Uncorrected Distance Visual Acuity Research Articles

Refractive tolerance in the use of monofocal intraocular lenses enhanced with new aspheric design.

To evaluate the refractive tolerance in eyes with enhanced monocular intraocular lens (IOL) with a new aspheric design. This study included two assessments. Clinical records of consecutive eyes with conventional monofocal IOL (SY60WF, Alcon) were retrospectively reviewed, and changes in uncorrected distance visual acuity (UDVA) with myopic and hyperopic refractive errors were evaluated using segmented regression analysis. Next, in 39 eyes of 39 cataract patients who received an enhanced monofocal IOL (NSP-3, Nidek), UDVA, refractive error, and photopic and mesopic contrast sensitivities were examined at one-three months postoperatively. Changes in the UDVA with refractive error were evaluated in the same manner. With resultant segmented regression lines, ranges of UDVA of 0.20 logMAR or better were obtained as refractive tolerances. The clinical records of 717 eyes of 551 patients with SY60WF were analyzed. Segmented regression analysis revealed a breakpoint in emmetropia and UDVA degradation myopically and hyperopically. The refractive tolerance was 2.03 D, while it was 0.73 D on the myopic side. In the prospective study, there was a breakpoint at -1.088 D, where there was a relatively flat slope between the breakpoint and emmetropia, then UDVA steeply degraded. Refractive tolerance on the myopic side was 1.12 D. There was no significant degradation in the photopic/mesopic contrast sensitivity. Enhanced monofocal IOLs provided wider myopic refractive tolerance, in which UDVA of 0.2 logMAR or better would be anticipated between emmetropia and myopic error of -1.12 D.

Cataract surgery in Australia: a review of the regional literature and outcomes from 5018 cases at a tertiary teaching hospital

ObjectivesTo report visual and surgical outcomes of phacoemulsification cataract surgery from 5018 consecutive cases from Sydney, Australia. A review of the Australian and New Zealand literature was undertaken to provide...

Objective Changes in the Contralateral Eye after Unilateral Cataract Surgery

Purpose: This study evaluated the objective changes in the contralateral eye after unilateral cataract surgery.Methods: The study was designed as retrospective observational study. It included 44 patients who underwent unilateral cataract surgery. Collected data were uncorrected and corrected visual acuity, spherical equivalent, intraocular pressure, contrast sensitivity (CS), stereoacuity, and anterior segment optical coherence tomography parameters. Data were collected preoperatively, and 1 week and 1 month postoperatively for each eye.Results: Following unilateral cataract surgery, the pupil size of the fellow eye decreased from 3.46 mm to 3.17 mm (postoperative week 1, <i>p</i> = 0.003) and 3.08 mm (postoperative month 1, <i>p</i> < 0.001). Anterior chamber depth of the fellow eye increased significantly from 3.16 mm to 3.27 mm (postoperative week 1, <i>p</i> = 0.005) and 3.26 mm (postoperative month 1, <i>p</i> = 0.001). Uncorrected distance visual acuity (UDVA) of the fellow eye improved significantly at postoperative week 1 (<i>p</i> = 0.042) and postoperative month 1 (<i>p</i> = 0.044). Change of UDVA of the fellow eye at postoperative month 1 was significantly correlated with that of the treated eye (<i>p</i> = 0.039).Conclusions: Anterior chamber structures changed and UDVA improved in the contralateral eye after unilateral cataract surgery in our cohort. Because fellow eyes were positively affected by monocular cataract surgery, it would be good information if planning for unilateral cataract surgery due to inevitable reasons.

Visual outcomes and safety profile of retropupillary iris-claw Artisan intraocular lens implants.

The Artisan is an iris-claw intraocular lens (IOL) that can be used to correct aphakia in eyes with insufficient capsular support. This study aims to evaluate long-term visual outcomes and complications following retropupillary implantation of the Artisan IOL at a Canadian centre. Retrospective chart review. Patients who underwent implantation of an Artisan IOL at a tertiary Canadian center between January 2013 and December 2021. Retrospective chart review was performed, and clinical outcomes at postoperative follow-up visits were summarized. Outcomes included postoperative best corrected and uncorrected distance visual acuity (BCDVA and UCDVA), intraocular pressure (IOP), as well as intraoperative and postoperative complications. Seventy-three eyes of 67 patients were evaluated. Mean follow-up duration was 11 months (range: 1-63 months). Common indications for Artisan implantation were IOL dislocation (n = 50; 68.5%) and aphakia (n = 23; 31.5%). Causes for IOL dislocation included idiopathic zonular weakness (n = 25; 34.2%), pseudo-exfoliation (n = 14; 19.2%), surgical complications (n = 6; 8.2%), trauma (n = 3; 4.1%), and Marfan syndrome (n = 2; 2.7%). Causes for aphakia included complicated cataract surgery (n = 20; 27.4%), ocular trauma (n = 2; 2.7%), and post-vitrectomy and lensectomy (n = 1; 1.4%). Average BCDVA (logMAR) was 0.62 ± 0.56 at preop, 0.46 ± 0.55 at 3 months postop, and 0.43 ± 0.55 at 9-12 months (p < 0.0001). Average UCDVA (logMAR) was 1.19 ± 0.68 at preop, 0.65 ± 0.60 at 3 months postop, and 0.42 ± 0.46 at 9-12 months (p < 0.0001). IOP did not differ significantly in follow-up. Pupil ovalization (n = 11, 15.1%) was the most common complication. Outcomes demonstrated favourable efficacy and safety of retropupillary Artisan IOL as an option for providing adequate visual rehabilitation for patients without sufficient capsular support.

Long-Term Outcomes of a 360-Degree Intracorneal Ring Implantation for Keratoconus: A 10-Year Follow-Up.

To evaluate the long-term visual, refractive, and tomographic outcomes of a 360-degree intracorneal ring implant for treating keratoconus (KC). This historical cohort study included 29 eyes of 29 patients with KC who underwent MyoRing implantation. Uncorrected and best-corrected distance visual acuity, refraction, keratometry, and corneal thickness were evaluated preoperatively and at 5 and 10 years postoperatively. Significant improvements were observed in all outcome measures at 5 and 10 years postoperatively compared with the preoperative values (P < 0.001). Uncorrected distance visual acuity improved from 1.25 ± 0.34 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.36 ± 0.24 logMAR at 5 years but showed regression to 0.48 ± 0.35 logMAR at 10 years. Corrected distance visual acuity similarly showed improvement from 0.50 ± 0.24 logMAR preoperatively to 0.18 ± 0.12 logMAR at 5 years, with some regression to 0.25 ± 0.22 logMAR at 10 years. Spherical equivalent improved from -9.38 ± 4.09 diopters (D) preoperatively to -2.70 ± 1.54 D at 5 years but regressed to -3.29 ± 2.22 D at 10 years. Although corneal flattening was observed at 5 years, a slight steepening trend was noted at 10 years. Corneal thickness exhibited an increase after 5 years (P < 0.001), but this trend reversed by the 10-year mark. MyoRing implantation demonstrated significant initial improvements in visual, refractive, and tomographic outcomes in patients with KC; however, some regression toward preoperative values was observed by the 10-year follow-up. This highlights the importance of continued monitoring to assess the long-term impact of the implant and to manage any potential late effects.

Visual, clinical and quality of life outcomes of a new multifocal IOL with optimized diffractive grating: a non-randomized clinical trial

BackgroundMultifocal intraocular lenses (IOLs) are designed to reduce dependence on spectacles by providing multiple focal points. However, they are associated with photic phenomena such as halos and glare, and may reduce contrast sensitivity. The BIOS Trifocal is a single-piece acrylic diffractive IOL with a closed-loop haptic design, optimized for centration and stability. It features an aspheric, aberration-neutral surface and a precisely engineered diffraction grating for effective energy distribution across multiple distances. This study aims to evaluate the visual, clinical, and quality of life outcomes of the BIOS Trifocal IOL for treatment of cataract and presbyopia.MethodsParticipants who met the inclusion criteria underwent implantation of the BIOS Trifocal IOL and were assessed at 30 and 90 days post-surgery. The evaluations included measurements of patient-reported outcomes using the NEI-VFQ 25 at postoperative day 30 and uncorrected and corrected distance visual acuity and defocus curves at postoperative day 90. Additionally, intraoperative and postoperative complications were documented. Visual acuity assessments were performed under photopic conditions, with a range of defocus from + 1.5 D to -3.0 D.ResultsSignificant improvements were observed in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and near visual acuity (UNVA) at both 30 and 90 days post-surgery (p < 0.001). The defocus curve demonstrated functional vision from + 1.5 D to -3.0 D, supporting the lens’s efficacy for near, intermediate, and far distances. Quality of life, as assessed by the NEI-VFQ 25, showed marked improvement across all domains (p < 0.05), with no significant complications directly attributable to the IOL.ConclusionsThe BIOS Trifocal IOL presented satisfactory effectivity in the treatment of cataract and presbyopia, providing functional vision across near, intermediate and far distances and maintaining good patient satisfaction. Trial RegistrationThis trial was registered at the ReBEC (Registro Brasileiro de Ensaios Clínicos – Brazilian Registry of Clinical Trials)database under the registration code RBR-772s6y at April 6th, 2020.

Real-world study of phakic refractive lens for correction of high myopia

BackgroundTo assess the safety and efficacy of phakic refractive lens (PRL) implantation for correcting high myopia, as well as an ophthalmic viscosurgical device-free (OVD-free) method for PRL implantation.MethodsIn this real-world prospective study, consecutive patients implanted with PRL in one or both eyes were enrolled. Based on the surgical techniques used, the eyes were divided into the OVD-free method group and the conventional method group. The patients were examined 2 h after surgery and were scheduled for follow-up at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months. The corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), the manifest refraction spherical equivalent (MRSE), intraocular pressure (IOP) and lens vault were assessed postoperatively. Corneal endothelial cell density (ECD) was measured at the 3- and 12-month postoperative visits.ResultsFifty-seven consecutive patients (108 eyes) were enrolled. At the 3-month postoperative visit, both mean UDVA and CDVA were significantly improved after PRL implantation (0.19 ± 0.21 and 0.01 ± 0.14 logMAR) with efficacy index and safety index of 0.92 and 1.30, respectively. None of the eyes had any loss of CDVA. The percentage of eyes within ± 0.50 D and ± 1.00 D of target refraction was 58% and 83%, respectively. Mean MRSE changed from − 14.49 ± 4.22 D, preoperatively, to − 1.22 ± 1.26 D at 1 day (P < 0.001) and remained stable thereafter. Mean endothelial cell loss was 11.3%, 9.6%, respectively, at 3 and 12 months, with no significant difference between the two follow-ups (P = 0.395). Fifty-nine eyes received the OVD-free method, and 49 eyes received the conventional method. The OVD-free method demonstrated a significant reduction in the incidence of early acute IOP elevations (28.8% vs. 53.1%, P = 0.022) compared to the conventional method. The difference of initial endothelial cell loss (9.4 ± 14.2% vs. 13.6 ± 14.6%) between the two groups trended toward significance (P = 0.056). In both groups, no other major complications were observed up to 12-month follow-up.ConclusionsPRL implantation was a safe, efficient, predictable and stable method for correcting high myopia. The potential of lower incidence of early acute IOP elevations makes the OVD-free method a promising alternative to the conventional method.Trail registration: Chinese Clinical Trial Registry, ChiCTR2100043600. Registered on 23 February 2021, https://www.chictr.org.cn/showproj.html?proj=122229

Occupational Outcomes of Photorefractive Keratectomy in Young Asian Military Aviators

INTRODUCTION: The Republic of Singapore Air Force started its corneal refractive surgery (CRS) Program in 2005 through the introduction of photorefractive keratectomy (PRK) to expand its recruitment pool of aviators. This study evaluates short- and long-term occupational outcomes of PRK on young Asian eyes with low-moderate myopia. METHODS: This is a retrospective cohort study of aircrew who underwent PRK under the CRS program over 12 yr. Data collected included demographic characteristics, preoperative spherical equivalent (SE) refraction, pachymetry, keratometry, pre- and postoperative uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity, and SE refraction. Outcome measures included long-term survival rates (i.e., achieving UDVA of 20/20 and flying without optical aids), short-term SE refractive accuracy/UDVA, and postoperative complications. RESULTS: Included for analysis were 274 eyes of 141 patients. Of these, 82.1% of eyes had UDVA of 20/20 at last follow-up. Cumulative survival rates were 99.8%, 96.5%, 92.9%, 84.7%, and 62.2% at 1, 2, 3, 5, and 10 yr of follow-up, respectively. At the 3-mo mark, 98.2% and 70.4% of eyes had SE refraction within ±0.50 D and ±0.13 D of intended correction, respectively, and 95.2% of eyes met standards for returning to flying duties. Postoperative complications included corneal haze (1.5%), steroid-induced intraocular pressure elevation (0.7%), and PRK-enhancement (0.7%). Higher preoperative myopia was the only risk factor for failure from multivariate analysis. DISCUSSION: PRK as a structured CRS program is effective both short- and long-term to enable flying without optical aids among young Asian aviators with low-moderate myopia. Ong SC, Chay I, Low J, Tan D, See B. Occupational outcomes of photorefractive keratectomy in young Asian military aviators. Aerosp Med Hum Perform. 2025; 96(2):121–127.

SMILE for correction of myopia in patients during the incipient phase of presbyopia.

To evaluate clinical outcomes and visual quality 12months after small incision lenticule extraction (SMILE) for correction of myopia with or without astigmatism in patients during the incipient phase of presbyopia. Peking University Third Hospital, Beijing, China. Retrospective observation study. Patients who had SMILE for myopia and myopic astigmatism with binocular plano target refraction and aged between 39 and 45years were included. Subjective refraction; distance, intermediate, and near visual acuities; defocus curve; anterior corneal surface aberrations and the Strehl ratio; accommodation function, and a subjective questionnaire assessing visual quality in real-life situations were evaluated 12months postoperatively. Clinical data of 29 cases were analyzed. The average patient age was 40.10 ± 0.94years. The mean preoperative manifest refraction was - 4.73 ± 1.11 D (range: - 2.13 to - 6.13 D) of spherical equivalent in right eyes. At the 12-month follow-up, binocular uncorrected distance visual acuity and uncorrected intermediate visual acuity ≥ 20/20 were achieved in all patients, and 96.6% (28/29) of patients achieved uncorrected near visual acuity ≥ 20/25. SMILE induced a statistically significant increase in spherical aberration, coma, and total higher-order aberrations (P < 0.001). For accommodative function, only the negative relative accommodation improved significantly after surgery (P < 0.001). The questionnaire demonstrated high patient satisfaction with near vision, and no one reported having severe visual disturbance. SMILE appeared to be safe and effective in improving distance vision in patients during the incipient phase of presbyopia, and a satisfactory amount of near vision was maintained in this group of subjects.

Topographic Pattern-Based Nomogram to Guide Keraring Implantation in Eyes with Mild to Moderate Keratoconus: Visual and Refractive Outcome

Background: To assess the outcome of Keraring (Mediphacos, Brazil) implantation according to a topographic pattern-based nomogram in eyes with mild to moderate keratoconus. Materials and Methods: A topographic pattern-based nomogram was used to guide Keraring selection in 47 consecutive eyes with stage I-II keratoconus (Amsler-Krumeich staging), which underwent femtosecond laser-assisted implantation at a single center. Electronic data of LogMar uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) manifest refraction and tomographic analysis (Pentacam HR, Oculus, Germany) measured preoperatively and at the last postoperative examination were retrospectively analyzed. Results: Mean follow-up was 18.8 months. (range 3–35). Mean UDVA improved (p &lt; 0.001) from 0.87 ± 0.27 to 0.35 ± 0.21. UDVA increased on average by 5.13 lines. Mean CDVA improved from 0.21 ± 0.10 to 0.09. ± 0.07, and the proportion of eyes with CDVA ≥ 20/25 increased from 29.8% to 85.1% after surgery. No eyes lost lines of CDVA. The Alpins correction index of astigmatism was 0.77 and the mean refractive cylinder decreased from 4.99 ± 1.89 to −2.31 ± 1.47 D (p &lt; 0.001). Mean and maximal keratometry was reduced on average by −2.10 ± 1.42 D and −3.02 ± 3.68 D, respectively (p &lt; 0.001). The RMS of corneal high-order aberrations dropped from 3.296 ± 1.180 µm to 2.192 ± 0.919 µm, and that of vertical coma from −2.656 ± 1.189 µm to −1.427 ± 1.024 µm (p &lt; 0.001). All topometric indices improved after surgery. Conclusions: Planning Keraring implantation using the topographic pattern-based nomogram is very effective and safe in eyes with mild to moderate keratoconus. Using that nomogram of UDVA and CDVA are clinically significant.

Femtosecond Laser Arcuate Keratotomy vs Toric Intraocular Lens Implantation in Cataract Surgery

After cataract surgery, postoperative residual astigmatism can influence a patient's visual quality and satisfaction. Finding ways to minimize this astigmatism is important. To compare the clinical outcomes of femtosecond laser arcuate keratotomy (FSAK) and toric intraocular lens (TIOL) implantation for astigmatism correction in patients undergoing femtosecond laser-assisted cataract surgery. This randomized clinical trial was conducted between October 2021 and September 2023 at the Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China. Patients with mild to moderate regular corneal astigmatism ranging from 0.75 diopters (D) to 3.00 D were recruited. Patients were randomly assigned in a 1:1 ratio to receive FSAK or TIOL implantation. The primary outcome was the subjective manifest refraction assessed at 3 months postoperatively. A total of 196 patients (mean [SD] age, 68.4 [13.7] years; 124 female [63%]) were randomized to the FSAK group (98 [50%]) or TIOL group (98 [50%]), and 92 patients (94%) and 95 patients (97%), respectively, finished the 3-month follow-up. At 3 months postoperatively, there was no difference in the refractive astigmatism between the 2 groups (mean [SD], 0.64 [0.64] D vs 0.54 [0.55] D; difference, 0.11 D; 95% CI, -0.06 to 0.27 D; P = .21). The mean (SD) uncorrected distance visual acuity was 0.15 (0.20) logMAR (Snellen equivalent, 20/28) for the FSAK group and 0.14 (0.19) logMAR (Snellen equivalent, 20/28) for the TIOL group (difference, 0.01 D; 95% CI, -0.04 to 0.06 D; P = .71). Subgroup analyses showed that TIOL implantation achieved lower residual astigmatism compared with FSAK when treating astigmatism exceeding 1.5 D or against-the-rule astigmatism. Results of this randomized clinical trial demonstrate that in study participants with mild to moderate astigmatism undergoing femtosecond laser-assisted cataract surgery, FSAK was not superior to TIOL implantation for astigmatism correction. However, for astigmatism exceeding 1.5 D or against-the-rule astigmatism, TIOL implantation demonstrated greater efficacy over FSAK. Future trials are needed to determine if there is greater efficacy of TIOL implantation over FSAK as suggested by subgroup analyses. ChiCTR.org.cn Identifier: ChiCTR2100051066.

The Influence of Axial Length on Visual Quality following SMILE Surgery in Patients with High Myopia.

This retrospective study aimed to investigate the subjective and objective visual outcomes following Small Incision Lenticule Extraction (SMILE) surgery in high myopic patients with varying axial lengths (AL). The study enrolled 113 highly myopic patients (202 eyes) who underwent SMILE surgery at Shanghai's Tenth People's Hospital from July 2021 to September 2023. Patients were classified into three groups based on the axial length before surgery: Group A (AL < 26mm, 62 eyes), Group B (26mm ≤ AL < 27mm, 88 eyes), and Group C (AL ≥ 27mm, 52 eyes). Preoperative and postoperative evaluations included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), equivalent spherical error, and ocular higher-order aberrations. Subjective visual quality was assessed using the Quality of Vision (QoV) questionnaire. One year postoperatively, there were no notable differences found in safety, efficacy, or stability among the groups (P>0.05). Postoperative spherical aberration, horizontal, and vertical coma increased compared to preoperative values and showed a positive association with axial length (P<0.05). Horizontal and vertical trefoil remained stable at all follow-up points without any significant inter-group variances (P>0.05). Postoperative QoV scores were obviously higher in Groups A (45.45±5.49) and B (46.34±3.25) compared to Group C (49.15±7.89). There was no correlation between QoV scores and axial length observed. The induced horizontal trefoil showed a positive correlation with changes in lens thickness (LT) one year after SMILE (r=0.22, p=0.03). SMILE surgery is a safe and effective approach for correcting high myopia, exhibiting a significant correlation observed between ocular high-order aberrations and axial length.

Keratorefractive Lenticule Extraction: Early Postoperative Day 1 Outcomes in 1350 Consecutive Procedures.

To evaluate postoperative visual outcomes on postoperative day 1 (POD1) after lenticule extraction in myopia astigmatism in a large cohort of over 1350 consecutive treatments. A retrospective review chart identified 1357 eyes consecutively treated with SCHWIND ATOS using lenticule extraction for myopic astigmatism who had at least 6 months of follow-up completed and for which POD1 was completely recorded. The standard visual and refractive outcomes, and astigmatism outcomes, were analyzed on POD1. As a sanity check, the stability of defocus and uncorrected distance visual acuity (UDVA) were evaluated from day 1 to 1-year postoperative follow-ups. On POD1, 82% of the eyes achieved an UDVA of 20/20 or better, with 82% of the eyes with postoperative UDVA being the same or better than the preoperative corrected distance visual acuity baseline, and only 2% of eyes lost 2 lines of corrected distance visual acuity. Postoperative spherical equivalent (+0.15 ± 0.35D) was within 0.75 D in 98% of the cases, with excellent stability from 1-week to 1-year postoperative follow-ups (11% eyes changing by 0.5D of defocus). Postoperative refractive astigmatism at POD1 (0.01 ± 0.08 D) was highly accurate, with over 99% of the cases within 0.5 D, and 99% within 5 degrees of the attempted axis. The astigmatic correction index (1.00 ± 0.08) showed 98% of the cases within 10% deviation. In this large cohort of over 1350 cases, lenticule extraction using SCHWIND ATOS is safe and effective on POD1, shows stability from 1-week to 1-year postoperative follow-ups, and suggests accurate and precise corrections for both defocus and astigmatism.

Visual outcomes, contrast sensitivity and defocus profile with an aspheric monofocal intraocular lens utilizing positive spherical aberration.

To evaluate visual outcomes following bilateral implantation of the RayOne EMV intraocular lens with targeted micro-monovision. Southend Private Hospital, UK. Retrospective cohort. 50 subjects (100 eyes) assessed at 12 to 18 months post-operatively. Emmetropia was targeted in the dominant eye and myopia of -0.50 to -1.00D in the non-dominant eye. Uncorrected and distance corrected visual acuity was assessed monocularly and binocularly at distance (6m), intermediate (70cm) and near (40cm). Defocus was assessed from +1.50D to -4.00D monocularly and binocularly. Contrast sensitivity was assessed using a computerised Pelli-Robson chart. Mean Spherical Equivalent (MSE) was -0.05±0.34D and -0.91±0.60D in the dominant and non-dominant eyes respectively. Uncorrected distance visual acuity (UDVA) was significantly different in the dominant (0.08±0.10LogMAR) and non-dominant eye (0.29±0.17LogMAR). (p<0.01). Corrected distance visual acuity (CDVA), distance corrected intermediate visual acuity (DCIVA) and distance corrected near visual acuity (DCNVA) were similar between eyes. However, significant differences were found between binocular uncorrected intermediate visual acuity (UIVA) (0.16±0.11LogMAR) and DCIVA (0.31±0.11LogMAR) (p <0.01) also, binocular uncorrected near visual acuity (UNVA)(0.30±0.17LogMAR) and DCNVA (0.50±0.19 LogMAR) (p<0.01). The non-dominant eye shows superior acuity eye in both UIVA (p<0.01) and UNVA(p<0.01). Contrast sensitivity showed no significant difference between eyes (p = 0.06). Significant improvement binocularly compared to monocularly was seen through imposed defocus -0.50 to -2.50D. The RayOne EMV with micro-monovision is a reliable method for improving intermediate and near visual acuity, by increasing the range of focus without compromise of distance acuity or contrast sensitivity.

Analysis of the correlations between changes in posterior segment and anterior chamber segment after implantable collamer lens implantation in highly myopic patients

PurposeTo evaluate the impact of Implantable Collamer Lens (ICL) implantation on anterior chamber angle parameters and posterior segment structures in highly myopic eyes and explore potential correlations between these changes. The study aimed to assess alterations in superficial and deep vessel density (SVD, DVD), foveal avascular zone (FAZ) area, and retinal nerve fiber layer (RNFL) thickness to clarify the safety profile of ICL implantation.MethodsProspective observational study, included 36 highly myopic eyes undergoing ICL implantation in surgery group and 23 non-surgical control eyes in non-surgery group. Anterior chamber parameters were assessed using AS-OCT, and posterior segment changes, including SVD, DVD, FAZ, and RNFL, were evaluated using OCT and OCTA preoperatively and at intervals up to 3 months postoperatively. Statistical analyses included paired t-tests, Wilcoxon tests, and Spearman correlation.ResultsICL implantation significantly improved uncorrected distance visual acuity (UDVA) (p < 0.01). Anterior chamber depth (ACD) and angle parameters, such as AOD and TISA, decreased initially but stabilized by 3 months. SVD and DVD showed early postoperative fluctuations, returning to baseline by 3 months, while the FAZ area and subfoveal choroidal thickness remained stable. Significant correlations were identified between anterior segment narrowing and posterior vascular changes, particularly in the pericentral region.ConclusionsICL implantation effectively and safely corrects high myopia, with stable anterior and posterior structural changes by 3 months. Transient vascular density fluctuations correlated with anterior chamber angle alterations, highlighting the need for long-term studies to further understand these dynamics and ensure retinal safety postoperatively.Trial registrationThe study was approved by the ethics committee of Aier Eye Hospital, Jinan University (No. GZAIER2023IRB25; China Clinical Trial Record No. MR-44-24-009241).

Outcomes of a non-diffractive extended depth of focus intraocular lens in patients with well-controlled glaucoma and ocular hypertension.

To assess visual outcomes and satisfaction of a non-diffractive extended depth of focus (EDOF) intraocular lens (IOL) in individuals with ocular hypertension (OHT) and well-controlled mild glaucoma undergoing cataract surgery. An investigator-initiated, single-center, prospective, interventional, noncomparative study conducted in Montreal, Canada. The study enrolled 31 patients (55 eyes) with OHT or mild glaucoma who received a non-diffractive EDOF IOL (Acrysof IQ Vivity). Participants underwent sequential cataract surgery with the Vivity IOL. Follow-up evaluations occurred at 1d, 1, and 3mo postoperatively, assessing uncorrected distance, intermediate, and near visual acuity. Questionnaires (QUVID: Questionnaire for visual disturbances and IOLSAT: Intraocular lens satisfaction) were administered pre and post-operatively to measure visual disturbances and spectacle independence in various lighting. Safety parameters included intraocular pressure (IOP), glaucoma medications, spherical equivalence, mean deviation and pattern standard deviation or square root of lost variance on Octopus visual field. At 1 and 3mo postoperatively, significant improvements were observed in uncorrected distance and intermediate visual acuity. Spectacle independence was enhanced for distance and intermediate vision, especially in bright light settings. Spectacle-free intermediate vision was improved even in dim lighting. Visual disturbances, particularly glare symptoms, were reduced, and there was a notable decrease in IOP and glaucoma medication burden at 3mo. There was more hazy vision postoperatively with no impact on visual acuity and visual satisfaction. The non-diffractive EDOF lens improves distance and intermediate spectacle-free visual function in patients with OHT and well-controlled glaucoma. The findings highlight significant improvements in visual acuity, reduced glare, enhanced spectacle independence, and improved visual performance in different lighting conditions.

Impact of central corneal astigmatism on postoperative visual outcomes in patients undergoing trifocal intraocular lens implantation

BackgroundTo investigate the impact of central corneal astigmatism on postoperative visual outcomes in patients with trifocal intraocular lens (IOL) implantation.MethodsThis retrospective study included 278 eyes of 278 patients who underwent uneventful cataract surgery with implantation of the trifocal IOL (AT LISA tri 839MP). Patients were divided into two groups according to the total corneal refractive power (TCRP) in 3 mm zone centered on the corneal apex: low astigmatism group, TCRP ≤ 0.75 diopter (D); high astigmatism group, TCRP > 0.75D. Postoperative evaluations were conducted at 3 months after surgery, including visual acuity, defocus curves, contrast sensitivity (CS), and objective and subjective visual quality.ResultsThe low astigmatism group exhibited significantly better uncorrected near and intermediate visual acuity than the high astigmatism group (both P < 0.05). Significantly higher percentages of eyes in the low astigmatism group achieved uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) of 0.00 logMAR or better compared to the high astigmatism group (UDVA: 67% vs. 54%, CDVA: 76% vs. 64%, both P < 0.05). Defocus curves revealed that the low astigmatism group showed better visual acuity at defocus levels of + 0.5D, 0D, -0.5D, -3.0D, and − 3.5D than the high astigmatism group (all P < 0.05). Moreover, the high astigmatism group showed significantly poorer CS, greater higher-order aberrations, and more symptoms of blurred vision and diplopia. Percentages of spectacle independence and patient satisfaction did not differ between groups.ConclusionsIn eyes with central corneal astigmatism above 0.75D, suboptimal postoperative visual outcomes may be obtained after trifocal IOL implantation.

Evaluation of a modified sutureless technique for scleral fixation of one-piece posterior chamber intraocular lens: a retrospective study.

This study presents the one-year outcomes of a modified technique for transscleral suture fixation of a posterior chamber intraocular lens (PCIOL) in aphakic eyes. A retrospective chart review was conducted on 45 patients who underwent transscleral suture fixation of a foldable one-piece PCIOL through scleral pockets. Preoperative data and follow-up data for a minimum of 12 months were collected for all patients. The mean preoperative and postoperative uncorrected distance visual acuity (UDVA) in LogMAR was 2.49 ± 0.54 and 0.54 ± 0.25, respectively (p < 0.01). The mean preoperative and postoperative best-corrected visual acuity (BCVA) in LogMAR was 0.52 ± 0.22 and 0.45 ± 0.24, respectively (p < 0.01). The mean endothelial cell loss was 110.46 ± 11.5 cells/mm2. Postoperative complications included transient corneal edema (17.7%), transient elevated intraocular pressure (22.2%), and non-significant vitreous hemorrhage (11.1%). No severe complications were observed. The modified technique provides stable PCIOL placement in aphakic eyes with long-term follow-up.

Outcome of a Mix-and-Match Approach with a Monofocal Aspherical and a Bifocal Extended Depth-of-Focus Intraocular Lens to Achieve Extended Monovision in Cataract Patients.

Extended monovision is a novel mix-and-match approach that has been recently introduced. It involves implanting an aspherical monofocal intraocular lens (IOL) for distance vision in the dominant eye, and a bifocal extended depth-of-focus (EDOF) IOL in the nondominant eye. The target refraction for the nondominant eye is - 1.25 diopters (D), and provides good intermediate vision at 80 cm, with an additional 1.5 D power for near vision at 36 cm. This study evaluates the visual outcomes and patient-reported experiences with this extended monovision strategy in cataract patients. Patients underwent uneventful conventional or femtosecond laser-assisted cataract surgery and implantation of an aspherical monofocal IOL (Hoya Vivinex XC1-SP, Hoya Surgical Optics, Tokyo, Japan) in the dominant eye [with a target refraction closest to the spherical equivalent (SE) of 0 D] and a rotationally asymmetric refractive bifocal EDOF IOL with an additional power of + 1.5 D (Lentis Comfort-LS-313 MF15, Teleon Surgical B.V, Spankeren, Netherlands) in the nondominant eye (target refraction closest to SE - 1.25 D). These patients were included in this retrospective study. Uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, and UNVA, respectively), and binocular defocus curves were determined. Additionally, uncorrected contrast sensitivity, stereoscopic depth perception, and halometry were measured. Patient satisfaction was evaluated using the PRSIQ and NEI-RQL-42 questionnaires. A total of 26 eyes from 13 patients were included in the study. The mean postoperative binocular UDVA, UIVA, and UNVA were 0.05 ± 0.09, - 0.08 ± 0.11, and 0.06 ± 0.07 logMAR, respectively. The defocus curve peaked at 0.0 D (6 m), with a mean visual acuity of 0.04 ± 0.09 logMAR. Functional vision above the cutoff value of 0.3 logMAR extended across the defocus steps from + 1.0 to - 3.5 D. The mean dependence on correction score reached a mean of 89.4 ± 23.9, with an overall satisfaction rate of 83.1 ± 13.2. To our knowledge, this is the first study to describe the combination of a monofocal IOL for distance vision and a rotationally asymmetric refractive bifocal EDOF IOL for intermediate and near distances, with the aim of achieving extended monovision. This approach demonstrated good visual acuity for all distances and a high patient satisfaction. It may be considered a promising alternative to multifocal IOLs.

Visual Performance After Bilateral Implantation of a New Enhanced Monofocal Hydrophobic Acrylic Intraocular Lens Targeted for Mini-Monovision.

The aim of this study was to evaluate visual outcomes and patient satisfaction after bilateral implantation of a new hydrophobic acrylic intraocular lens called Clareon (Alcon) using the mini-monovision technique. A single-center, prospective, nonrandomized study was conducted in Tandil (Buenos Aires, Argentina), including patients scheduled for cataract surgery. To achieve mini-monovision, the spherical equivalent was calculated between -0.25 and +0.25 D for the dominant eye, and between -0.75 and -1.00 D for the non-dominant eye. The main outcomes were uncorrected distance visual acuity (UDVA) and uncorrected intermediate visual acuity (UIVA) evaluated at 66 cm. A secondary outcome, patient satisfaction, was assessed using the CatQuest-9SF questionnaire. The mean binocular UDVA was 0.01 ± 0.05 logMAR three months after surgery, while the mean binocular UIVA was 0.20 ± 0.06 logMAR. The postoperative mean spherical equivalent in the dominant eye was -0.27 ± 0.12, and in the non-dominant eye was -0.87 ± 0.25. Before surgery, the CatQuest-9SF questionnaire revealed that 83.33% of patients were dissatisfied with their vision during daily activities. Over 50% reported significant difficulties with reading newspapers, sewing, and reading TV subtitles. Additionally, 66.6% struggled with recognizing faces, 50% with seeing product prices, and 50% with walking on uneven ground. Post-surgery, most patients experienced improved vision for daily tasks, with no reports of high dissatisfaction or significant difficulties. Patients were quite satisfied with their vision for hobbies and TV subtitles, and very satisfied (90%) with seeing supermarket prices. patients implanted with a new enhanced monofocal IOL using the mini-monovision technique showed improved distance and intermediate visual acuity, reduced need for glasses, and expressed a high degree of satisfaction.