AIM:To assess the visual outcomes of aspheric multifocal intraocular lenses(IOLs) compared with spherical multifocal IOL after cataract surgery.METHODS:Potential prospective controlled trials that comparing aspheric m...AIM:To assess the visual outcomes of aspheric multifocal intraocular lenses(IOLs) compared with spherical multifocal IOL after cataract surgery.METHODS:Potential prospective controlled trials that comparing aspheric multifocal IOL implantation with spherical multifocal IOL group were extracted from the computer database.The statistical analysis was carried out using Stata 10 software.Standardized mean differences with 95% confidence intervals(CIs) were calculated for continuous variables.The pooled estimates were computed in the use of a random-effects model. RESULTS:A systematic review identified five prospective nonrandomized controlled trials,including 178 aspheric multifocal IOL and 164 spherical multifocal IOL.There was no significant difference in uncorrected distance visual acuity(95%CI,-0.248 to 0.152;P=0.641) and uncorrected near visual acuity(95% CI,-0.210 to 0.428;P=0.504) between aspheric multifocal IOL and spherical multifocal IOL.Statistically significant differences were detected less spherical aberration in aspheric multifocal IOL(95% CI,-1.111 to-0.472;P<0.001) when compared to spherical multifocal IOL.Spherical multifocal IOL showed a greater higher order aberration compared to the aspheric multifocal IOL(95% CI,-1.024 to-0.293;P<0.001).Sensitivity analysis suggested that the results were relatively reliable. CONCLUSION:The overall findings indicated that aspheric multifocal IOL and spherical multifocal IOL provided similar visual acuity at near and distance.Patients implanted with aspheric multifocal IOL had less spherical aberration and higher order aberration than patients with spherical multifocal IOL.Further well organized,prospective controlled trials involving larger patient numbers are needed.展开更多
AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ·MET...AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ·METHODS: Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively: monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best - corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire. ·RESULTS:Threemonthspostoperatively,themonocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups. ·CONCLUSION: Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractivepower than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo.展开更多
Purpose:To evaluate visual outcomes after implantation of an aspheric multifocal /intraocular lens.(MIOL).or an aspheric monofocal intraocular lens (IOL).Methods:This was a prospective nonrandomized study.During 3-mon...Purpose:To evaluate visual outcomes after implantation of an aspheric multifocal /intraocular lens.(MIOL).or an aspheric monofocal intraocular lens (IOL).Methods:This was a prospective nonrandomized study.During 3-months of post-operative follow-up,the following outcomes for SN6AD1 MIOL.(multifocal group).and SN60WF IOL (monofocal group) were compared:uncorrected (UDVA) and corrected (CDVA) distance visual acuity,uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity,Chinese character near visual acuity,uncorrected intermediate visual acuity (UIVA) under high (100% contrast) and low contrast.(10% contrast),UIVA for different IOL powers,and a quality-of-life questionnaire.Results:UNVA,DCNVA,and UIVA under high contrast in the multifocal group were significantly better than those in the monofocal group (P<0.05).UDVA,CDVA and UIVA under low contrast did not differ between groups at 63 cm and 100 cm (P >0.05).In most cases,Chinese character near visual acuity was significantly better in the multifocal group.(P < 0.05).UNVA and UIVA at 63 cm improved over time during 3 months post-operatively.Better UIVA was found in emmetropic and mild myopic eyes as compared to hyperopic ones.The patients in the multifocal group had a higher degree of satisfaction and performed better on near and intermediate tasks,although with greater complaints of visual disturbance.Conclusion:The SN6AD1 MIOL provides significantly better UNVA,DCNVA and UIVA under high contrast conditions,and better Chinese character near visual acuity.Patients receiving the SN6AD1 MIOL reported a better quality of vision in spite of more serious visual disturbances.Better UIVA was observed in emmetropic and mildly myopic eyes.展开更多
AIM: To compare higher order aberrations in two aspherical intraocular lenses(IOLs): Akreos advanced optics(AO) and Dr. Schmidt Microcrystalline 6125 aspheric anterior surface(MC6125AS) with each other. METHODS: Forty...AIM: To compare higher order aberrations in two aspherical intraocular lenses(IOLs): Akreos advanced optics(AO) and Dr. Schmidt Microcrystalline 6125 aspheric anterior surface(MC6125AS) with each other. METHODS: Forty eyes of 39 patients underwent phacoemulsification and Akreos AO and MC6125 AS were implanted in their eyes in a random manner. Three months post-operatively, higher order aberrations including spherical aberration, coma aberration, and total aberrations were measured and compared.RESULTS: The total aberration was 0.24±0.17 in eyes with Dr. Schmidt and 0.20 ±0.01 in eyes with Akreos AO(P =0.361). The mean of coma aberration was 0.17 ±0.21 and 0.09 ±0.86 in Dr. Schmidt and Akreos lenses,respectively(P =0.825). Total spherical aberration was almost the same in both groups(mean: 0.05, P =0.933).Best corrected visual acuity in Akreos AO(0.10±0.68) and Dr. Schmidt(0.09±0.67) did not differ significantly(P =0.700). CONCLUSION: There is no statistically significant difference in the higher order aberrations between these two aspherical lenses.展开更多
With the evolution of cataract surgery from visual rehabilitation to refractive surgery, aspheric intraocular lenses(IOLs) are being increasingly used in the field of ophthalmology. This increased use can be attribute...With the evolution of cataract surgery from visual rehabilitation to refractive surgery, aspheric intraocular lenses(IOLs) are being increasingly used in the field of ophthalmology. This increased use can be attributed to negative or zero spherical aberrations with unique optical designs, which counteract some of the positive spherical aberrations of the cornea. These alterations reduce the total spherical aberration of human eyes and improve the visual acuity in patients with cataract postoperatively. At present, various types of aspheric IOLs are used worldwide. Although the implantation of aspheric IOL is beneficial to the patients who need correction of spherical aberrations, much controversy is still associated with ocular residual spherical aberrations that facilitate the best visual quality for patients postoperatively. In order to provide reference for future clinical work and scientific research, this report reviews the relationship between the ocular residual spherical aberration of human eyes and visual quality.展开更多
Objective: To compare patient-reported outcomes after implantation of the ZA9003 intraocular lens(IOLs), or the MCX11 ASP IOLs or the spherical IOLs(HQ-201HEP). Methods: Prospective nonrandomized controlled trial was ...Objective: To compare patient-reported outcomes after implantation of the ZA9003 intraocular lens(IOLs), or the MCX11 ASP IOLs or the spherical IOLs(HQ-201HEP). Methods: Prospective nonrandomized controlled trial was used. A total of 105 patients(210 eyes) were divided into three groups according to the type of IOLs: ZA9003(35 patients, 70 eyes), MCX11 ASP(35 patients, 70 eyes) or HQ-201HEP(35 patients, 70 eyes). The main outcome was scores of Catquest nine-item short-form questionnaire. Additional outcome was best corrected visual acuities, spherical aberration(SA) and total higher-order aberrations(HOAs). Results: The global score was significantly lower in the spherical IOL group than the aspherical IOL group of-020 μm SA(P < 0.05) and the aspherical IOL group of-027 μm SA(P < 0.05), and no significant difference was found in the global score between the aspherical IOL group of-020 μm SA than the aspherical IOL group of-027 μm SA(P > 0.05). Significant differences were also found in question 2, question 5, question 6 and question 8 between the spherical IOLs and the aspherical IOLs. Conclusion: Implantation of an aspherical IOL could improve vision-related quality of life compared with a spherical IOL. However, there were no statistically significant differences in vision-related quality of life between aspheric IOLs with different negative spherical aberrations.展开更多
AIM:To evaluate the accuracy of eight different intraocular lens(IOL)power calculation formulas for a segmented multifocal IOL.METHODS:A total of 53 eyes of 41 adult cataract patients who underwent phacoemulsification...AIM:To evaluate the accuracy of eight different intraocular lens(IOL)power calculation formulas for a segmented multifocal IOL.METHODS:A total of 53 eyes of 41 adult cataract patients who underwent phacoemulsification and implantation with the SBL-3 segmented multifocal IOL between January 1,2017 and January 31,2019 were included in this retrospective study.Preoperative biometry measurements were obtained using an IOL Master.Manifest refraction was performed at least 4 wk postoperatively.Accuracy of the eight formulas[Barrett Universal II,Emmetropia Verifying Optical(EVO),Haigis,Hill-RBF 2.0,Hoffer Q,Holladay 1,Kane,and SRK/T]was analyzed.RESULTS:Using current lens constants,all formulas exhibited errors of slight myopic shift in refractive prediction.The Barrett Universal II formula had a significantly lower median absolute error(MedAE)than did Holladay 1(P=0.02),Kane(P=0.001)and Hill-RBF 2.0(P<0.001)formulas.The Haigis formula had a lower MedAE value than did the Hill-RBF 2.0 formula(P=0.005).Differences in MedAE values among SRK/T,EVO and Hoffer Q formulas were not significant.After optimizing lens constants,the MedAE values of all formulas were reduced;significant changes were noted for EVO(P=0.022),Haigis(P=0.048);Hill-RBF 2.0(P=0.014),Holladay 1(P=0.045)and Kane(P=0.022)formulas.All formulas performed equally well after optimization of lens constants(P=0.203).CONCLUSION:All eight formulas tend to result in a myopic shift when using current lens constants.Optimized lens constants improve the accuracy of these formulas among adult Chinese patients.展开更多
AIM: To investigate the independent factors associated with photic phenomena in patients implanted with refractive,rotationally asymmetric,multifocal intraocular lenses(MIOLs).METHODS: Thirty-four eyes of 34 patients ...AIM: To investigate the independent factors associated with photic phenomena in patients implanted with refractive,rotationally asymmetric,multifocal intraocular lenses(MIOLs).METHODS: Thirty-four eyes of 34 patients who underwent unilateral cataract surgery,followed by implantation of rotationally asymmetric MIOLs were included.Distance and near visual acuity outcomes,intraocular aberrations,preferred reading distances,preoperative and postoperative refractive errors,mesopic and photopic pupil diameters,and the mesopic and photopic kappa angles were assessed.Patients were also administered a satisfaction survey.Photic phenomena were graded by questionnaire.Independent-related factors were identified by correlation and bivariate logistic regression analyses.RESULTS: The distance from the photopic to the mesopic pupil center(pupil center shift) was significantly associated with glare/halo symptoms [odds ratio(OR)=2.065,95% confidence interval(CI)=0.916-4.679,P=0.006] and night vision problems(OR=1.832,95% CI=0.721-2.158,P=0.007).The preoperative photopic angle kappa was significantly associated with glare/halo symptoms(OR=2.155,95% CI=1.065-4.362,P=0.041).The photopic angle kappa was also significantly associated with glare/halo symptoms(OR=2.155,95% CI=1.065-4.362,P=0.041) and with night vision problems(OR=1.832,95% CI=0.721-2.158,P=0.007) in patients implanted with rotationally asymmetric MIOLs.CONCLUSION: A large pupil center shift and misalignment between the visual and pupillary axis(angle kappa)may play a role in the occurrence of photic phenomena after implantation of rotationally asymmetric MIOLs.展开更多
Multifocal intraocular lenses(IOLs) are currently usually implanted for the treatment of cataracts because they have been proved to be superior to monofocal IOLs with respect to spectacle independence. In turn, they a...Multifocal intraocular lenses(IOLs) are currently usually implanted for the treatment of cataracts because they have been proved to be superior to monofocal IOLs with respect to spectacle independence. In turn, they are associated with a higher prevalence of dysphotopsia symptoms that is one of the most common causes of patient dissatisfaction. Neuroadaptation seems to play a major role in the optimal adaptation to multifocal IOLs. In this context, the development of strategies that facilitate the neuroadaptation process to multifocality might be an effective strategy to reduce patients' dissatisfaction. Video games have been proved to be effective for the improvement of visual acuity and for the promotion of neuroplasticity in elderly subjects and other populations with cortical-related visual impairment. This narrative review highlights the physiological potential of video games as a perceptual strategy to improve visual acuity and promote neuroplasticity in patients using multifocalIOLs, although research is still needed to confirm these benefits in this specific population, with only one comparative study to this date providing evidence of them.展开更多
AIM:To compare the visual performance of pseudophakic eyes implanted with Al-UV and SN60WF aspheric intraocular lens(IOL),and to investigate the correlations between visual quality parameters and pupil size.METHODS:Th...AIM:To compare the visual performance of pseudophakic eyes implanted with Al-UV and SN60WF aspheric intraocular lens(IOL),and to investigate the correlations between visual quality parameters and pupil size.METHODS:This prospective comparative study included 105 eyes of 90 patients with age-related cataract who underwent uneventful phacoemulsification.The subjects were divided into two groups according to the implanted IOL type.Three months postoperatively,visual acuity and contrast sensitivity were measured,wave-front aberrations were assessed using a KR-IW aberrometer(Topcon),and objective optical quality parameters were performed using an optical quality analysis system-OQAS Il(Visiometrics).Independent sample Mest and Spearman correlation analysis were used for data analysis.RESULTS:There were no significant differences found in visual acuity,contrast sensitivity and visual quality parameters between the two groups(P>0.05).The measured intraocular spherical aberration(SA)in Al-UV IOL eyes of-0.19±0.05 pm was close to the designed SA value of-0.20 pm.The modulation transfer function cutoff,Strehl ratio and OQAS values were negatively correlated with pupil size in both groups(P<0.01).CONCLUSION:The subjective and objective visual quality in pseudophakic eyes with A1-UV and SN60WF IOLs are comparable.For aspheric IOL eyes,visual quality decreases with increasing pupil size.展开更多
AIM:To evaluate clinical outcomes of unilateral implantation of a diffractive multifocal intraocular lens(IOL)in patients with contralateral monofocal IOL.METHODS:Twenty-two patients who already had implantation of a ...AIM:To evaluate clinical outcomes of unilateral implantation of a diffractive multifocal intraocular lens(IOL)in patients with contralateral monofocal IOL.METHODS:Twenty-two patients who already had implantation of a monofocal IOL in unilateral eye underwent implantation of a diffractive multifocal IOL in contralateral eye were enrolled.After 1,6,and 12 mo,uncorrected and distant corrected distant visual acuity(UCDVA and DCDVA),uncorrected and distant corrected intermediate-visual acuity(UCIVA and DCIVA),uncorrected and distant corrected near visual acuity(UCNVA and DCNVA),and contrast sensitivity were obtained.Halo/glare symptoms,spectacle dependence,and patient satisfaction were also evaluated.RESULTS:The mean age was 67.86±7.25 y and the average interval between two IOL implantations was 645.82±878.44 d.At 1 mo,binocular UCDVA was lower than 0.20 logMAR in 76%of patients(mean 0.12±0.13 logMAR),which increased to 90%by 6 and 12 mo.The binocular UCDVA was significantly better than the monocular results(P<0.05)at 1,6,and 12 mo.Additionally,UCNVA was lower than 0.40 logMAR in 82%of patients,increasing to 90%by 6 and 12 mo.Mean UCNVA in the multifocal IOL implanted eye was statistically significantly better than that in the monofocal IOL implanted eye(P<0.05)at 1,6,and 12 mo.About 5%of patients at 1 and 6 mo,reported"severe glare or halo".Patient satisfaction rates were 95%and 91%at 6 and 12 mo,respectively.CONCLUSION:Unilateral implantation of multifocal IOL in patients with a contralateral,monofocal IOL implantation results in high patient satisfaction rate,with low severe glare or halo rate during follow-up.It can represent a good option for patients who have previously had a monofocal IOL implantation regardless of two year interval duration between two IOL implantations.展开更多
AIM: To compare the visual functional outcomes with accommodating and multifocal intraocular lenses(IOLs).METHODS: Our retrospective comparative study included 51 patients(60 eyes) received implantation of an accommod...AIM: To compare the visual functional outcomes with accommodating and multifocal intraocular lenses(IOLs).METHODS: Our retrospective comparative study included 51 patients(60 eyes) received implantation of an accommodating IOL(Tetraflex;16 patients,20 eyes),a refractive multifocal IOL(Re Zoom;18 patients,20 eyes),or a diffractive multifocal IOL(ZMA00;17 patients,20 eyes).Subjective refraction,visual acuity,contrast sensitivity(CS),intraocular aberration,and subjective photic phenomena were detected at 3mo after surgery.RESULTS: The spherical equivalent in the three groups was-0.38±0.54 D,0.14±0.56 D,and 0.35±0.41 D,respectively.No statistically significant differences were found in uncorrected and corrected distance visual acuity and uncorrected intermediate visual acuity among the groups(P=0.39).The Re Zoom group had significantly better distance-corrected intermediate visual acuity than the ZMA00 group(P=0.003).The ZMA00 group had significantly better near visual acuity than the other groups(P<0.05).Better contrast sensitivity values were observed in the Tetraflex group under most of the spatial frequencies conditions(P=0.025).The total aberration was lowest in the ZMA00 group(P=0.000),and the spherical aberration was highest in the Tetraflex group(P=0.000).The three groups had similar frequency of ghosting and glare,and the Tetraflex group had a low rate of halos(P=0.01).CONCLUSION: Both accommodating and multifocal IOLs can successfully restore distance and uncorrected intermediate visual acuities.Tetraflex accommodating IOLs perform better in CS and with less halos of photic phenomena.Re Zoom refractive multifocal IOLs havebetter performance in distance-corrected intermediate visual acuity than ZMA00 diffractive multifocal IOLs,and the latter achieved better near visual acuity and efficiently decreased the optical aberration.展开更多
·AIM:To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens(IOL)and asymmetric refractive multifocal IOL.·METHODS:The prospective nonrandom,comparative stu...·AIM:To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens(IOL)and asymmetric refractive multifocal IOL.·METHODS:The prospective nonrandom,comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs:AT LISA tri 839 MP(30 eyes;Carl Zeiss Meditec,Germany)and LS-313 MF30(30 eyes;Oculentis GmbH,Germany).Visual acuity,refractive outcome,contrast sensitivity,defocus curves,quality of vision,and optical phenomena were evaluated at3 mo postoperatively.·RESULTS:There were no statistical differences between groups in uncorrected distance visual acuity(P=0.13)and uncorrected near visual acuity(P=0.54).In contrast,uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group(P=0.02).No significant statistical between-group difference was detected in cylinder(P=0.43).Compared to trifocal group,spherical refraction and spherical equivalent in refractive multi focal group were more myopic(P<0.01).Under photopic conditions,no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree(cpd).The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group(P=0.01,P=0.034,respectively).The questionnaires of quality of vision and optical phenomena showed no differences between groups.·CONCLUSION:Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity.Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.展开更多
AIM: To assess the binocular visual function in bilateral cataract patients with unilateral astigmatism after combined implantations of Toric with multifocal intraocular lens(IOL), and to compare with that of Toric an...AIM: To assess the binocular visual function in bilateral cataract patients with unilateral astigmatism after combined implantations of Toric with multifocal intraocular lens(IOL), and to compare with that of Toric and monofocal IOL implantation.· METHODS: All the 30 patients with unilateral astigmatism suffered bilateral cataract were randomly divided into two groups: Toric plus multifocal IOL group and Toric plus monofocal IOL group. Uncorrected and corrected visual acuity at distance(5.0 m), intermediate distance(0.6 m), and near(0.33 m), contrast sensitivity,and stereopsis were assessed 6mo after surgery.Patients were also surveyed for visual disturbances and spectacle dependence.·RESULTS: Binocular uncorrected visual acuity(log MAR)of Toric/multifocal IOL eyes at distance, intermediate,near were 0.05±0.05, 0.24±0.10, and 0.14±0.06 respectively.The values of Toric plus monofocal IOL eyes were 0.06 ±0.07, 0.26±0.08, and 0.37 ±0.10 respectively. These values did not indicate significant differences between two groups with exception of near visual acuity. In the photopic condition(with or without glare), the contrast sensitivity of multifocal IOL eyes was significant lower than the monofocal IOL eyes in 18 cpd. In the mesopic condition, the contrast sensitivity of multifocal group was significant lower than monofocal group in 12 cpd, and in mesopic glare condition, this significant difference was found both in 6 cpd and 12 cpd. The stereopsis of Toric/multifocal IOL eyes decreased slightly(100 ±80 seconds of arc, t =2.222, P =0.136). Mean near vision for patient satisfaction was statistically significantly higher in Toric/multifocal IOL group patients versus than that in Toric/monofocal IOL group(80% vs 25.5%, P =0.000). Visual disturbance was not noticed in either group.·CONCLUSION: Although the combination of Toric and multifocal IOL implantation results in compromising stereoacuity, it can still provide patients with high levels of spectacle freedom and good overall binocular visual acuity.展开更多
AIM:To evaluate clinical outcomes after implantation of a new diffractive aspheric multifocal intraocular lens(IOL) with +3.00 addition power.METHODS:This is a retrospective,consecutive case series of cataract patient...AIM:To evaluate clinical outcomes after implantation of a new diffractive aspheric multifocal intraocular lens(IOL) with +3.00 addition power.METHODS:This is a retrospective,consecutive case series of cataract patients who underwent bilateral implantation of the Optiflex MO/HF D012(Moss Vision Inc.Ltd,London,UK) multifocal IOL.Patients followed for 6 mo were included in the study.Data on distance,intermediate and near visual acuity,refractive error [manifest spherical equivalent(MSE)],contrast sensitivity,adverse events,subjective symptoms,spectacle independence and patient satisfaction [visual function questionnaire(VFQ)-25 questionnaire] were retrieved from electronic medical records and analyzed.RESULTS:Forty eyes of 20 patients with a mean age of 66.7±8.5 y(range:53-82) were included in the study.Mean uncorrected distance,near and intermediate visual acuity remained stable through postoperative visits and was 0.19±0.19 log MAR,Jaeger 4 and Jaeger 3 respectively at the 6 mo visit.At the end of postoperative 6 mo,MSE was-0.14±0.42 diopters(D) and 98% of the eyes were within 1.00 D of target refraction.Postoperative low contrast(10%) visual acuity remained stable(P=0.54) through follow up visits with a mean of 0.35±0.17 log MAR at the 6 mo visit.There were no reported adverse events.None of the patients reported subjective symptoms of halo or glare.Spectacle independence rate was 90%.Mean VFQ-25 questionnaire score was 93.5±6.12.CONCLUSION:The Optiflex MO/HF-DO12 IOL was safely implanted and successfully restored distance,intermediate and near visual acuity without impairing contrast sensitivity.High levels of spectacle independence were achieved at all distances including intermediate distance.展开更多
Dear Editor,We write you to present a 20-year-old man with resistant spasm of accommodation without any organic cause treated with clear lens extraction(CLE)with phacoemulsification and multifocal intraocular lens(IOL...Dear Editor,We write you to present a 20-year-old man with resistant spasm of accommodation without any organic cause treated with clear lens extraction(CLE)with phacoemulsification and multifocal intraocular lens(IOL)implantation.Spasm of accommodation is a rare condition展开更多
BACKGROUND Asymmetric multifocal intraocular lenses(IOLs)are now widely used in the modern cataract surgery,providing a good level of visual performance over a range of distances and high postoperative patient satisfa...BACKGROUND Asymmetric multifocal intraocular lenses(IOLs)are now widely used in the modern cataract surgery,providing a good level of visual performance over a range of distances and high postoperative patient satisfaction.We report a case of improved visual quality after shifting the near segment of an asymmetrical multifocal IOL to the superotemporal placement in the dominant eye of a glaucoma patient.CASE SUMMARY A 72-year-old woman with bilateral glaucoma underwent phacoemulsification in the dominant eye(left eye)with implantation of an asymmetrical multifocal IOL.Postoperative uncorrected distance visual acuity(UDVA)was 0.0 logMAR(20/20 Snellen)and uncorrected near visual acuity(UNVA)was 0.1 logMAR(20/25 Snellen).Two weeks later,the patient presented to our clinic with decreased vision due to migration of lens epithelial cells to IOL anterior surface and edema of corneal endothelial cells.Anterior capsule polishing and superotemporal placement of near segment[+3.00 diopter(D)addition(add)]of IOL were performed.As a result,UDVA at the first week and first year after reposition was 0.0 logMAR(20/20 Snellen),and compared with 0.3 logMAR(20/40 Snellen)in the first week,the UNVA was improved to 0.0 logMAR(20/20 Snellen)one year after surgery.CONCLUSION The postoperative inflammatory reaction and lens epithelial cells proliferation were obvious in this glaucoma patient.Capsule polishing and rotation of the lens were beneficial to the patient,which not only enhanced the patient's vision,but also improved the patient's satisfaction.Therefore,glaucoma patients need to be cautious of implanting multifocal IOLs.Placement of a near segment of an asymmetrical multifocal IOL in the dominant eye should be performed on an individual basis.展开更多
Purpose : To evaluate the clinical effects of implantation of Array multifocal intraocular lenses.Methods : Thirty-one cases (37 eyes) of cataract patients, including 15 males(19 eyes)and 16 females(18 eyes), were inv...Purpose : To evaluate the clinical effects of implantation of Array multifocal intraocular lenses.Methods : Thirty-one cases (37 eyes) of cataract patients, including 15 males(19 eyes)and 16 females(18 eyes), were involved in this study. All patients underwent standard phacoemulsification with Array multifocal intraocular lens implantation. The complications during operation, postoperative distant visual acuity, near visual acuity,corneal curvature and visual symptoms were observed.Results : the mean value of best postoperative visual acuity was recorded as follows: uncorrected distant visual acuity was 0. 8, the best-corrected distant visual acuity was 0.9, uncorrected near visual acuity was 0. 5, near visual acuity with distant-corrected was 0.6, the best-corrected near visual acuity wss 0.9. The astigmatism of cornea was less than 1.5 D pre-operatively and post-operatively. One patient complained of glare. Conclusion : Array multifocal intraocular lens can provide good distant and near visual acuity. With observation of more cases and follow-up of longer time, we can draw a further conclusion. Eye Science 2001; 17 : 57 - 60.展开更多
Background:To compare objective electrophysiological contrast sensitivity function(CSF)in patients implanted with either multifocal intraocular lenses(MIOLs)or monofocal intraocular lenses(IOLs)by pattern reversal vis...Background:To compare objective electrophysiological contrast sensitivity function(CSF)in patients implanted with either multifocal intraocular lenses(MIOLs)or monofocal intraocular lenses(IOLs)by pattern reversal visual evoked potentials(prVEP)measurements.Methods:Fourty-five cataract patients were randomly allocated to receive bilaterally:apodized diffractive-refractive Alcon Acrysof MIOL(A),full diffractive AMO Tecnis MIOL(B)or monofocal Alcon Acrysof IOL(C).Primary outcomes:1-year differences in objective binocular CSF measured by prVEP with sinusoid grating stimuli of 6 decreasing contrast levels at 6 spatial frequencies.Secondary outcomes:psychophysical CSF measured with VCTS-6500,photopic uncorrected distance(UDVA),and mesopic and photopic uncorrected near and intermediate visual acuities(UNVA and UIVA respectively).Results:Electrophysiological CSF curve had an inverted U-shaped morphology in all groups,with a biphasic pattern in Group B.Group A showed a lower CSF than group B at 4 and 8 cpd,and a lower value than group C at 8 cpd.Psychophysical CSF in group A exhibited a lower value at 12 cpd than group B.Mean photopic and mesopic UNVA and UIVA were worse in monofocal group compared to the multifocal groups.Mesopic UNVA and UIVA were better in group B.Conclusions:Electrophysiological CSF behaves differently depending on the types of multifocal or monofocal IOLs.This may be related to the visual acuity under certain conditions or to IOL characteristics.This objective method might be a potential new tool to investigate on MIOL differences and on subjective device-related quality of vision.展开更多
AIM:To evaluate clinical outcomes following implantation of an extended range of vision intraocular lens(IOL),the ZXR00,and a diffractive multifocal IOL with+2.75 diopters(D)add power,the ZKB00.METHODS:Totally 30 pati...AIM:To evaluate clinical outcomes following implantation of an extended range of vision intraocular lens(IOL),the ZXR00,and a diffractive multifocal IOL with+2.75 diopters(D)add power,the ZKB00.METHODS:Totally 30 patients who underwent either bilateral implantation of the ZXR00 IOL with intended emmetropia(ZXR00 emmetropia group:20 eyes)and intended micromonovision(ZXR00 monovision group:20 eyes),or bilateral implantation of the ZKB00 IOL with intended emmetropia(ZKB00 group:20 eyes)were included in this study.Visual acuity at 4 m,80,and 40 cm;and the types of halos(misty,fine,and rainbow)were analyzed at one and three months after surgery.RESULTS:There were no significant differences in distance visual acuity among the three groups.The mean uncorrected intermediate visual acuity was better in the ZXR00 emmetropia and monovision groups(0.02 logMAR and 0.02 logMAR,respectively)than in the ZKB00 group(0.14 logMAR).The mean uncorrected near visual acuity was worse in the ZXR00 emmetropia group(0.26 logMAR)than in the ZXR00 monovision and ZKB00 groups(0.12 logMAR and 0.10 logMAR,respectively).There was an increased incidence of rainbow halos in the ZKB00 group vs in either ZXR00 group(P=0.033).CONCLUSION:Implantation of the ZXR00 IOL with intended micromonovision provide superior visual acuity than implantation of the ZXR00 IOL with intended emmetropia.The ZXR00 IOLs tend to show a lower incidence of rainbow halos than did the ZKB00 IOL.展开更多
文摘AIM:To assess the visual outcomes of aspheric multifocal intraocular lenses(IOLs) compared with spherical multifocal IOL after cataract surgery.METHODS:Potential prospective controlled trials that comparing aspheric multifocal IOL implantation with spherical multifocal IOL group were extracted from the computer database.The statistical analysis was carried out using Stata 10 software.Standardized mean differences with 95% confidence intervals(CIs) were calculated for continuous variables.The pooled estimates were computed in the use of a random-effects model. RESULTS:A systematic review identified five prospective nonrandomized controlled trials,including 178 aspheric multifocal IOL and 164 spherical multifocal IOL.There was no significant difference in uncorrected distance visual acuity(95%CI,-0.248 to 0.152;P=0.641) and uncorrected near visual acuity(95% CI,-0.210 to 0.428;P=0.504) between aspheric multifocal IOL and spherical multifocal IOL.Statistically significant differences were detected less spherical aberration in aspheric multifocal IOL(95% CI,-1.111 to-0.472;P<0.001) when compared to spherical multifocal IOL.Spherical multifocal IOL showed a greater higher order aberration compared to the aspheric multifocal IOL(95% CI,-1.024 to-0.293;P<0.001).Sensitivity analysis suggested that the results were relatively reliable. CONCLUSION:The overall findings indicated that aspheric multifocal IOL and spherical multifocal IOL provided similar visual acuity at near and distance.Patients implanted with aspheric multifocal IOL had less spherical aberration and higher order aberration than patients with spherical multifocal IOL.Further well organized,prospective controlled trials involving larger patient numbers are needed.
基金Zhejiang Key Innovation Team Project(No. 2009R50039)Doctoral Fund of Ministry of Education of China (No: 20100101120135)Key Lab Fund of Zhejiang Province, China (No. 2011E10006)
文摘AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ·METHODS: Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively: monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best - corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire. ·RESULTS:Threemonthspostoperatively,themonocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups. ·CONCLUSION: Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractivepower than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo.
基金Guangdong scientific and technological grants 2011B031800223
文摘Purpose:To evaluate visual outcomes after implantation of an aspheric multifocal /intraocular lens.(MIOL).or an aspheric monofocal intraocular lens (IOL).Methods:This was a prospective nonrandomized study.During 3-months of post-operative follow-up,the following outcomes for SN6AD1 MIOL.(multifocal group).and SN60WF IOL (monofocal group) were compared:uncorrected (UDVA) and corrected (CDVA) distance visual acuity,uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity,Chinese character near visual acuity,uncorrected intermediate visual acuity (UIVA) under high (100% contrast) and low contrast.(10% contrast),UIVA for different IOL powers,and a quality-of-life questionnaire.Results:UNVA,DCNVA,and UIVA under high contrast in the multifocal group were significantly better than those in the monofocal group (P<0.05).UDVA,CDVA and UIVA under low contrast did not differ between groups at 63 cm and 100 cm (P >0.05).In most cases,Chinese character near visual acuity was significantly better in the multifocal group.(P < 0.05).UNVA and UIVA at 63 cm improved over time during 3 months post-operatively.Better UIVA was found in emmetropic and mild myopic eyes as compared to hyperopic ones.The patients in the multifocal group had a higher degree of satisfaction and performed better on near and intermediate tasks,although with greater complaints of visual disturbance.Conclusion:The SN6AD1 MIOL provides significantly better UNVA,DCNVA and UIVA under high contrast conditions,and better Chinese character near visual acuity.Patients receiving the SN6AD1 MIOL reported a better quality of vision in spite of more serious visual disturbances.Better UIVA was observed in emmetropic and mildly myopic eyes.
文摘AIM: To compare higher order aberrations in two aspherical intraocular lenses(IOLs): Akreos advanced optics(AO) and Dr. Schmidt Microcrystalline 6125 aspheric anterior surface(MC6125AS) with each other. METHODS: Forty eyes of 39 patients underwent phacoemulsification and Akreos AO and MC6125 AS were implanted in their eyes in a random manner. Three months post-operatively, higher order aberrations including spherical aberration, coma aberration, and total aberrations were measured and compared.RESULTS: The total aberration was 0.24±0.17 in eyes with Dr. Schmidt and 0.20 ±0.01 in eyes with Akreos AO(P =0.361). The mean of coma aberration was 0.17 ±0.21 and 0.09 ±0.86 in Dr. Schmidt and Akreos lenses,respectively(P =0.825). Total spherical aberration was almost the same in both groups(mean: 0.05, P =0.933).Best corrected visual acuity in Akreos AO(0.10±0.68) and Dr. Schmidt(0.09±0.67) did not differ significantly(P =0.700). CONCLUSION: There is no statistically significant difference in the higher order aberrations between these two aspherical lenses.
文摘With the evolution of cataract surgery from visual rehabilitation to refractive surgery, aspheric intraocular lenses(IOLs) are being increasingly used in the field of ophthalmology. This increased use can be attributed to negative or zero spherical aberrations with unique optical designs, which counteract some of the positive spherical aberrations of the cornea. These alterations reduce the total spherical aberration of human eyes and improve the visual acuity in patients with cataract postoperatively. At present, various types of aspheric IOLs are used worldwide. Although the implantation of aspheric IOL is beneficial to the patients who need correction of spherical aberrations, much controversy is still associated with ocular residual spherical aberrations that facilitate the best visual quality for patients postoperatively. In order to provide reference for future clinical work and scientific research, this report reviews the relationship between the ocular residual spherical aberration of human eyes and visual quality.
基金supported by the Health Bureau of Shanghai City(201440029)
文摘Objective: To compare patient-reported outcomes after implantation of the ZA9003 intraocular lens(IOLs), or the MCX11 ASP IOLs or the spherical IOLs(HQ-201HEP). Methods: Prospective nonrandomized controlled trial was used. A total of 105 patients(210 eyes) were divided into three groups according to the type of IOLs: ZA9003(35 patients, 70 eyes), MCX11 ASP(35 patients, 70 eyes) or HQ-201HEP(35 patients, 70 eyes). The main outcome was scores of Catquest nine-item short-form questionnaire. Additional outcome was best corrected visual acuities, spherical aberration(SA) and total higher-order aberrations(HOAs). Results: The global score was significantly lower in the spherical IOL group than the aspherical IOL group of-020 μm SA(P < 0.05) and the aspherical IOL group of-027 μm SA(P < 0.05), and no significant difference was found in the global score between the aspherical IOL group of-020 μm SA than the aspherical IOL group of-027 μm SA(P > 0.05). Significant differences were also found in question 2, question 5, question 6 and question 8 between the spherical IOLs and the aspherical IOLs. Conclusion: Implantation of an aspherical IOL could improve vision-related quality of life compared with a spherical IOL. However, there were no statistically significant differences in vision-related quality of life between aspheric IOLs with different negative spherical aberrations.
基金Supported by National Key Research and Development Program of China(No.2017YFC1104600)National Natural Science Foundation of China(No.81770909)。
文摘AIM:To evaluate the accuracy of eight different intraocular lens(IOL)power calculation formulas for a segmented multifocal IOL.METHODS:A total of 53 eyes of 41 adult cataract patients who underwent phacoemulsification and implantation with the SBL-3 segmented multifocal IOL between January 1,2017 and January 31,2019 were included in this retrospective study.Preoperative biometry measurements were obtained using an IOL Master.Manifest refraction was performed at least 4 wk postoperatively.Accuracy of the eight formulas[Barrett Universal II,Emmetropia Verifying Optical(EVO),Haigis,Hill-RBF 2.0,Hoffer Q,Holladay 1,Kane,and SRK/T]was analyzed.RESULTS:Using current lens constants,all formulas exhibited errors of slight myopic shift in refractive prediction.The Barrett Universal II formula had a significantly lower median absolute error(MedAE)than did Holladay 1(P=0.02),Kane(P=0.001)and Hill-RBF 2.0(P<0.001)formulas.The Haigis formula had a lower MedAE value than did the Hill-RBF 2.0 formula(P=0.005).Differences in MedAE values among SRK/T,EVO and Hoffer Q formulas were not significant.After optimizing lens constants,the MedAE values of all formulas were reduced;significant changes were noted for EVO(P=0.022),Haigis(P=0.048);Hill-RBF 2.0(P=0.014),Holladay 1(P=0.045)and Kane(P=0.022)formulas.All formulas performed equally well after optimization of lens constants(P=0.203).CONCLUSION:All eight formulas tend to result in a myopic shift when using current lens constants.Optimized lens constants improve the accuracy of these formulas among adult Chinese patients.
文摘AIM: To investigate the independent factors associated with photic phenomena in patients implanted with refractive,rotationally asymmetric,multifocal intraocular lenses(MIOLs).METHODS: Thirty-four eyes of 34 patients who underwent unilateral cataract surgery,followed by implantation of rotationally asymmetric MIOLs were included.Distance and near visual acuity outcomes,intraocular aberrations,preferred reading distances,preoperative and postoperative refractive errors,mesopic and photopic pupil diameters,and the mesopic and photopic kappa angles were assessed.Patients were also administered a satisfaction survey.Photic phenomena were graded by questionnaire.Independent-related factors were identified by correlation and bivariate logistic regression analyses.RESULTS: The distance from the photopic to the mesopic pupil center(pupil center shift) was significantly associated with glare/halo symptoms [odds ratio(OR)=2.065,95% confidence interval(CI)=0.916-4.679,P=0.006] and night vision problems(OR=1.832,95% CI=0.721-2.158,P=0.007).The preoperative photopic angle kappa was significantly associated with glare/halo symptoms(OR=2.155,95% CI=1.065-4.362,P=0.041).The photopic angle kappa was also significantly associated with glare/halo symptoms(OR=2.155,95% CI=1.065-4.362,P=0.041) and with night vision problems(OR=1.832,95% CI=0.721-2.158,P=0.007) in patients implanted with rotationally asymmetric MIOLs.CONCLUSION: A large pupil center shift and misalignment between the visual and pupillary axis(angle kappa)may play a role in the occurrence of photic phenomena after implantation of rotationally asymmetric MIOLs.
基金Coco-Martin MB,Maldonado-López MJ,Molina-Martín A and Pi?ero DP are supported by CDTI(Centro para el Desarrollo Tecnológico Industrial,Ministry of Economy and Competitiveness of Spain)by means of the program PID(“Proyectos de Investigación y Desarrollo”)The author Pi?ero DP has been also supported by the Ministry of Economy,Industry and Competitiveness of Spain within the program Ramón y Cajal(RYC-2016-20471)Valenzuela PL is supported by a contract granted by University of Alcalá(FPI2016)
文摘Multifocal intraocular lenses(IOLs) are currently usually implanted for the treatment of cataracts because they have been proved to be superior to monofocal IOLs with respect to spectacle independence. In turn, they are associated with a higher prevalence of dysphotopsia symptoms that is one of the most common causes of patient dissatisfaction. Neuroadaptation seems to play a major role in the optimal adaptation to multifocal IOLs. In this context, the development of strategies that facilitate the neuroadaptation process to multifocality might be an effective strategy to reduce patients' dissatisfaction. Video games have been proved to be effective for the improvement of visual acuity and for the promotion of neuroplasticity in elderly subjects and other populations with cortical-related visual impairment. This narrative review highlights the physiological potential of video games as a perceptual strategy to improve visual acuity and promote neuroplasticity in patients using multifocalIOLs, although research is still needed to confirm these benefits in this specific population, with only one comparative study to this date providing evidence of them.
基金Supported by Project of Science&Technology Department of Sichuan Province(No.2019YJ0381)Key Project of Sichuan Health and Family Planning Commission(No.18ZD022).
文摘AIM:To compare the visual performance of pseudophakic eyes implanted with Al-UV and SN60WF aspheric intraocular lens(IOL),and to investigate the correlations between visual quality parameters and pupil size.METHODS:This prospective comparative study included 105 eyes of 90 patients with age-related cataract who underwent uneventful phacoemulsification.The subjects were divided into two groups according to the implanted IOL type.Three months postoperatively,visual acuity and contrast sensitivity were measured,wave-front aberrations were assessed using a KR-IW aberrometer(Topcon),and objective optical quality parameters were performed using an optical quality analysis system-OQAS Il(Visiometrics).Independent sample Mest and Spearman correlation analysis were used for data analysis.RESULTS:There were no significant differences found in visual acuity,contrast sensitivity and visual quality parameters between the two groups(P>0.05).The measured intraocular spherical aberration(SA)in Al-UV IOL eyes of-0.19±0.05 pm was close to the designed SA value of-0.20 pm.The modulation transfer function cutoff,Strehl ratio and OQAS values were negatively correlated with pupil size in both groups(P<0.01).CONCLUSION:The subjective and objective visual quality in pseudophakic eyes with A1-UV and SN60WF IOLs are comparable.For aspheric IOL eyes,visual quality decreases with increasing pupil size.
基金Supported by the Student Research Grant of University of Ulsan College of Medicine,Seoul,Korea(No.17-18)Grant from the Asan Institute for Life Sciences,Seoul,Korea(No.2014-464)。
文摘AIM:To evaluate clinical outcomes of unilateral implantation of a diffractive multifocal intraocular lens(IOL)in patients with contralateral monofocal IOL.METHODS:Twenty-two patients who already had implantation of a monofocal IOL in unilateral eye underwent implantation of a diffractive multifocal IOL in contralateral eye were enrolled.After 1,6,and 12 mo,uncorrected and distant corrected distant visual acuity(UCDVA and DCDVA),uncorrected and distant corrected intermediate-visual acuity(UCIVA and DCIVA),uncorrected and distant corrected near visual acuity(UCNVA and DCNVA),and contrast sensitivity were obtained.Halo/glare symptoms,spectacle dependence,and patient satisfaction were also evaluated.RESULTS:The mean age was 67.86±7.25 y and the average interval between two IOL implantations was 645.82±878.44 d.At 1 mo,binocular UCDVA was lower than 0.20 logMAR in 76%of patients(mean 0.12±0.13 logMAR),which increased to 90%by 6 and 12 mo.The binocular UCDVA was significantly better than the monocular results(P<0.05)at 1,6,and 12 mo.Additionally,UCNVA was lower than 0.40 logMAR in 82%of patients,increasing to 90%by 6 and 12 mo.Mean UCNVA in the multifocal IOL implanted eye was statistically significantly better than that in the monofocal IOL implanted eye(P<0.05)at 1,6,and 12 mo.About 5%of patients at 1 and 6 mo,reported"severe glare or halo".Patient satisfaction rates were 95%and 91%at 6 and 12 mo,respectively.CONCLUSION:Unilateral implantation of multifocal IOL in patients with a contralateral,monofocal IOL implantation results in high patient satisfaction rate,with low severe glare or halo rate during follow-up.It can represent a good option for patients who have previously had a monofocal IOL implantation regardless of two year interval duration between two IOL implantations.
基金Supported by the National Natural Science Foundation of China(No.81600721)the Key Laboratory Program of Shandong Eye Institute(NO.2014-1)+2 种基金Medicine Science and Technology Development Program of Shandong Province(No.2015WS0204)the Science and Technology plan of Qingdao,China(No.15-9-1-35-jch)the Innovation Project of Shandong Academy of Medical Sciences
文摘AIM: To compare the visual functional outcomes with accommodating and multifocal intraocular lenses(IOLs).METHODS: Our retrospective comparative study included 51 patients(60 eyes) received implantation of an accommodating IOL(Tetraflex;16 patients,20 eyes),a refractive multifocal IOL(Re Zoom;18 patients,20 eyes),or a diffractive multifocal IOL(ZMA00;17 patients,20 eyes).Subjective refraction,visual acuity,contrast sensitivity(CS),intraocular aberration,and subjective photic phenomena were detected at 3mo after surgery.RESULTS: The spherical equivalent in the three groups was-0.38±0.54 D,0.14±0.56 D,and 0.35±0.41 D,respectively.No statistically significant differences were found in uncorrected and corrected distance visual acuity and uncorrected intermediate visual acuity among the groups(P=0.39).The Re Zoom group had significantly better distance-corrected intermediate visual acuity than the ZMA00 group(P=0.003).The ZMA00 group had significantly better near visual acuity than the other groups(P<0.05).Better contrast sensitivity values were observed in the Tetraflex group under most of the spatial frequencies conditions(P=0.025).The total aberration was lowest in the ZMA00 group(P=0.000),and the spherical aberration was highest in the Tetraflex group(P=0.000).The three groups had similar frequency of ghosting and glare,and the Tetraflex group had a low rate of halos(P=0.01).CONCLUSION: Both accommodating and multifocal IOLs can successfully restore distance and uncorrected intermediate visual acuities.Tetraflex accommodating IOLs perform better in CS and with less halos of photic phenomena.Re Zoom refractive multifocal IOLs havebetter performance in distance-corrected intermediate visual acuity than ZMA00 diffractive multifocal IOLs,and the latter achieved better near visual acuity and efficiently decreased the optical aberration.
基金Supported by Key Research and Development Projects of Shaanxi Province(No.2017SF-246)Science and Technology Planning Project of Xi’an(No.2017116SF/YX010No.201805097YX5SF31)。
文摘·AIM:To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens(IOL)and asymmetric refractive multifocal IOL.·METHODS:The prospective nonrandom,comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs:AT LISA tri 839 MP(30 eyes;Carl Zeiss Meditec,Germany)and LS-313 MF30(30 eyes;Oculentis GmbH,Germany).Visual acuity,refractive outcome,contrast sensitivity,defocus curves,quality of vision,and optical phenomena were evaluated at3 mo postoperatively.·RESULTS:There were no statistical differences between groups in uncorrected distance visual acuity(P=0.13)and uncorrected near visual acuity(P=0.54).In contrast,uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group(P=0.02).No significant statistical between-group difference was detected in cylinder(P=0.43).Compared to trifocal group,spherical refraction and spherical equivalent in refractive multi focal group were more myopic(P<0.01).Under photopic conditions,no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree(cpd).The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group(P=0.01,P=0.034,respectively).The questionnaires of quality of vision and optical phenomena showed no differences between groups.·CONCLUSION:Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity.Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.
文摘AIM: To assess the binocular visual function in bilateral cataract patients with unilateral astigmatism after combined implantations of Toric with multifocal intraocular lens(IOL), and to compare with that of Toric and monofocal IOL implantation.· METHODS: All the 30 patients with unilateral astigmatism suffered bilateral cataract were randomly divided into two groups: Toric plus multifocal IOL group and Toric plus monofocal IOL group. Uncorrected and corrected visual acuity at distance(5.0 m), intermediate distance(0.6 m), and near(0.33 m), contrast sensitivity,and stereopsis were assessed 6mo after surgery.Patients were also surveyed for visual disturbances and spectacle dependence.·RESULTS: Binocular uncorrected visual acuity(log MAR)of Toric/multifocal IOL eyes at distance, intermediate,near were 0.05±0.05, 0.24±0.10, and 0.14±0.06 respectively.The values of Toric plus monofocal IOL eyes were 0.06 ±0.07, 0.26±0.08, and 0.37 ±0.10 respectively. These values did not indicate significant differences between two groups with exception of near visual acuity. In the photopic condition(with or without glare), the contrast sensitivity of multifocal IOL eyes was significant lower than the monofocal IOL eyes in 18 cpd. In the mesopic condition, the contrast sensitivity of multifocal group was significant lower than monofocal group in 12 cpd, and in mesopic glare condition, this significant difference was found both in 6 cpd and 12 cpd. The stereopsis of Toric/multifocal IOL eyes decreased slightly(100 ±80 seconds of arc, t =2.222, P =0.136). Mean near vision for patient satisfaction was statistically significantly higher in Toric/multifocal IOL group patients versus than that in Toric/monofocal IOL group(80% vs 25.5%, P =0.000). Visual disturbance was not noticed in either group.·CONCLUSION: Although the combination of Toric and multifocal IOL implantation results in compromising stereoacuity, it can still provide patients with high levels of spectacle freedom and good overall binocular visual acuity.
文摘AIM:To evaluate clinical outcomes after implantation of a new diffractive aspheric multifocal intraocular lens(IOL) with +3.00 addition power.METHODS:This is a retrospective,consecutive case series of cataract patients who underwent bilateral implantation of the Optiflex MO/HF D012(Moss Vision Inc.Ltd,London,UK) multifocal IOL.Patients followed for 6 mo were included in the study.Data on distance,intermediate and near visual acuity,refractive error [manifest spherical equivalent(MSE)],contrast sensitivity,adverse events,subjective symptoms,spectacle independence and patient satisfaction [visual function questionnaire(VFQ)-25 questionnaire] were retrieved from electronic medical records and analyzed.RESULTS:Forty eyes of 20 patients with a mean age of 66.7±8.5 y(range:53-82) were included in the study.Mean uncorrected distance,near and intermediate visual acuity remained stable through postoperative visits and was 0.19±0.19 log MAR,Jaeger 4 and Jaeger 3 respectively at the 6 mo visit.At the end of postoperative 6 mo,MSE was-0.14±0.42 diopters(D) and 98% of the eyes were within 1.00 D of target refraction.Postoperative low contrast(10%) visual acuity remained stable(P=0.54) through follow up visits with a mean of 0.35±0.17 log MAR at the 6 mo visit.There were no reported adverse events.None of the patients reported subjective symptoms of halo or glare.Spectacle independence rate was 90%.Mean VFQ-25 questionnaire score was 93.5±6.12.CONCLUSION:The Optiflex MO/HF-DO12 IOL was safely implanted and successfully restored distance,intermediate and near visual acuity without impairing contrast sensitivity.High levels of spectacle independence were achieved at all distances including intermediate distance.
文摘Dear Editor,We write you to present a 20-year-old man with resistant spasm of accommodation without any organic cause treated with clear lens extraction(CLE)with phacoemulsification and multifocal intraocular lens(IOL)implantation.Spasm of accommodation is a rare condition
基金Supported by National Natural Science Foundation of China,No.81974130Natural Science Foundation of Hunan Province,China,No.2020JJ4882.
文摘BACKGROUND Asymmetric multifocal intraocular lenses(IOLs)are now widely used in the modern cataract surgery,providing a good level of visual performance over a range of distances and high postoperative patient satisfaction.We report a case of improved visual quality after shifting the near segment of an asymmetrical multifocal IOL to the superotemporal placement in the dominant eye of a glaucoma patient.CASE SUMMARY A 72-year-old woman with bilateral glaucoma underwent phacoemulsification in the dominant eye(left eye)with implantation of an asymmetrical multifocal IOL.Postoperative uncorrected distance visual acuity(UDVA)was 0.0 logMAR(20/20 Snellen)and uncorrected near visual acuity(UNVA)was 0.1 logMAR(20/25 Snellen).Two weeks later,the patient presented to our clinic with decreased vision due to migration of lens epithelial cells to IOL anterior surface and edema of corneal endothelial cells.Anterior capsule polishing and superotemporal placement of near segment[+3.00 diopter(D)addition(add)]of IOL were performed.As a result,UDVA at the first week and first year after reposition was 0.0 logMAR(20/20 Snellen),and compared with 0.3 logMAR(20/40 Snellen)in the first week,the UNVA was improved to 0.0 logMAR(20/20 Snellen)one year after surgery.CONCLUSION The postoperative inflammatory reaction and lens epithelial cells proliferation were obvious in this glaucoma patient.Capsule polishing and rotation of the lens were beneficial to the patient,which not only enhanced the patient's vision,but also improved the patient's satisfaction.Therefore,glaucoma patients need to be cautious of implanting multifocal IOLs.Placement of a near segment of an asymmetrical multifocal IOL in the dominant eye should be performed on an individual basis.
文摘Purpose : To evaluate the clinical effects of implantation of Array multifocal intraocular lenses.Methods : Thirty-one cases (37 eyes) of cataract patients, including 15 males(19 eyes)and 16 females(18 eyes), were involved in this study. All patients underwent standard phacoemulsification with Array multifocal intraocular lens implantation. The complications during operation, postoperative distant visual acuity, near visual acuity,corneal curvature and visual symptoms were observed.Results : the mean value of best postoperative visual acuity was recorded as follows: uncorrected distant visual acuity was 0. 8, the best-corrected distant visual acuity was 0.9, uncorrected near visual acuity was 0. 5, near visual acuity with distant-corrected was 0.6, the best-corrected near visual acuity wss 0.9. The astigmatism of cornea was less than 1.5 D pre-operatively and post-operatively. One patient complained of glare. Conclusion : Array multifocal intraocular lens can provide good distant and near visual acuity. With observation of more cases and follow-up of longer time, we can draw a further conclusion. Eye Science 2001; 17 : 57 - 60.
文摘Background:To compare objective electrophysiological contrast sensitivity function(CSF)in patients implanted with either multifocal intraocular lenses(MIOLs)or monofocal intraocular lenses(IOLs)by pattern reversal visual evoked potentials(prVEP)measurements.Methods:Fourty-five cataract patients were randomly allocated to receive bilaterally:apodized diffractive-refractive Alcon Acrysof MIOL(A),full diffractive AMO Tecnis MIOL(B)or monofocal Alcon Acrysof IOL(C).Primary outcomes:1-year differences in objective binocular CSF measured by prVEP with sinusoid grating stimuli of 6 decreasing contrast levels at 6 spatial frequencies.Secondary outcomes:psychophysical CSF measured with VCTS-6500,photopic uncorrected distance(UDVA),and mesopic and photopic uncorrected near and intermediate visual acuities(UNVA and UIVA respectively).Results:Electrophysiological CSF curve had an inverted U-shaped morphology in all groups,with a biphasic pattern in Group B.Group A showed a lower CSF than group B at 4 and 8 cpd,and a lower value than group C at 8 cpd.Psychophysical CSF in group A exhibited a lower value at 12 cpd than group B.Mean photopic and mesopic UNVA and UIVA were worse in monofocal group compared to the multifocal groups.Mesopic UNVA and UIVA were better in group B.Conclusions:Electrophysiological CSF behaves differently depending on the types of multifocal or monofocal IOLs.This may be related to the visual acuity under certain conditions or to IOL characteristics.This objective method might be a potential new tool to investigate on MIOL differences and on subjective device-related quality of vision.
基金Supported by the Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Science and ICT(No.2018R1C1B6002794)Korea University Grant(No.K1625491,No.K1722121,No.K1811051)。
文摘AIM:To evaluate clinical outcomes following implantation of an extended range of vision intraocular lens(IOL),the ZXR00,and a diffractive multifocal IOL with+2.75 diopters(D)add power,the ZKB00.METHODS:Totally 30 patients who underwent either bilateral implantation of the ZXR00 IOL with intended emmetropia(ZXR00 emmetropia group:20 eyes)and intended micromonovision(ZXR00 monovision group:20 eyes),or bilateral implantation of the ZKB00 IOL with intended emmetropia(ZKB00 group:20 eyes)were included in this study.Visual acuity at 4 m,80,and 40 cm;and the types of halos(misty,fine,and rainbow)were analyzed at one and three months after surgery.RESULTS:There were no significant differences in distance visual acuity among the three groups.The mean uncorrected intermediate visual acuity was better in the ZXR00 emmetropia and monovision groups(0.02 logMAR and 0.02 logMAR,respectively)than in the ZKB00 group(0.14 logMAR).The mean uncorrected near visual acuity was worse in the ZXR00 emmetropia group(0.26 logMAR)than in the ZXR00 monovision and ZKB00 groups(0.12 logMAR and 0.10 logMAR,respectively).There was an increased incidence of rainbow halos in the ZKB00 group vs in either ZXR00 group(P=0.033).CONCLUSION:Implantation of the ZXR00 IOL with intended micromonovision provide superior visual acuity than implantation of the ZXR00 IOL with intended emmetropia.The ZXR00 IOLs tend to show a lower incidence of rainbow halos than did the ZKB00 IOL.
