAR, and 0.12±0.07 logMAR, and -0.01±0.10 logMAR, 0.04±0.10 logMAR, and 0.04±0.11 logMAR in the control group, respectively (P=.022, P=.033, P=.053, respectively). Implantation of a trifocal IOL in highly myopic eyes with low IOL power (0.0 to 10.0 D) provided satisfactory short-term visual and refractive outcomes; however, results were not as good as those obtained in eyes with higher dioptric IOL power.

November consultation #3

To evaluate the influences of preoperative pupil parameters on the visual outcomes of the SBL-3, a rotationally asymmetric multifocal intraocular lens (IOL) with a surface-embedded near segment.Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom.Retrospective comparative case series.Postoperatively, patients divided into 4 groups according to their pupil size as follows: Group A: 2.50 to 2.99 mm, Group B: 3.00 to 3.50 mm, Group C: 3.51 to 4.00 mm, and Group D: 4.01 to 4.50 mm. The uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities, IOL centration and tilt, and quality of vision (QoV) questionnaires were compared between the 4 groups for 18 months postoperatively.The study comprised 90 patients (180 eyes). The mean preoperative pupil (photopic and mesopic) diameter was 4.3 mm ± 0.3 (SD) and 5.6 ± 1.4 mm, respectively, which decreased to 3.8 ± 0.7 mm and 4.9 ± 1.2 mm, respectively, at 18 months. Eighteen months postoperatively, both photopic and mesopic pupil groups had a statistically significant reduction in size from preoperative levels. No significant differences in UDVA, UIVA, and UNVA were found between the groups (P > .001). Significant differences in the QoV questionnaire day scores and night scores were found between the 4 groups (P < .001).The rotationally asymmetric multifocal IOL provided excellent optical performance during 18-months follow-up. The preoperative photopic pupil is an important parameter for consideration of this type of IOL because smaller pupils have a significant negative subjective impact on QoV.

Pupil influence on the quality of vision in rotationally asymmetric multifocal IOLs with surface-embedded near segment

To evaluate the influences of preoperative pupil parameters on the visual outcomes of the SBL-3, a rotationally asymmetric multifocal intraocular lens (IOL) with a surface-embedded near segment. Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom. Retrospective comparative case series. Postoperatively, patients divided into 4 groups according to their pupil size as follows: Group A: 2.50 to 2.99mm, Group B: 3.00 to 3.50mm, Group C: 3.51 to 4.00mm, and Group D: 4.01 to 4.50mm. The uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities, IOL centration and tilt, and quality of vision (QoV) questionnaires were compared between the 4 groups for 18months postoperatively. The study comprised 90 patients (180 eyes). The mean preoperative pupil (photopic and mesopic) diameter was 4.3mm±0.3 (SD) and 5.6±1.4mm, respectively, which decreased to 3.8±0.7mm and 4.9±1.2mm, respectively, at 18months. Eighteen months postoperatively, both photopic and mesopic pupil groups had a statistically significant reduction in size from preoperative levels. No significant differences in UDVA, UIVA, and UNVA were found between the groups (P>.001). Significant differences in the QoV questionnaire day scores and night scores were found between the 4 groups (P<.001). The rotationally asymmetric multifocal IOL provided excellent optical performance during 18-months follow-up. The preoperative photopic pupil is an important parameter for consideration of this type of IOL because smaller pupils have a significant negative subjective impact on QoV.

Prospective multicenter trial of a small-aperture intraocular lens in cataract surgery

To evaluate the clinical acceptability of monocular implantationof the small-aperture (IC-8) intraocular lens (IOL) in 1eye and an aspheric monofocal IOL in the fellow eye of bilateral cataract patients over 6months postoperatively. Twelve clinics in Austria, Belgium, Germany, Italy, Spain, and Norway. Prospective case series. The visual acuity, depth of focus, contrast sensitivity, patient satisfaction, visual symptoms, and adverse events were assessed in patients who had bilateral cataract surgery followed by implantation of the small-aperture IOL in 1 eye and an aspheric monofocal IOL in the fellow eye. Uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities were reported in Snellen notation. The study comprised 105 patients. At 6months, the UDVA, UIVA, and UNVA in eyes with the small-aperture IOL were 20/23, 20/24, and 20/30, respectively. Ninety-nine percent, 95%, and 79% of patients achieved 20/32 or better binocular UDVA, UIVA, and UNVA, respectively. Ninety-three patients (95.9%) reported they would have the procedure again versus 4 patients (4.1%) who reported they would not have the procedure again. In eyes with the small-aperture IOL, the target-corrected defocus curve measured with 0.75 diopter (D) of myopia extended the range of functional near vision by an additional diopter without loss of distance vision compared with the distance-corrected defocus curves. The mean UIVA and UNVA remained at 20/25 and 20/32, respectively, for up to 1.5 D of residual astigmatism in eyes with the small-aperture IOL. The small-aperture IOL showed excellent visual performance, safety, patient satisfaction, and tolerance to residual astigmatism 6months after implantation.

Clinical outcomes of a new extended range of vision intraocular lens: International Multicenter Concerto Study

To analyze the clinical outcomes after implantation of an extended range of vision intraocular lens (IOL), the Tecnis Symfony, in a routine clinical setting. Forty clinical sites in Finland, France, Germany, Norway, Spain, Sweden, and the United Kingdom. Prospective case series. The study comprised 411 patients who had bilateral implantation of the extended range of vision IOL, with intended micro-monovision in 1 group (monovision group) and intended emmetropia in the other group (non-monovision group). Visual acuity, spectacle independence, patient and surgeon satisfaction, and photic phenomena were analyzed during the 4- to 6-month follow-up. The monovision group comprised 112 patients and the non-monovision group, 299 patients. The mean decimal uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities were 0.95, 0.81, and 0.69, respectively, 4 to 6months postoperatively. Significantly better UIVA (P=.003) and UNVA (P=.011) were found in the monovision group than in the non-monovision group. Spectacle independence was high, with 14.4% of eyes requiring reading spectacles frequently. More than 90% of patients reported no or mild halos, glare, starbursts, or other photic phenomena. Patient satisfaction scores (median) for distance, intermediate, and near vision were 9.0, 10.0, and 8.0, respectively. The satisfaction score for near vision increased to 9.0 in the monovision group. More than 91% of patients said they would recommend the same procedure to their friends and family. The extended range of vision IOL provided successful visual restoration across all distances after cataract surgery, with a minimal level of disturbing photic phenomena and high levels of patient satisfaction. Dr. Cochener is a clinical investigator for Revision Optics, Inc., Horus Vision LLC, Alcon Laboratories, Inc., Abbott Medical Optics, Inc., Théa Pharma GmbH, and Santen, Inc.; she is also a consultant to Alcon Laboratories, Inc., Abbott Medical Optics, Inc., Théa Pharma GmbH, and Santen, Inc.

Clinical Outcomes After Implantation of a Trifocal Toric Intraocular Lens.

To evaluate the visual, refractive, and contrast sensitivity outcomes, as well as the level of photic phenomena, after cataract surgery with implantation of a trifocal diffractive toric intraocular lens (IOL). This prospective study included 56 eyes with corneal astigmatism of 1.00 diopters (D) or greater of 28 patients (age: 23 to 78 years) undergoing cataract surgery with implantation of the trifocal toric IOL AT LISA tri toric 939MP (Carl Zeiss Meditec, Jena, Germany). Monocular and binocular visual outcomes, refractive changes, contrast sensitivity, and photic phenomena perception (Halo & Glare Simulator; Eyeland-Design Network GmbH, Vreden, Germany) were evaluated at 3 months postoperatively. Mean 3-month postoperative monocular uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities were 0.13±0.15, 0.08±0.15, and 0.13±0.18 logMAR, respectively. Binocular postoperative CDVA, DCIVA, and DCNVA values were 0.10 logMAR or better in all cases. A total of 88.2%, 88.2%, and 95.5% of eyes achieved binocular UDVA, UIVA, and UNVA values of 0.20 logMAR or better, respectively. Postoperative refractive cylinder was 0.50 D or less and 1.00 D or less in 78.6% and 98.2% of eyes, respectively. Photopic contrast sensitivity was significantly better than mesopic values for the spatial frequencies of 6 (P=.007), 12 (P=.005), and 18 cycles/degree (P=.011). Mean size and intensity of halos were 50.67±15.69 and 54.89±17.86, respectively. Mean glare size and intensity were 39.67±3.51 and 44.67±15.01, respectively. The evaluated trifocal diffractive toric IOL provides an effective restoration of the distance, intermediate, and near vision after cataract surgery with good levels of visual quality and minimal photic phenomena.

Comparison of clinical outcomes with 2 small-incision diffractive multifocal intraocular lenses

To evaluate and compare the clinical results of 2 diffractive multifocal small-incision intraocular lenses (IOLs) implanted after biaxial microincision cataract surgery (MICS). Atatürk Training and Research Hospital, 2nd Ophthalmology Department, Ankara, Turkey. Comparative case series. Eyes that had biaxial MICS with implantation of an Acri.Lisa 366D IOL (Group 1) or Acriva Reviol MFM 611 IOL (Group 2) were followed for at least 6 months postoperatively. Uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities; corrected distance visual acuity; distance-corrected intermediate and near visual acuities; and contrast sensitivity measurements with and without glare were determined. Early and late complications and subjective complaints were recorded and evaluated. The study enrolled 60 eyes of 32 patients. The preoperative and intraoperative data were comparable in the 2 IOL groups. There were no statistically significant postoperative differences in the mean spherical equivalent (Group 1, -0.30 diopter (D) ± 0.30 [SD]; Group 2, -0.26 ± 0.28 D; P=.584), mean UDVA (0.80 ± 0.14 and 0.86 ± 0.17, respectively; P=.158), and mean Jaeger UNVA (1.46 ± 0.73 and J 1.23 ± 0.50, respectively; P=.155). However, there was a significant difference in mean Jaeger UIVA (3.06 ± 0.90 and 2.23 ± 0.72, respectively; P=.000). Mesopic contrast sensitivity and the incidence of complications and dysphotopsia symptoms were not significantly different between the 2 IOL groups. Both IOLs provided excellent distance and near visual acuity and contrast sensitivity. The Group 2 IOL gave better intermediate distance results.

Visual outcomes and patient satisfaction after cataract surgery with toric multifocal intraocular lens implantation

To evaluate visual outcomes and patient satisfaction after toric multifocal intraocular lens (IOL) implantation in patients with cataract and corneal astigmatism. University Eye Clinic Maastricht, The Netherlands. Cohort study. Patients with cataract, corneal astigmatism, and a motivation for spectacle independency had cataract surgery with implantation of a toric diffractive multifocal IOL (AT Lisa). Three months postoperatively, the uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities; corrected distance, intermediate, and near visual acuities; residual refractive astigmatism; defocus curve; contrast sensitivity; and patient satisfaction were evaluated. Forty-five eyes of 25 patients were enrolled. Postoperatively, the mean UDVA was 0.04logMAR ± 0.15 (SD) and 98% of eyes achieved a UDVA of 20/40 or better. The mean UNVA was 0.20 ± 0.16 logMAR and the mean UIVA (at 60 cm), 0.40 ± 0.16 logMAR. Residual refractive astigmatism of -1.00 diopter or less was achieved in approximately 90% of eyes. Contrast sensitivity levels were high. Approximately 50% of patients reported moderate glare, halos, and starburst symptoms. Spectacle independency for distance and near vision was achieved by 95% of patients and 79% of patients, respectively. Toric IOL implantation in patients with cataract and corneal astigmatism provided good distance and near visual outcomes and acceptable intermediate visual outcomes, allowing patients with considerable amounts of corneal astigmatism to achieve spectacle independence at distance and near. No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.