ZCB00 Intraocular Lens Research Articles

Clinical Outcomes of a New Monofocal Intraocular Lens in Patients Undergoing Phacovitrectomy for Idiopathic Epiretinal Membrane

Introduction: The purpose of this study was to evaluate the clinical outcomes and quality of life of newly generated monofocal intraocular lens (IOL) in patients diagnosed with idiopathic epiretinal membrane (IEM) following phacovitrectomy. Methods: In this prospective study, 42 patients with IEM and cataract underwent pars plana vitrectomy. They were divided into the ICB00 group (21 patients) and the ZCB00 group (21 patients). Data collected before and after the surgery were compared between the two groups, including uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), vision-related quality of life (VRQOL), intraocular pressure, contrast sensitivity (CS), and central macular thickness (CMT). Results: The preoperative characteristics of the two groups showed no significant differences. However, at the 6-month follow-up after surgery, there were significant improvements in UDVA (p < 0.001), UIVA (p < 0.001), VRQOL (p < 0.001), CS (p < 0.001), and CMT (p < 0.001) compared to baseline. Notably, the Eyhance ICB00 group showed a significantly higher UCIVA value at 6 months post-surgery when compared to the Tecnis ZCB00 group (p = 0.001), while other parameters did not show significant differences between the groups. Conclusion: The Eyhance IOL significantly improved both intermediate and distance visual acuity, with no notable difference in quality of life or CS compared to the Tecnis ZCB00 IOL after IEM removal. It appears to be a favorable choice for combined cataract and vitreoretinal surgery, offering enhanced vision for daily tasks and a promising alternative to traditional monofocal IOLs.

Modified intraocular lens power selection method according to biometric subgroups Eom IOL power calculator

This study evaluates the accuracy of a newly developed intraocular lens (IOL) power calculation method that applies four different IOL power calculation formulas according to 768 biometric subgroups based on keratometry, anterior chamber depth, and axial length. This retrospective cross-sectional study was conducted in at Korea University Ansan Hospital. A total of 1600 eyes from 1600 patients who underwent phacoemulsification and a ZCB00 IOL in-the-bag implantation were divided into two datasets: a reference dataset (1200 eyes) and a validation dataset (400 eyes). Using the reference dataset and the results of previous studies, the Eom IOL power calculator was developed using 768 biometric subgroups. The median absolute errors (MedAEs) and IOL Formula Performance Indexes (FPIs) of the Barrett Universal II, Haigis, Hoffer Q, Holladay 1, Ladas Super, SRK/T, and Eom formulas using the 400-eye validation dataset were compared. The MedAE of the Eom formula (0.22 D) was significantly smaller than that of the other four formulas, except for the Barrett Universal II and Ladas Super formulas (0.24 D and 0.23 D, respectively). The IOL FPI of the Eom formula was 0.553, which ranked first, followed by the Ladas Super (0.474), Barrett Universal II (0.470), Holladay 1 (0.444), Hoffer Q (0.396), Haigis (0.392), and SRK/T (0.361) formulas. In conclusion, the Eom IOL power calculator developed in this study demonstrated similar or slightly better accuracy than the Barrett Universal II and Ladas Super formulas and was superior to the four traditional IOL power calculation formulas.

Accuracy of new intraocular lens calculation formulas in Chinese eyes with short axial lengths.

To compare the measurement accuracy of new/updated intraocular lens (IOL) power calculation methods, namely, Kane, Emmetropia Verifying Optical (EVO), with existing methods (Barrett Universal II, Olsen, Haigis, Hoffer Q, Holladay 1, SRK/T) in Chinese eyes with axial lengths ≤ 22.5 mm. The study included data from patients who underwent uneventful cataract surgery with the insertion of ZCB00 IOL. Refractive prediction errors were determined by calculating the difference between postoperative refraction and the predicted refraction using each formula. Various parameters were evaluated, including mean prediction error (ME), mean absolute error (MAE), median absolute error (MedAE), and the percentage of eyes with prediction errors (PE) within different ranges. The study enrolled 38 eyes of 38 patients, and the Barrett Universal II formula demonstrated the lowest MAE and MedAE among the tested formulas. Post hoc analysis using Wilcoxon signed-rank pairwise comparisons for non-parametric samples with Bonferroni correction revealed no significant difference in postoperative refractive prediction among all the formulas (P > 0.05). The percentage of eyes with PE within ± 0.5 D was as follows: Barrett Universal II, 81.58%; Haigis, 78.95%; EVO, 76.32%; Olsen, 76.32%; Holladay I, 73.68%; SRK/T, 71.05%; Kane, 68.42%; and Hoffer Q, 65.79%. The Barrett Universal II formula was more accurate than the other formulas for Chinese eyes with AL ≤ 22.5 mm.

Evaluation of a New Monofocal Intraocular Lens in Patients Undergoing Cataract and Vitrectomy Surgery for Idiopathic Macular Hole

Purpose To evaluate the usefulness of a newly generated monofocal intraocular lens (IOL) in patients who underwent combined cataract and pars plana vitrectomy (PPV) surgery for idiopathic macular hole (MH). Methods A prospective study was conducted on 89 eyes of 89 patients who underwent combined cataract and PPV surgery for MH. The patients were divided into two groups: Eyhance ICB00 and Tecnis ZCB00. Pre-operative characteristics, post-operative visual outcomes, contrast sensitivity, and complications were compared between the two groups. A univariate regression analysis was performed to identify the factors that may affect the postoperative visual outcomes. Results Both groups showed significant improvement in mean corrected distance visual acuity (CDVA) six months post-operation (p < 0.001). There was no significant difference in pre-operative characteristics or complications between the two groups. However, the Eyhance ICB00 group showed a significantly higher uncorrected intermediate visual acuity (UCIVA) value at 6 months after surgery than the Tecnis ZCB00 group (p = 0.014). Contrast sensitivity values were not significantly different between the two groups. The univariate regression analysis revealed a significant correlation between preoperative CDVA and minimum linear diameter of MH with postoperative UCIVA in the Eyhance ICB00 group. Conclusions The newly generated Eyhance ICB00 IOL showed promising results in terms of post-operative UCIVA, with no significant difference in complications or contrast sensitivity values compared to the Tecnis ZCB00 IOL. These findings suggest that the Eyhance ICB00 IOL may be a useful option for patients who undergo combined cataract and PPV surgery for idiopathic MH, particularly for those who require intermediate visual acuity.

Visual function assessment of Chinese cataract patients after individual aspheric intraocular lens implantation according to preoperative cornea spherical aberration.

Aspheric intraocular lens (IOLs) implantation has been widely applied in cataract surgery. However, there is no consensus on the optimal guidance for the operations in IOLs implantation. This study evaluated the visual function of Chinese cataract patients six months after cataract surgery with two different guiding ideologies. We evaluated 50 patients (61 eyes) with implantation of different aspheric IOLs (SN60WF IOLs, ZCB00 IOLs, PY-60AD IOLs, AO IOLs) 6 months after cataract surgery. Twenty-four patients (30 eyes) under individual implantation were ascribed to group 1 and 26 patients (31 eyes) with randomized implantation were ascribed to the control group (group 2). Postoperatively parameters included monocular best-corrected visual acuity (BCVA), contrast sensitivity (CS), total spherical aberration Z (4, 0) at 5 mm pupil size, and patient satisfaction. The quality of life after operation was assessed through the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). Six months after cataract operation, the contrast sensitivity with glare of group 1 at 2.5∘ was 0.697 ± 0.027, and 0.532 ± 0.049 in group 2. Besides, there was no significant difference at any other special frequency. The mean spherical aberration Z (4, 0) at 5 mm pupil size in group 1 was 0.015 ± 0.028 um, and in group 2 was 0.043 ± 0.109 um, with a significant difference (p< 0.01). The mean scores obtained from NEI VFQ-25 were not significantly different. It is effective to implant aspheric IOLs individually according to preoperative corneal spherical aberration. Patients obtained better contrast sensitivity with glare at 2.5∘, but there was no significant difference in BCVA, contrast sensitivity at other special frequency, and subjective visual function.

Accuracy of 24 IOL Power Calculation Methods.

To scrutinize the accuracy of 24 intraocular lens (IOL) power calculation formulas in unoperated eyes. In a series of consecutive patients undergoing phacoemulsification and implantation of the Tecnis 1 ZCB00 IOL (Johnson & Johnson Vision), the following formulas were evaluated: Barrett Universal II, Castrop, EVO 2.0, Haigis, Hoffer Q, Hoffer QST, Holladay 1, Holladay 2, Holladay 2 (AL Adjusted), K6 (Cooke), Kane, Karmona, LSF AI, Naeser 2, OKULIX, Olsen (OLCR), Olsen (standalone), Panacea, PEARL-DGS, RBF 3.0, SRK/T, T2, VRF, and VRF-G. The IOLMaster 700 (Carl Zeiss Meditec AG) was used for biometric measurements. With optimized lens constants, the mean prediction error (PE) and its standard deviation (SD), the median absolute error (MedAE), the mean absolute error (MAE), and the percentage of eyes with prediction erros within ±0.25, ±0.50, ±0.75, ±1.00, and ±2.00 D were analyzed. Three hundred eyes of 300 patients were enrolled. The heteroscedastic method revealed statistically significant differences (P < .05) among formulas. Newly developed methods such as the VRF-G (standard deviation [SD] ±0.387 D), Kane (SD ±0.395 D), Hoffer QST (SD ±0.404 D), and Barrett Universal II (SD ±0.405) were more accurate than older formulas (P < .05). These formulas also yielded the highest percentage of eyes with a PE within ±0.50 D (84.33%, 82.33%, 83.33%, and 81.33%, respectively). Newer formulas (Barrett Universal II, Hoffer QST, K6, Kane, Karmona, RBF 3.0, PEARL-DGS, and VRF-G) were the most accurate predictors of postoperative refractions. [J Refract Surg. 2023;39(4):249-256.].

Effect of anatomical differences and intraocular lens design on negative dysphotopsia.

To assess the effect of ocular anatomy and intraocular lens (IOL) design on negative dysphotopsia (ND). Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands. Ray-tracing study based on clinical data. Ray-tracing simulations were performed to assess the effect of anatomical differences and differences in IOL design on the peripheral retinal illumination. To that end, eye models that incorporate clinically measured anatomical differences between eyes of patients with ND and eyes of pseudophakic controls were created. The anatomical differences included pupil size, pupil centration, and iris tilt. The simulations were performed with different IOL designs, including a simple biconvex IOL design and a more complex clinical IOL design with a convex-concave anterior surface. Both IOL designs were analyzed using a clear edge and a frosted edge. As ND is generally considered to be caused by a discontinuity in peripheral retinal illumination, this illumination profile was determined for each eye model and the severity of the discontinuity was compared between eye models. The peripheral retinal illumination consistently showed a more severe discontinuity in illumination with ND-specific anatomy. This difference was the least pronounced, 8%, with the frosted edge clinical IOL and the most pronounced, 18%, with the clear edge biconvex IOL. These results show that small differences in the ocular anatomy or IOL design affect the peripheral retinal illumination. Therewith, they can increase the severity of ND by up to 18%.

Comparison of newer Kane formula with Sanders Retzlaff Kraff/Theoretical and Barrett Universal II for calculation of intraocular lens power in Indian eyes.

Purpose:To compare the efficacy of Kane formula with Sanders Retzlaff Kraff/Theoretical (SRK/T) and Barrett Universal II in predicting intraocular lens (IOL) power in Indian eyes.Methods:This retrospective study conducted in a tertiary care eye hospital. Data from patients having uneventful cataract surgery with Tecnis ZCB00 IOL implantation were obtained from Lenstar and electronic medical records. Eyes were divided into subgroups based on axial length (AL) as short (<22.0 mm), medium (22–24 mm), and long (>24 mm). The predicted refractive outcome for each patient was calculated after optimizing the lens constant. Prediction error was calculated by subtracting the predicted spherical equivalent from achieved spherical equivalent 1 week post-surgery. The mean absolute error (MAE) and median absolute error (MedAE) and percentage of eyes within 0.25, 0.5, 1, and 2 D were calculated for each formula. Friedman test, Cochrane Q test were used for statistical analysis.Results:Out of the 350 eyes included in the study, we found that without lens constant optimization, Barrett formula performed better than SRK/T and Kane (P < 0.0001). Over the entire range of axial lengths, Kane formula performed slightly inferior compared to Barrett and SRK-T, both of which performed equally well (P = 0.006). On subgroup analysis, Kane formula performed inferiorly for medium eyes as compared to the other two. No significant differences were noted between the formulae for short and long eyesConclusion:Kane formula did not outperform Barrett Universal II and SRK/T in Indian eyes.

Clinical Results of Cataract Surgery Using the ARTIS ® PL E Intraocular Lens

Purpose: To compare the clinical outcomes of cataract surgery using the ARTIS ® PL E (Cristalens Industrie, Lannion, France) intraocular lens (IOL) and conventional Tecnis ® ZCB00 (Johnson &amp; Johnson Vision, Santa Ana, CA, USA) IOL.Methods: This retrospective study examined patients who underwent in-the-bag implantation of either an ARTIS ® PL E (33 eyes, group A) or Tecnis ® ZCB00 (45 eyes, group B) IOL after phacoemulsification performed by a single surgeon. Best-corrected visual acuity (BCVA), spherical equivalent, and higher-order aberrations (HOA) were measured 1 and 3 months after cataract surgery.Results: Preoperative BCVA did not differ significantly in groups A and B. Postoperative BCVA at 1 and 3 months improved significantly (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) in both groups compared to preoperative baseline BCVA. At 1 and 3 months postoperatively, total HOA, spherical aberration, and coma were significantly lower compared to the preoperative baseline HOA (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) in both groups. However, there were no significant differences in the trefoil values 1 and 3 months postoperatively compared to the preoperative baseline in both groups. The absolute refractive error 3 months postoperatively was 0.27 ± 0.20 (group A) and 0.28 ± 0.20 (group B), both within ± 0.50 diopters of the targeted goal diopter; there were no significant differences in the accuracy or predictability of the IOL power calculation in both groups (&lt;i&gt;p&lt;/i&gt; = 0.390, &lt;i&gt;p&lt;/i&gt; = 0.959). The absolute refractive error 1 and 3 months postoperatively did not differ significantly; there were no significant differences in the stability of both IOLs (&lt;i&gt;p&lt;/i&gt; = 0.482, &lt;i&gt;p&lt;/i&gt; = 0.372).Conclusions: Conventional cataract surgery using the ARTIS ® PL E IOL significantly increased the BCVA, while obtaining comparable clinical results to the verified Tecnis ® ZCB00 IOL in postoperative visual acuity and HOA.

Algorithmic intraocular lens power calculation formula selection by keratometry, anterior chamber depth and axial length.

PurposeTo compare the prediction accuracy of algorithmic intraocular lens (IOL) power calculation formula selection method using conventional formulas (Haigis, Hoffer Q, Holladay 1, SRK/T and/or Barrett Universal II) based on keratometry (K), anterior chamber depth (ACD) and axial length (AL).MethodsA total of 1653 patients (1653 eyes) implanted with Tecnis ZCB00 IOL during cataract surgery were enrolled in this study. Intraocular lens (IOL) power calculation formulas with a small absolute value in the sum of the area under the curve measured by K, ACD and AL subgroup were selected to calculate IOL power in the relevant biometry subgroup. The median absolute error (MedAE) calculated by the Haigis, Hoffer Q, Holladay 1, SRK/T and Barrett Universal II formulas individually was compared to that calculated by the algorithmic selection method using four formulas, Haigis, Hoffer Q, Holladay 1 and SRK/T, or five formulas when Barrett is included.ResultsThe MedAE was 0.27 D in the Haigis, 0.30 D in the Hoffer Q, 0.27 D in the Holladay 1, 0.29 D in the SRK/T and 0.26 D in the Barrett Universal II formulas. The MedAEs determined by the algorithmic selection method using four (019 D) and five (0.21 D) formulas were significantly lower than those by the conventional IOL power calculation formulas.ConclusionsThe IOL power calculation formula selection method by biometry subgroup combined with biometric parameters K, ACD and AL may offer a more superior postoperative refractive error prediction in cataract surgery.

Reply

We are pleased by the interest elicited by our work.1 To deal with a new intraocular lens (IOL) implies several considerations that cannot be summarized in only 1 preliminary study. Our main goal in this publication was to compare the clinical outcomes of this new monofocal IOL, Tecnis Eyhance ICB00, to a well-known monofocal aspheric IOL, TECNIS ZCB00.1 The 2 IOLs share the same material and platform and the same chromatic aberration and spherical aberration (SA) (−0.27 μm for 6 mm aperture).2 The Tecnis Eyhance IOL increases depth of focus due to a higher-order aspheric anterior surface with a continuous and localized increase in power from the periphery to the center of the IOL. This is a fundamentally different approach than using SA to extend the depth of focus. Primarily, SA affects the power by a factor of r2, where r is the radius of the pupil. It is for this reason that the effects of primary SA are heavily noticeable for larger pupil sizes, with an increase in the depth of focus and decrease in distance vision quality. This was confirmed by a preclinical study based on clinically relevant metrics, which compared the outcomes provided by TECNIS Eyhance IOL with monofocal IOLs with different aspheric designs and different levels of SA and chromatic aberration.3,4 While TECNIS Eyhance IOL provided improvement in intermediate vision and maintained the distance image quality of an aspheric monofocal IOL, independently of the pupil size, the spherical IOL demonstrated a pupil-dependent behavior: it improved intermediate simulated vision and decreased distance image quality for large pupils, whereas, for small pupils, its performance was similar to an aspheric IOL.4 Therefore, because the depth of focus is not increased through a modification of the SA of the Eyhance IOL, we do not expect that eventual corneal SA and pupil size differences between the 2 groups of patients would affect the outcomes of our study, as suggested by Vamosi and Nemeth.1 We also think that, in a preliminary study, the comparison of 2 IOLs of the same platform adds more value than the comparison of IOLs with different designs and materials. Nevertheless, the suggestion to compare the intermediate vision outcomes of Tecnis Eyhance IOL with those of other monofocal IOLs such as SA-free aspheric IOLs is intriguing and would merit future studies. Regarding the remark about mesopic contrast sensitivity, we clearly stated in the discussion of our article, “in future studies, it could be interesting to compare the mesopic contrast sensitivity between the Eyhance ICB00 IOL and the ZCB00 IOL” and with other monofocal IOLs.1 Of interest, the mesopic contrast sensitivity is a well-known strength of the Tecnis IOL platform.5 We agree that further investigations are necessary to assess whether the new approach of the Tecnis Eyhance IOL represents a step forward in investigating the still little-explored field of intermediate vision.

Clinical Evaluation of a Novel Preloaded Intraocular Lens Delivery System During Routine Cataract Surgery.

PurposeTo evaluate the clinical handleability and acceptability of a novel preloaded intraocular lens (IOL) delivery system for implantation of the TECNIS ZCB00 IOL (Johnson & Johnson Surgical Vision, Inc., Santa Ana, CA, USA) during routine small-incision cataract surgery.Subjects and MethodsIn this prospective, open-label, noncomparative, unilateral or bilateral, multicenter study, adult subjects with unilateral or bilateral cataracts scheduled for IOL implantation were enrolled. Surgeons and surgical technicians completed per-eye day-of-surgery and end-of-surgical-day questionnaires. The primary endpoint of the study was the rate of acceptable overall clinical performance of the preloaded IOL delivery system. Other endpoints included additional responses from the questionnaires, preimplantation incision size, and safety.ResultsThe study included 91 eyes that underwent cataract surgery and IOL implantation using the preloaded delivery system and were available for the 1-day postoperative visit. Five surgeons and 14 surgical technicians from four investigational sites participated in the study. The rate of acceptable overall clinical performance was 100% (91/91) of eyes, with most responses (78/91; 85.7%) being the highest possible rating of 5 (very satisfied). Favorable responses by most surgeons and surgical technicians regarding additional endpoints further highlighted the handleability and acceptability of the preloaded delivery system. No ocular adverse events or lens findings (ie, no cases of IOL instability, haptic breakage, IOL marking, or crimping) were reported.ConclusionThe results of this study demonstrated that this preloaded IOL delivery system was safe and effective during routine small-incision cataract surgery.Trial RegistrationGerman Clinical Trials Register identifier, DRKS00014757.

Comparison of posterior capsule folds following intracapsular implantation of three types of intraocular lenses with different haptic design

AIM: To compare the incidence of posterior capsule folds among different types of intraocular lens (IOL) to determine risk factors of posterior capsule folds. METHODS: It was a retrospective study. We collected the cases in which the patients underwent phacoemulsification (PHACO) and IOL implantation and at least one of the three types of IOL was implanted, including 2-haptic 3-piece IOLs (HOYA PY60AD), 4-haptic 1-piece IOLs (Bausch&amp;Lomb AO), 2-haptic 1-piece IOLs (AMO Tecnis ZCB00). The posterior capsule folds were measured using slit lamp microscope 2d after the surgery. Information of patient’s age, gender, length of ocular axis, intraocular pressure, types of IOL were recorded. Posterior capsule fold risk indicators were identified by using logistic regression analysis. RESULTS: One hundred eighty-seven patients (242 eyes) had been collected, including 80 eyes implanted with HOYA PY60AD IOLs, 81 eyes implanted with Bausch&amp;Lomb AO IOLs, 81 eyes implanted with AMO Tecnis ZCB00 IOLs. The incidence of posterior capsule folds of patients implanted with HOYA PY60AD IOLs was significantly higher than those of patients implanted with AMO Tecnis ZCB00 IOLs. While the incidence of patients implanted with Bausch&amp;Lomb AO IOLs was significantly lower than those of patients implanted with AMO Tecnis ZCB00 IOLs. Multi-factor logistics regression analysis demonstrated that independent risk factors were type of IOLs and length of ocular axis. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs increased the risk of posterior capsule folds [P=0.020, OR (95%CI)=2.145 (1.129, 4.073)], while using Bausch&amp;Lomb AO IOLs reduced the risk [P=0.001, OR (95%CI)=0.274 (0.127, 0.591)]. Shorter ocular axis might increase the risk of posterior capsule folds [P=0.012, OR (95%CI)=0.669 (0.489, 0.915)]. CONCLUSION: Haptic design should be an important consideration in IOL design. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs is more likely to lead to posterior capsule folds formation, while using Bausch&amp;Lomb AO IOLs is less likely to lead the formation. The posterior capsule folds are more engendered in eyes with shorter ocular axis.

Comparison of a new swept-source optical biometer with a partial coherence interferometry

BackgroundThe purpose of this study is to compare the biometric parameters and intraocular lens (IOL) power calculation by a new swept-source optical coherence tomography (SS-OCT) biometer with those by a partial coherence interferometry (PCI) biometer.MethodsMedical records of 175 eyes from 175 patients were retrospectively reviewed. One of two monofocal IOLs (Tecnis ZCB00 or Acrysof SA60AT) were implanted in the eyes. Axial length (AL), mean keratometry (Km), J0, J45 and anterior chamber depth (ACD) were compared between PCI and SS-OCT biometers. The refractive mean error (ME) and refractive mean absolute error (MAE) were also compared. Examination failure rates were calculated in each device.ResultsOut of 175 eyes, 150 eyes were successfully examined by both devices. AL was measured slightly shorter when using SS-OCT than PCI biometer, while Km was measured higher (P < .0001, P = .03, respectively, paired t-test). J0, J45 and ACD were not significantly different between two devices. ME and MAE calculated using SRK-T, Hoffer Q, and Haigis formula were not significantly different except MAE calculated with Haigis formula for Tecnis ZCB00 IOLs (P = .03, paired t-test). The examination failure rates were 14.29 and 1.14% when using the PCI and SS-OCT biometers, respectively.ConclusionsAL and Km don’t seem to be comparable between two devices, while J0, J45, and ACD do. IOL power calculation using SRK-T and Hoffer Q was correlated between the devices. The penetration ability of a SS-OCT biometer is superior.

Evaluation of anterior capsular contraction syndrome after cataract surgery with commonly used intraocular lenses.

PurposeThe purpose of this study was to compare the incidence of anterior capsular contraction syndrome (ACCS) in cataract patients after implantation with one of two most commonly used hydrophobic acrylic lenses.SettingThis study included patients from Loma Linda University, Loma Linda, CA, USA.DesignThis study is a retrospective chart review.MethodsIn this study, 1,047 eyes of 811 patients with and without known ACCS risk factors who underwent successful phacoemulsification and intraocular lens (IOL) implantation were included. Eyes that sustained intraoperative capsular tears and patients with a postoperative follow-up of <1 month were excluded. Each patient underwent surgery by the same surgeon receiving either the SN60WF IOL or the ZCB00 IOL. The duration of postoperative follow-up along with the presence of ACCS and the dimensions of the anterior capsule opening in these cases were recorded. The incidence of ACCS between the two lenses was compared.ResultsACCS was significantly (P=0.045) less frequent in those patients who received the ZCB00 lens compared to those who received the SN60WF lens, despite a significantly greater (P<0.0001) number of patients with ACCS risk factors in the ZCB00 cohort.ConclusionIn a direct comparison of the ZCB00 and SN60WF IOLs, a lower incidence of ACCS was found with ZCB00 IOL.

Two single-piece acrylic intraocular lens choices and their effect on patient-reported driving habits

To determine whether intraocular lens (IOL) type affects patient driving habits 6months to 5years after cataract surgery, and to determine whether there were differences in self-reported driving habits between patients who received 1 of 2 IOLs. John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Retrospective case series. Patients completed a telephone-administered Driving Habits Questionnaire (DHQ) 6months to 5years afterhaving bilateral cataract surgery with a single-piece hydrophobic acrylic IOL, SN60WF (Group 1) or ZCB00 IOL (Group 2), in both eyes. The study comprised 260 patients (130 in each IOL group). Of these, 117 in Group 1 and 114 in Group 2 were still active drivers. The DHQ response differences for each IOL group did not reach statistical significance, except for self-rated quality of driving and difficulties with driving at night. Forthese significant differences, contradictory results were found. Patients with either of the monofocal IOLs had similar self-reported driving habits after bilateral cataract surgery. The choice of IOL did not affect patients' postoperative driving habits.

Reading and quality of life differences between Tecnis ZCB00 monofocal and Tecnis ZMB00 multifocal intraocular lenses.

To compare the NEI-RQL-42 quality of life questionnaire and the Radner Vissum reading test outcomes after bilateral cataract surgery with implantation of Tecnis ZCB00 monofocal and Tecnis ZMB00 multifocal intraocular lens (IOL). Forty-two eyes of 21 patients who had phacoemulsification were implanted with Tecnis ZCB00 IOL and 82 eyes of 41 patients were implanted with Tecnis ZMB00 IOL. They answered the NEI-RQL-42 questionnaire before cataract surgery and 3 months after it. The Radner Vissum test was performed 3 months after the surgery with optical correction for near vision in patients with monofocal IOL, but without it in patients with multifocal IOL. Regarding the NEI-RQL-42 test, the multifocal group obtained better results in items 2, 7, 8, 11, 13, 31, and 40, and in the following categories: near vision, dependence on correction, and suboptimal correction (p<0.05). The monofocal group only showed better results in item 17. As for the Radner Vissum test, the multifocal group obtained significantly better results in phrases 1, 3, 4, and 5, and in the number of incorrect syllables (p<0.05). Patients with Tecnis ZMB00 multifocal IOL report a higher quality of life regarding the lack of need for optical correction for near vision in their daily activities, but halos in vision at night. Additionally, patients with multifocal IOL achieve similar or better reading quality at near vision and under photopic lighting conditions than patients with monofocal IOL with near vision optical correction.

Effect of a single-piece aspheric hydrophobic acrylic intraocular lens design on centration and rotation

To assess the rotation and centration stability of the new design features of a 1-piece aspheric hydrophobic acrylic intraocular lens (IOL). National Eye Hospital, Cairo, Egypt. Randomized clinical trial. Patients in this study had implantation of a 1-piece Tecnis 1 ZCB00 IOL or a 3-piece Sensar AR40e IOL. Decentration and rotation were recorded immediately postoperatively, and 2 to 3 days and 8 weeks postoperatively. This was done using 2 slitlamp eyepieces and referring to constant corneal landmarks (ie, the limbus and the phaco incision). Thirty-two 1-piece IOLs and 30 3-piece IOLs were implanted. Although the 1-piece IOLs moved toward the corneal center more than the 3-piece IOLs between 3 days and 8 weeks postoperatively (P=.054), the difference was not statistically significant between 0 day and 3 days or during the entire follow-up (P=.546 and P=.367, respectively). There were no statistically significant differences in the horizontal or vertical components of this movement between the 2 groups (P=.883 and P=.636, respectively). The mean rotation was 2.5 degrees ± 9.1 (SD) in the 1-piece IOL group and 0 ± 6.5 degrees in the 3-piece IOL group, with no statistically significant difference between the groups (P=.521). The new 1-piece design showed relatively good centration and stability in the horizontal, vertical, and rotational aspects.

Decentration and tilt of a single-piece aspheric intraocular lens compared with the lens position in young phakic eyes

To compare the tilt and decentration of a single-piece aspheric intraocular lens (IOL) and the position of the natural crystalline lens in young individuals. Department of Ophthalmology, Knappschafts Hospital, Sulzbach, Germany. This prospective noncomparative single-center study included volunteers younger than 40 years with no ocular abnormalities (crystalline lens group) and patients older than age 62 who had uneventful cataract surgery and Tecnis ZCB00 IOL implantation (IOL group). All eyes were examined with the OPD-Scan II; spherical aberration, vertical coma Z(3,-1), and horizontal coma Z(3,1) were analyzed with a 5.0 mm pupil. Lens tilt and decentration were studied with a new Purkinje meter. The crystalline lens group and IOL group comprised 20 subjects (40 eyes) each. Both groups showed compensation for corneal spherical aberration and neutralization of horizontal corneal coma. All lenses were tilted upward (mean 2.2 degrees, crystalline lens; 2.5 degrees, IOL) and to the temporal side (mean 3.1 degrees, crystalline lens; 2.6 degrees, IOL). The crystalline lenses were decentered downward (mean 0.16 mm) and to the temporal side (mean 0.07 mm). The IOL was displaced to the nasal side of the pupil (mean 0.06 mm) with almost no vertical mean decentration (0.02 mm upward). The aspheric IOL and young crystalline lens compensated for mean corneal spherical aberration, resulting in low total spherical aberration. The position of the IOLs showed minimal decentration and tilt and was mirror symmetrical, comparable to the position of the crystalline lens in young individuals. The slight malpositioning partially compensated for corneal horizontal coma.