●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical tria...●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications.展开更多
AIM:To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses(IOL)and to compare the surgical outcomes with the four-haptics posterior chamber(PC)-IOL technique.METHODS:We retrospectiv...AIM:To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses(IOL)and to compare the surgical outcomes with the four-haptics posterior chamber(PC)-IOL technique.METHODS:We retrospectively analyzed 16 eyes of 16 patients who underwent transscleral fixation of C-loop PCIOLs using a flapless one-knot suture technique,which were followed up for longer than 17mo.In this technique,the capsulorless IOL was suspended using a single suture for transscleral fixation of four feet.Then we compared its surgical outcomes and complications with the four-haptics PC-IOLs using the Student's t test and Chi-square test.RESULTS:Sixteen patients of 16 eyes with a mean age of 58.3±10.1y(42-76y)who received transscleral C-loop IOL implantation due to trauma,vitrectomy,or cataract surgery with inadequate capsule support showed improved visual acuity.The difference was not significant between two IOLs except the surgery time(P>0.05).The mean operation times of C-loop IOL surgery was 24.1±1.83min and 31.3±4.47min of the four-haptics PC-IOL method(P<0.0001).In the C-loop IOLs group,there was statistical difference between the preoperative and the postoperative UCVA(log MAR,1.20±0.50 vs 0.57±0.32,P=0.0003).There was no statistical difference between the preoperative and the postoperative BCVA(log MAR,0.66±0.46 vs 0.40±0.23,P=0.056).However,there was no statistically significant difference in postoperative UCVA and BCVA between the two IOLs(P>0.05).We did not detect any optic capture,IOL decentration or dislocation,suture exposed,or cystoid macular edema in patients underwent C-loop IOLs surgery.CONCLUSION:The novel flapless one-knot suture technique for transscleral fixation of C-loop IOL is a simple,reliable,and stable technique.展开更多
AIM:To evaluate the postoperative intraocular lens(IOL)rotational stability and residual refractive astigmatism following combined 25-gauge vitrectomy and cataract surgery with implantation of a plate haptic toric IOL...AIM:To evaluate the postoperative intraocular lens(IOL)rotational stability and residual refractive astigmatism following combined 25-gauge vitrectomy and cataract surgery with implantation of a plate haptic toric IOL.METHODS:In this retrospective case series,32 eyes of 32 patients underwent a combined 25-gauge vitrectomy and phacoemulsification for vitreoretinal diseases and cataract with regular corneal astigmatism of at least 1 diopter(D).A plate haptic toric IOL(AT Torbi 709M,Carl Zeiss Meditec AG)was implanted in all eyes.The outcome measures were rotational stability and refractive astigmatism up to 6mo postoperatively as well as the best corrected visual acuity(BCVA).RESULTS:Preoperative refractive astigmatism was 2.14±1.17 D,which was significantly reduced to 0.77±0.37 D six to eight weeks postoperatively and remained stable throughout the observation period(0.67±0.44 D at three months and 0.75±0.25 D at six months;for all groups:P<0.0001 compared to baseline).BCVA improved significantly from 0.36±0.33 logMAR preoperatively to 0.10±0.15 logMAR following surgery(P=0.02).Mean IOL axis deviation from the target axis was 3.4°±2.9°after six to eight weeks and significantly decreased over time(2.4°±2.6°six months after surgery;P=0.04).In one patient IOL,re-alignment was performed.CONCLUSION:Corneal astigmatism is significantly reduced following combined 25-gauge vitrectomy and cataract surgery.The plate haptic toric IOL position and axis remain stable during the observation period of six months.展开更多
AIM:To assess the performance of a bespoke software for automated counting of intraocular lens(IOL)glistenings in slit-lamp images.METHODS:IOL glistenings from slit-lamp-derived digital images were counted manually an...AIM:To assess the performance of a bespoke software for automated counting of intraocular lens(IOL)glistenings in slit-lamp images.METHODS:IOL glistenings from slit-lamp-derived digital images were counted manually and automatically by the bespoke software.The images of one randomly selected eye from each of 34 participants were used as a training set to determine the threshold setting that gave the best agreement between manual and automatic grading.A second set of 63 images,selected using randomised stratified sampling from 290 images,were used for software validation.The images were obtained using a previously described protocol.Software-derived automated glistenings counts were compared to manual counts produced by three ophthalmologists.RESULTS:A threshold value of 140 was determined that minimised the total deviation in the number of glistenings for the 34 images in the training set.Using this threshold value,only slight agreement was found between automated software counts and manual expert counts for the validating set of 63 images(κ=0.104,95%CI,0.040-0.168).Ten images(15.9%)had glistenings counts that agreed between the software and manual counting.There were 49 images(77.8%)where the software overestimated the number of glistenings.CONCLUSION:The low levels of agreement show between an initial release of software used to automatically count glistenings in in vivo slit-lamp images and manual counting indicates that this is a non-trivial application.Iterative improvement involving a dialogue between software developers and experienced ophthalmologists is required to optimise agreement.The results suggest that validation of software is necessary for studies involving semi-automatic evaluation of glistenings.展开更多
AIM:To compare the clinical outcomes between two approaches for sutureless scleral-fixated intraocular lens(SFIOL)in children with Marfan syndrome(MFS).METHODS:The study included 15 children(26 eyes)with lens subluxat...AIM:To compare the clinical outcomes between two approaches for sutureless scleral-fixated intraocular lens(SFIOL)in children with Marfan syndrome(MFS).METHODS:The study included 15 children(26 eyes)with lens subluxation due to MFS.These children underwent lensectomy,anterior vitrectomy,and sutureless SFIOL.According to the position of placement of intraocular lens(IOL)haptics,two study groups were reviewed for best corrected visual acuity(BCVA)and postoperative complications:group A,14 eyes with haptics fixated at 2.0 mm from the limbus;group B,12 eyes with the haptics fixated at 2.5 mm from the limbus.RESULTS:The mean axial length for all patients was 25.66±2.35 mm.Postoperative BCVA in logMAR were significant improved in both groups(0.77±0.32 to 0.17±0.12 in group A,0.66±0.25 to 0.24±0.12 in group B,both P<0.001)while no significant difference between two groups(P>0.05).Pupillary capture was main postoperative complication,occurring between 3d and 18mo.It occurred in 7 eyes in group A and one eye in group B(P=0.02).CONCLUSION:Sutureless SFIOL is an effective treatment approach for lens subluxation in children with MFS.Pupillary capture is the main postoperative complication.Fixated IOL haptics at 2.5 mm from the limbus can reduce the occurrence of pupillary capture.展开更多
AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who...AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who received sulcus-placed SPA-IOLs between 2006 and 2009 were reviewed. None of the patients underwent IOL exchange. Charts of six age-matched patients who received sulcus placed 3P-IOLs were reviewed as a control group. RESULTS: Mean follow up was 16 mo for SPA-IOL and 23 mo for 3P-IOL. Five of 8 patients in the SPA-IOL group required chronic use of IOP lowering medications at final follow up. Of these, one patient needed glaucoma implant surgery for uncontrolled IOP. One patient in the 3P-IOL group used chronic aqueous suppression pre- and postoperatively. Four of eight eyes with SPAIOL were treated with chronic topical steroids and or non-steroidal anti-inflammatory drugs for cystoid macu-la edema, chronic uveitis, pigment dispersion syndrome or a combination of the above, compared to none in the control group. Mean best-corrected visual acuity was 20/35 in the SPA-IOL group and 20/47 in the 3PIOL group.CONCLUSION: Sulcus placed SPA-IOLs are associated with increased ocular morbidity. In select cases good visual acuity may be achieved. Due to postoperative rotation of sulcus placed toric SPA-IOLs stable astigmatism correction cannot be achieved. Alternative intraocular lenses should be considered when in-the-bag placement of SPA-IOL is not possible.展开更多
Background:To evaluate efficacy and safety of combined pars plana vitrectomy(PPV)and scleral fixated intraocular lens(SFIOL)surgery as a single procedure.Methods:Retrospective interventional case series done at a tert...Background:To evaluate efficacy and safety of combined pars plana vitrectomy(PPV)and scleral fixated intraocular lens(SFIOL)surgery as a single procedure.Methods:Retrospective interventional case series done at a tertiary eye care center in Northern India.Eleven patients who underwent combined PPV and SFIOL surgery were included and analyzed retrospectively.Results:Mean age of the patients was 43.36±15.12 years(range,22-64 years).Eight were male.Mean baseline best corrected visual acuity(BCVA)was 0.78±0.63 logMAR units while the mean post-operative BCVA at 6 months follow-up was 0.37±0.29 logMAR units,the visual gain being statistically significant(P=0.021).None of the patients had a drop in BCVA with nine patients having final BCVA better than 0.48 logMAR units.Choroidal detachment(CD)was the only notable complication,seen in three patients.Other complications included two cases of intraoperative retinal breaks,a case each of reversible corneal edema,ocular hypertension and cystoid macular edema.Conclusions:Combined PPV and SFIOL is an efficacious procedure for managing IOL/lens dislocation and aphakia in a single surgery.There may be short-term reversible complications with no impact on final visual gain.展开更多
Advances in intraocular lens(IOL)design have rendered cataract surgery a refractive procedure.Newer IOL types include bifocal,trifocal and extended depth of focus(EDOF)IOLs.Their basic difference nestles in the number...Advances in intraocular lens(IOL)design have rendered cataract surgery a refractive procedure.Newer IOL types include bifocal,trifocal and extended depth of focus(EDOF)IOLs.Their basic difference nestles in the number of focal points that each lens provides,which in turn leads to different visual outcomes.Familiarity of surgeons with the various characteristics of each lens is of utmost importance for accurate IOL selection to match each patient’s needs.In this review,we aim to compare the clinical outcomes after implantation of multifocal and EDOF IOLs in terms of distance,intermediate and near vision,contrast sensitivity,and reading performance.Finally,we discuss the defocus curve and the optical and photic phenomena associated with each type of IOL.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 evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens(IOL) during a 12-month follow-up.METHODS:Prospective comparative study including 75 eyes of 38 patients(44-70 ...AIM:To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens(IOL) during a 12-month follow-up.METHODS:Prospective comparative study including 75 eyes of 38 patients(44-70 y) undergoing uneventful cataract surgery.Each patient was randomly assigned to one type of IOL,bifocal(35 eyes) or trifocal(40 eyes).Visual,refractive,and contrast sensitivity changes were evaluated in a 12-month follow-up.The binocular defocus curve was also measured at 12 mo postoperatively.RESULTS:No statistically significant differences between groups were found in postoperative uncorrected and corrected distance visual acuities(P≥0.276).Postoperative corrected near visual acuity(33 cm) was significantly better in the trifocal group during all follow-up(P≤0.004) as well as 6-month uncorrected near(P=0.008) and distancecorrected near visual acuities(P=0.016)(33/40 cm).Significantly better uncorrected intermediate and distance corrected-intermediate visual acuity were found during all follow-up in the trifocal group(P<0.001),which was consistent with differences among groups in binocular defocus curve.Differences among groups in contrast sensitivity were minimal,being only significant at 6 months for some low to medium spatial frequencies(P≤0.006).CONCLUSION:Bifocal and trifocal diffractive IOLs are able to provide an effective visual restoration which is maintained during a 12-month follow-up,with a clear benefit of the trifocal IOL for the intermediate vision.展开更多
AIM:To investigate and compare the quality of life,satisfaction,contrast sensitivity,glare,depth perception,and intraocular lens(IOL)rotation in patients who underwent trifocal toric and bifocal toric IOLs.METHODS:A t...AIM:To investigate and compare the quality of life,satisfaction,contrast sensitivity,glare,depth perception,and intraocular lens(IOL)rotation in patients who underwent trifocal toric and bifocal toric IOLs.METHODS:A total of 80 eyes of 40 patients were included in this prospective study.Twenty patients in each group were implanted with trifocal toric and bifocal toric IOL,respectively.Preoperative and postoperative 6-month measurements were recorded for both patient groups.Comprehensive anterior and posterior segment examinations,distance-intermediate-near visual acuity values and the visual function scale questionnaire results were evaluated at these examinations.Patient satisfaction,contrast sensitivity,glare,intermediate-near and distance stereopsis and IOL rotation were also evaluated.RESULTS:No significant difference was found between the groups in terms of distance and near visual acuities(P=0.269,P=0.451).Intermediate visual acuity was significantly increased in the trifocal toric group(P<0.001).The visual function scale results were increased after surgery in both groups(P=0.001 and P<0.001),with no difference determined between them(P=0.158 and P=0.691).The number of patients wearing glasses was low in both groups and there was no significant difference between the groups(P>0.05).The overall satisfaction in the trifocal toric group was significantly higher than in the bifocal toric group(P=0.03).The highest sensitivity was observed at 6 cpd spatial frequency in all patients under photopic conditions(1.80±0.24 logU,1.74±0.20 logU).Distance-intermediate-near binocular depth perception results in both groups were higher in the trifocal toric group(P=0.02,0.048,0.003,respectively).Although there was no significant difference for 3 meters stereopsis,the trifocal toric group had higher depth perception(P=0.577).Mean rotation was 5.76°±3.93°in the trifocal toric group and 12°±7.1°in the bifocal toric group.CONCLUSION:Better results in the middle distance are obtained in the trifocal toric group and less IOL rotation due to digital system-coordinated surgery.Moreover,the overall satisfaction in the trifocal toric group is significantly higher than in the bifocal toric group.展开更多
AIM: To conduct a Meta-analysis pooling randomized controlled trials(RCTs) to compare hydrophobic with hydrophilic acrylic intraocular lenses in terms of posterior capsule opacification(PCO) development.METHODS: Elect...AIM: To conduct a Meta-analysis pooling randomized controlled trials(RCTs) to compare hydrophobic with hydrophilic acrylic intraocular lenses in terms of posterior capsule opacification(PCO) development.METHODS: Electronic databases including PubMed,Embase, and the Cochrane Library were queried from their starting till January 2020. RCTs investigating the impact of hydrophobic versus hydrophilic acrylic intraocular lenses on PCO were considered eligible in this study. The pooled effect estimates were calculated using the random-effects model.RESULTS: Thirteen RCTs comprising of 939 patients(1263 eyes) were covered in this study. Patients with hydrophobic acrylic intraocular lenses had a lower PCO score than those with a hydrophilic acrylic intraocular lenses [standard mean difference:-1.80;95% confidence interval(CI):-2.62 to-0.98;P<0.001]. Moreover, the frequency of neodymium-doped yttrium aluminum garnet(Nd:YAG)capsulotomy in patients with hydrophobic acrylic intraocular lenses was significantly lower than patients with hydrophilic acrylic intraocular lenses(relative risk: 0.38;95%CI: 0.20-0.71;P=0.003).CONCLUSION: These findings suggest that hydrophobic acrylic intraocular lenses are superior to hydrophilic acrylic intraocular lenses in patients after cataract surgery due to lower PCO score and reduced Nd:YAG capsulotomy. While similar studies are conducted by other researchers, the present study conducted subgroup analyses that show superior results with hydrophobic lenses in trials conducted in western countries.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
Purpose: To assess the visual outcome after implantation of the new Hydrophylic IOL type 41 B/G accommodating intraocular lens (AIOL). Methods: The presented lens was implanted during cataract surgery. All patients we...Purpose: To assess the visual outcome after implantation of the new Hydrophylic IOL type 41 B/G accommodating intraocular lens (AIOL). Methods: The presented lens was implanted during cataract surgery. All patients were offered follow-ups, allowing two postoperative measurements to be performed at 3 months and between 2020 and 2021. The mean time between lens implantation and last follow-up was 5.3 years (min. 1 year, max. 10 years). Excluded were patients with age-related macular degeneration or amblyopia. Patients with a foreign lens implanted into the second eye were included in a separate control group. Corrected distance (CDVA) and uncorrected distance visual acuity (UDVA) at 5 m, and corrected near (CNVA) and uncorrected near visual acuity (UNVA) at 40 cm were assessed. Furthermore, the postoperative spherical equivalent (SE), the dependence on spectacles and the occurrence of optical phenomena were evaluated. Results: The final study cohort consists of 65 patients with 119 implanted AIOLs. Significantly better visual results were obtained in both postoperative follow-ups compared with the preoperative results. The mean values of the last follow-up for the UNVA, CNVA, UDVA, and CDVA were 0.107 ± 0.10;0.039 ± 0.08;0.097 ± 0.11;and 0.040 ± 0.09 logMAR, respectively. Visual outcomes remained on a high level for up to 10 years and showed significantly better results compared to the control group. Postoperative SE was significantly improved. Nearly 70% of patients were no longer dependent on glasses. Furthermore, the occurrence of disturbing optical phenomena was denied by all patients. Conclusion: The results of this AIOL are particularly promising, especially since gratifying visual results could still be measured 10 years after implantation.展开更多
AIM:To evaluate the effects of posterior corneal surface measurements on the accuracy of total estimated corneal astigmatism.METHODS:Fifty-seven patients with toric intraocular lens(IOL) implantation and posterior cor...AIM:To evaluate the effects of posterior corneal surface measurements on the accuracy of total estimated corneal astigmatism.METHODS:Fifty-seven patients with toric intraocular lens(IOL) implantation and posterior corneal astigmatism exceeding 0.5 diopter were enrolled in this retrospective study.The keratometric astigmatism(KA) and total corneal astigmatism(TA) were measured using a Pentacam rotating Scheimpflug camera to assess the outcomes of AcrySof IOL implantation.Toric lOLs were evaluated in 26 eyes using KA measurements and in 31 eyes using TA measurements.Preoperative corneal astigmatism and postoperative refractive astigmatism were recorded for statistical analysis.The cylindrical power of toric lOLs was estimated in all eyes.RESULTS:In all cases,the difference of toric IOL astigmatism magnitude between KA and TA measurements for the estimation of preoperative corneal astigmatism was statistically significant.Of a total of 57 cases,the 50.88%decreased from T_n to T_(n-1) and 10.53%decreased from T_n to T_(n-2).In all cases,5.26%increased from T_n to T_(n+1).The mean postoperative astigmatism within the TA group was significantly lower than that in the KA group.CONCLUSION:The accuracy of total corneal astigmatism calculations and the efficacy of toric IOL correction can be enhanced by measuring both the anterior and posterior corneal surfaces using a Pentacam rotating Scheimpflug camera.展开更多
AIM: To evaluate the impact of 4 different intraocular lenses(IOLs) on posterior capsule opacification(PCO) by comparing the neodymium: yttrium-aluminum-garnet(Nd:YAG) laser capsulotomy rates.METHODS: This retrospecti...AIM: To evaluate the impact of 4 different intraocular lenses(IOLs) on posterior capsule opacification(PCO) by comparing the neodymium: yttrium-aluminum-garnet(Nd:YAG) laser capsulotomy rates.METHODS: This retrospective study included 4970 eyes of 4013 cataract patients who underwent phacoemulsification and IOL implantation between January 2000 and January 2008 by the same surgeon at one clinic. Four different IOLs were assessed. The outcome parameter was the incidence of Nd:YAG laser posterior capsulotomies.· RESULTS: An Nd:YAG laser posterior capsulotomy was performed in 153(3.07%) of the 4970 eyes. The mean follow-up time was 84 mo for all of the IOL groups. The percentage of eyes developing PCO was significantly greater for the acrylic hydrophilic IOLs than for the hydrophobic IOLs, although eyes with acrylic hydrophilic IOLs did not require Nd:YAG laser capsulotomy as soon as eyes with acrylic hydrophobic IOLs. There was no difference between the long-term PCO rates when 1-and 3-piece acrylic hydrophobic IOLs were compared or when IOLs made of the same material but with different haptic angles were compared.· CONCLUSION: In this study, eyes with acrylic hydrophilic IOLs were more likely to develop PCO than those with acrylic hydrophobic IOLs. The lens design(1-piece versus 3-piece and varying haptic angles) did not affect the PCO rate.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
The study was to report a new two-point scleralfixation technique for foldable intraocular lenses with four haptics.Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera ...The study was to report a new two-point scleralfixation technique for foldable intraocular lenses with four haptics.Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite points.The postoperative best-corrected visual acuities(BCVAs) of all patients were significantly better than their preoperative BCVA.The results demonstrate that two-point,scleral fixations of foldable,intraocular lenses might be practicable and effective.展开更多
This study aims to evaluate the clinical results of posterior chamber implantable collamer lens(ICL) implantation in adults with high myopic anisometropic amblyopia. Thirteen patients aged 27.04±7.24 y(range 19.2...This study aims to evaluate the clinical results of posterior chamber implantable collamer lens(ICL) implantation in adults with high myopic anisometropic amblyopia. Thirteen patients aged 27.04±7.24 y(range 19.2 to 42.5) were studied. ICL implantation was performed in 13 amblyopic eyes. The mean myopic anisometropia was significantly dropped from-10.70±3.02 D preoperatively to +0.09±1.67 D at 1 mo postoperatively. The logMAR CDVA at 3 d, 1, 3 and mean 9 mo postoperatively improved by a mean of 1.69, 2.50, 3.01 and 3.00 lines and gained more than 2 lines accounted for 23.08%(3 eyes), 41.67%(5 eyes), 63.63%(7 eyes) and 55.56%(5 eyes), respectively. The contrast sensitivity of amblyopic eyes was significantly increased after surgery. Four patients partially recovered near stereopsis(400" to 100"). There was no severe complications were observed. ICL implantation alone can improve vision, contrast sensitivity, and partial restoration of binocular vision in adult patients with high myopic anisometropia.展开更多
AIM: To evaluate the accuracy of three commonly used biometric formulae across different axial lengths(ALs) at one United States Veterans Affairs teaching hospital.METHODS: A retrospective chart review was conducted f...AIM: To evaluate the accuracy of three commonly used biometric formulae across different axial lengths(ALs) at one United States Veterans Affairs teaching hospital.METHODS: A retrospective chart review was conducted from November 2013 to May 2018. One eye of each patient who underwent cataract surgery with a monofocal intraocular lens(IOL) was included. The range of postoperative follow-up period was from 3 wk to 4 mo. The Holladay 2, Barrett Universal II, and Hill-Radial Basis Function(Hill-RBF) formulae were used to predict the postoperative refraction for all cataract surgeries. For each formula, we calculated the prediction errors [including mean absolute prediction error(MAE)] and the percentage of eyes within ±0.25 diopter(D) and ±0.5 D of predicted refraction. We performed subgroup analyses for short(AL<22.0 mm), medium(AL 22.0-25.0 mm), and long eyes(AL>25.0 mm).RESULTS: A total of 1131 patients were screened, and 909 met the inclusion criteria. Resident ophthalmologists were the primary surgeons in 710(78.1%) cases. We found no statistically significant difference in predictive accuracy among the three formulae over the entire AL range or in the short, medium, and long eye subgroups. Across the entire AL range, the Hill-RBF formula resulted in the lowest MAE(0.384 D) and the highest percentage of eyes with postoperative refraction within ±0.25 D(42.7%) and ±0.5 D(75.5%) of predicted. All three formulae had the highest MAEs(>0.5 D) and lowest percentage within ±0.5 D of predicted refraction(<55%) in short eyes.CONCLUSION: In cataract surgery patients at our teaching hospital, three commonly used biometric formulae demonstrate similar refractive accuracy across all ALs. Short eyes pose the greatest challenge to predicting postoperative refractive error.展开更多
文摘●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications.
基金Supported by the Gongli Hospital of Pudong New Area,Shanghai(No.2017YQNJJ-13)。
文摘AIM:To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses(IOL)and to compare the surgical outcomes with the four-haptics posterior chamber(PC)-IOL technique.METHODS:We retrospectively analyzed 16 eyes of 16 patients who underwent transscleral fixation of C-loop PCIOLs using a flapless one-knot suture technique,which were followed up for longer than 17mo.In this technique,the capsulorless IOL was suspended using a single suture for transscleral fixation of four feet.Then we compared its surgical outcomes and complications with the four-haptics PC-IOLs using the Student's t test and Chi-square test.RESULTS:Sixteen patients of 16 eyes with a mean age of 58.3±10.1y(42-76y)who received transscleral C-loop IOL implantation due to trauma,vitrectomy,or cataract surgery with inadequate capsule support showed improved visual acuity.The difference was not significant between two IOLs except the surgery time(P>0.05).The mean operation times of C-loop IOL surgery was 24.1±1.83min and 31.3±4.47min of the four-haptics PC-IOL method(P<0.0001).In the C-loop IOLs group,there was statistical difference between the preoperative and the postoperative UCVA(log MAR,1.20±0.50 vs 0.57±0.32,P=0.0003).There was no statistical difference between the preoperative and the postoperative BCVA(log MAR,0.66±0.46 vs 0.40±0.23,P=0.056).However,there was no statistically significant difference in postoperative UCVA and BCVA between the two IOLs(P>0.05).We did not detect any optic capture,IOL decentration or dislocation,suture exposed,or cystoid macular edema in patients underwent C-loop IOLs surgery.CONCLUSION:The novel flapless one-knot suture technique for transscleral fixation of C-loop IOL is a simple,reliable,and stable technique.
文摘AIM:To evaluate the postoperative intraocular lens(IOL)rotational stability and residual refractive astigmatism following combined 25-gauge vitrectomy and cataract surgery with implantation of a plate haptic toric IOL.METHODS:In this retrospective case series,32 eyes of 32 patients underwent a combined 25-gauge vitrectomy and phacoemulsification for vitreoretinal diseases and cataract with regular corneal astigmatism of at least 1 diopter(D).A plate haptic toric IOL(AT Torbi 709M,Carl Zeiss Meditec AG)was implanted in all eyes.The outcome measures were rotational stability and refractive astigmatism up to 6mo postoperatively as well as the best corrected visual acuity(BCVA).RESULTS:Preoperative refractive astigmatism was 2.14±1.17 D,which was significantly reduced to 0.77±0.37 D six to eight weeks postoperatively and remained stable throughout the observation period(0.67±0.44 D at three months and 0.75±0.25 D at six months;for all groups:P<0.0001 compared to baseline).BCVA improved significantly from 0.36±0.33 logMAR preoperatively to 0.10±0.15 logMAR following surgery(P=0.02).Mean IOL axis deviation from the target axis was 3.4°±2.9°after six to eight weeks and significantly decreased over time(2.4°±2.6°six months after surgery;P=0.04).In one patient IOL,re-alignment was performed.CONCLUSION:Corneal astigmatism is significantly reduced following combined 25-gauge vitrectomy and cataract surgery.The plate haptic toric IOL position and axis remain stable during the observation period of six months.
文摘AIM:To assess the performance of a bespoke software for automated counting of intraocular lens(IOL)glistenings in slit-lamp images.METHODS:IOL glistenings from slit-lamp-derived digital images were counted manually and automatically by the bespoke software.The images of one randomly selected eye from each of 34 participants were used as a training set to determine the threshold setting that gave the best agreement between manual and automatic grading.A second set of 63 images,selected using randomised stratified sampling from 290 images,were used for software validation.The images were obtained using a previously described protocol.Software-derived automated glistenings counts were compared to manual counts produced by three ophthalmologists.RESULTS:A threshold value of 140 was determined that minimised the total deviation in the number of glistenings for the 34 images in the training set.Using this threshold value,only slight agreement was found between automated software counts and manual expert counts for the validating set of 63 images(κ=0.104,95%CI,0.040-0.168).Ten images(15.9%)had glistenings counts that agreed between the software and manual counting.There were 49 images(77.8%)where the software overestimated the number of glistenings.CONCLUSION:The low levels of agreement show between an initial release of software used to automatically count glistenings in in vivo slit-lamp images and manual counting indicates that this is a non-trivial application.Iterative improvement involving a dialogue between software developers and experienced ophthalmologists is required to optimise agreement.The results suggest that validation of software is necessary for studies involving semi-automatic evaluation of glistenings.
文摘AIM:To compare the clinical outcomes between two approaches for sutureless scleral-fixated intraocular lens(SFIOL)in children with Marfan syndrome(MFS).METHODS:The study included 15 children(26 eyes)with lens subluxation due to MFS.These children underwent lensectomy,anterior vitrectomy,and sutureless SFIOL.According to the position of placement of intraocular lens(IOL)haptics,two study groups were reviewed for best corrected visual acuity(BCVA)and postoperative complications:group A,14 eyes with haptics fixated at 2.0 mm from the limbus;group B,12 eyes with the haptics fixated at 2.5 mm from the limbus.RESULTS:The mean axial length for all patients was 25.66±2.35 mm.Postoperative BCVA in logMAR were significant improved in both groups(0.77±0.32 to 0.17±0.12 in group A,0.66±0.25 to 0.24±0.12 in group B,both P<0.001)while no significant difference between two groups(P>0.05).Pupillary capture was main postoperative complication,occurring between 3d and 18mo.It occurred in 7 eyes in group A and one eye in group B(P=0.02).CONCLUSION:Sutureless SFIOL is an effective treatment approach for lens subluxation in children with MFS.Pupillary capture is the main postoperative complication.Fixated IOL haptics at 2.5 mm from the limbus can reduce the occurrence of pupillary capture.
基金Supported by NIH Center Core,No.P30EY014801Research to Prevent Blindness Unrestricted Grant,Department of Defense,No.DOD-Grant#W81XWH-09-1-0675
文摘AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who received sulcus-placed SPA-IOLs between 2006 and 2009 were reviewed. None of the patients underwent IOL exchange. Charts of six age-matched patients who received sulcus placed 3P-IOLs were reviewed as a control group. RESULTS: Mean follow up was 16 mo for SPA-IOL and 23 mo for 3P-IOL. Five of 8 patients in the SPA-IOL group required chronic use of IOP lowering medications at final follow up. Of these, one patient needed glaucoma implant surgery for uncontrolled IOP. One patient in the 3P-IOL group used chronic aqueous suppression pre- and postoperatively. Four of eight eyes with SPAIOL were treated with chronic topical steroids and or non-steroidal anti-inflammatory drugs for cystoid macu-la edema, chronic uveitis, pigment dispersion syndrome or a combination of the above, compared to none in the control group. Mean best-corrected visual acuity was 20/35 in the SPA-IOL group and 20/47 in the 3PIOL group.CONCLUSION: Sulcus placed SPA-IOLs are associated with increased ocular morbidity. In select cases good visual acuity may be achieved. Due to postoperative rotation of sulcus placed toric SPA-IOLs stable astigmatism correction cannot be achieved. Alternative intraocular lenses should be considered when in-the-bag placement of SPA-IOL is not possible.
文摘Background:To evaluate efficacy and safety of combined pars plana vitrectomy(PPV)and scleral fixated intraocular lens(SFIOL)surgery as a single procedure.Methods:Retrospective interventional case series done at a tertiary eye care center in Northern India.Eleven patients who underwent combined PPV and SFIOL surgery were included and analyzed retrospectively.Results:Mean age of the patients was 43.36±15.12 years(range,22-64 years).Eight were male.Mean baseline best corrected visual acuity(BCVA)was 0.78±0.63 logMAR units while the mean post-operative BCVA at 6 months follow-up was 0.37±0.29 logMAR units,the visual gain being statistically significant(P=0.021).None of the patients had a drop in BCVA with nine patients having final BCVA better than 0.48 logMAR units.Choroidal detachment(CD)was the only notable complication,seen in three patients.Other complications included two cases of intraoperative retinal breaks,a case each of reversible corneal edema,ocular hypertension and cystoid macular edema.Conclusions:Combined PPV and SFIOL is an efficacious procedure for managing IOL/lens dislocation and aphakia in a single surgery.There may be short-term reversible complications with no impact on final visual gain.
文摘Advances in intraocular lens(IOL)design have rendered cataract surgery a refractive procedure.Newer IOL types include bifocal,trifocal and extended depth of focus(EDOF)IOLs.Their basic difference nestles in the number of focal points that each lens provides,which in turn leads to different visual outcomes.Familiarity of surgeons with the various characteristics of each lens is of utmost importance for accurate IOL selection to match each patient’s needs.In this review,we aim to compare the clinical outcomes after implantation of multifocal and EDOF IOLs in terms of distance,intermediate and near vision,contrast sensitivity,and reading performance.Finally,we discuss the defocus curve and the optical and photic phenomena associated with each type of IOL.
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 evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens(IOL) during a 12-month follow-up.METHODS:Prospective comparative study including 75 eyes of 38 patients(44-70 y) undergoing uneventful cataract surgery.Each patient was randomly assigned to one type of IOL,bifocal(35 eyes) or trifocal(40 eyes).Visual,refractive,and contrast sensitivity changes were evaluated in a 12-month follow-up.The binocular defocus curve was also measured at 12 mo postoperatively.RESULTS:No statistically significant differences between groups were found in postoperative uncorrected and corrected distance visual acuities(P≥0.276).Postoperative corrected near visual acuity(33 cm) was significantly better in the trifocal group during all follow-up(P≤0.004) as well as 6-month uncorrected near(P=0.008) and distancecorrected near visual acuities(P=0.016)(33/40 cm).Significantly better uncorrected intermediate and distance corrected-intermediate visual acuity were found during all follow-up in the trifocal group(P<0.001),which was consistent with differences among groups in binocular defocus curve.Differences among groups in contrast sensitivity were minimal,being only significant at 6 months for some low to medium spatial frequencies(P≤0.006).CONCLUSION:Bifocal and trifocal diffractive IOLs are able to provide an effective visual restoration which is maintained during a 12-month follow-up,with a clear benefit of the trifocal IOL for the intermediate vision.
文摘AIM:To investigate and compare the quality of life,satisfaction,contrast sensitivity,glare,depth perception,and intraocular lens(IOL)rotation in patients who underwent trifocal toric and bifocal toric IOLs.METHODS:A total of 80 eyes of 40 patients were included in this prospective study.Twenty patients in each group were implanted with trifocal toric and bifocal toric IOL,respectively.Preoperative and postoperative 6-month measurements were recorded for both patient groups.Comprehensive anterior and posterior segment examinations,distance-intermediate-near visual acuity values and the visual function scale questionnaire results were evaluated at these examinations.Patient satisfaction,contrast sensitivity,glare,intermediate-near and distance stereopsis and IOL rotation were also evaluated.RESULTS:No significant difference was found between the groups in terms of distance and near visual acuities(P=0.269,P=0.451).Intermediate visual acuity was significantly increased in the trifocal toric group(P<0.001).The visual function scale results were increased after surgery in both groups(P=0.001 and P<0.001),with no difference determined between them(P=0.158 and P=0.691).The number of patients wearing glasses was low in both groups and there was no significant difference between the groups(P>0.05).The overall satisfaction in the trifocal toric group was significantly higher than in the bifocal toric group(P=0.03).The highest sensitivity was observed at 6 cpd spatial frequency in all patients under photopic conditions(1.80±0.24 logU,1.74±0.20 logU).Distance-intermediate-near binocular depth perception results in both groups were higher in the trifocal toric group(P=0.02,0.048,0.003,respectively).Although there was no significant difference for 3 meters stereopsis,the trifocal toric group had higher depth perception(P=0.577).Mean rotation was 5.76°±3.93°in the trifocal toric group and 12°±7.1°in the bifocal toric group.CONCLUSION:Better results in the middle distance are obtained in the trifocal toric group and less IOL rotation due to digital system-coordinated surgery.Moreover,the overall satisfaction in the trifocal toric group is significantly higher than in the bifocal toric group.
文摘AIM: To conduct a Meta-analysis pooling randomized controlled trials(RCTs) to compare hydrophobic with hydrophilic acrylic intraocular lenses in terms of posterior capsule opacification(PCO) development.METHODS: Electronic databases including PubMed,Embase, and the Cochrane Library were queried from their starting till January 2020. RCTs investigating the impact of hydrophobic versus hydrophilic acrylic intraocular lenses on PCO were considered eligible in this study. The pooled effect estimates were calculated using the random-effects model.RESULTS: Thirteen RCTs comprising of 939 patients(1263 eyes) were covered in this study. Patients with hydrophobic acrylic intraocular lenses had a lower PCO score than those with a hydrophilic acrylic intraocular lenses [standard mean difference:-1.80;95% confidence interval(CI):-2.62 to-0.98;P<0.001]. Moreover, the frequency of neodymium-doped yttrium aluminum garnet(Nd:YAG)capsulotomy in patients with hydrophobic acrylic intraocular lenses was significantly lower than patients with hydrophilic acrylic intraocular lenses(relative risk: 0.38;95%CI: 0.20-0.71;P=0.003).CONCLUSION: These findings suggest that hydrophobic acrylic intraocular lenses are superior to hydrophilic acrylic intraocular lenses in patients after cataract surgery due to lower PCO score and reduced Nd:YAG capsulotomy. While similar studies are conducted by other researchers, the present study conducted subgroup analyses that show superior results with hydrophobic lenses in trials conducted in western countries.
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Purpose: To assess the visual outcome after implantation of the new Hydrophylic IOL type 41 B/G accommodating intraocular lens (AIOL). Methods: The presented lens was implanted during cataract surgery. All patients were offered follow-ups, allowing two postoperative measurements to be performed at 3 months and between 2020 and 2021. The mean time between lens implantation and last follow-up was 5.3 years (min. 1 year, max. 10 years). Excluded were patients with age-related macular degeneration or amblyopia. Patients with a foreign lens implanted into the second eye were included in a separate control group. Corrected distance (CDVA) and uncorrected distance visual acuity (UDVA) at 5 m, and corrected near (CNVA) and uncorrected near visual acuity (UNVA) at 40 cm were assessed. Furthermore, the postoperative spherical equivalent (SE), the dependence on spectacles and the occurrence of optical phenomena were evaluated. Results: The final study cohort consists of 65 patients with 119 implanted AIOLs. Significantly better visual results were obtained in both postoperative follow-ups compared with the preoperative results. The mean values of the last follow-up for the UNVA, CNVA, UDVA, and CDVA were 0.107 ± 0.10;0.039 ± 0.08;0.097 ± 0.11;and 0.040 ± 0.09 logMAR, respectively. Visual outcomes remained on a high level for up to 10 years and showed significantly better results compared to the control group. Postoperative SE was significantly improved. Nearly 70% of patients were no longer dependent on glasses. Furthermore, the occurrence of disturbing optical phenomena was denied by all patients. Conclusion: The results of this AIOL are particularly promising, especially since gratifying visual results could still be measured 10 years after implantation.
文摘AIM:To evaluate the effects of posterior corneal surface measurements on the accuracy of total estimated corneal astigmatism.METHODS:Fifty-seven patients with toric intraocular lens(IOL) implantation and posterior corneal astigmatism exceeding 0.5 diopter were enrolled in this retrospective study.The keratometric astigmatism(KA) and total corneal astigmatism(TA) were measured using a Pentacam rotating Scheimpflug camera to assess the outcomes of AcrySof IOL implantation.Toric lOLs were evaluated in 26 eyes using KA measurements and in 31 eyes using TA measurements.Preoperative corneal astigmatism and postoperative refractive astigmatism were recorded for statistical analysis.The cylindrical power of toric lOLs was estimated in all eyes.RESULTS:In all cases,the difference of toric IOL astigmatism magnitude between KA and TA measurements for the estimation of preoperative corneal astigmatism was statistically significant.Of a total of 57 cases,the 50.88%decreased from T_n to T_(n-1) and 10.53%decreased from T_n to T_(n-2).In all cases,5.26%increased from T_n to T_(n+1).The mean postoperative astigmatism within the TA group was significantly lower than that in the KA group.CONCLUSION:The accuracy of total corneal astigmatism calculations and the efficacy of toric IOL correction can be enhanced by measuring both the anterior and posterior corneal surfaces using a Pentacam rotating Scheimpflug camera.
文摘AIM: To evaluate the impact of 4 different intraocular lenses(IOLs) on posterior capsule opacification(PCO) by comparing the neodymium: yttrium-aluminum-garnet(Nd:YAG) laser capsulotomy rates.METHODS: This retrospective study included 4970 eyes of 4013 cataract patients who underwent phacoemulsification and IOL implantation between January 2000 and January 2008 by the same surgeon at one clinic. Four different IOLs were assessed. The outcome parameter was the incidence of Nd:YAG laser posterior capsulotomies.· RESULTS: An Nd:YAG laser posterior capsulotomy was performed in 153(3.07%) of the 4970 eyes. The mean follow-up time was 84 mo for all of the IOL groups. The percentage of eyes developing PCO was significantly greater for the acrylic hydrophilic IOLs than for the hydrophobic IOLs, although eyes with acrylic hydrophilic IOLs did not require Nd:YAG laser capsulotomy as soon as eyes with acrylic hydrophobic IOLs. There was no difference between the long-term PCO rates when 1-and 3-piece acrylic hydrophobic IOLs were compared or when IOLs made of the same material but with different haptic angles were compared.· CONCLUSION: In this study, eyes with acrylic hydrophilic IOLs were more likely to develop PCO than those with acrylic hydrophobic IOLs. The lens design(1-piece versus 3-piece and varying haptic angles) did not affect the PCO rate.
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.
文摘The study was to report a new two-point scleralfixation technique for foldable intraocular lenses with four haptics.Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite points.The postoperative best-corrected visual acuities(BCVAs) of all patients were significantly better than their preoperative BCVA.The results demonstrate that two-point,scleral fixations of foldable,intraocular lenses might be practicable and effective.
基金Supported by Natural Science Foundation of China (No.81670848 No.81470626)
文摘This study aims to evaluate the clinical results of posterior chamber implantable collamer lens(ICL) implantation in adults with high myopic anisometropic amblyopia. Thirteen patients aged 27.04±7.24 y(range 19.2 to 42.5) were studied. ICL implantation was performed in 13 amblyopic eyes. The mean myopic anisometropia was significantly dropped from-10.70±3.02 D preoperatively to +0.09±1.67 D at 1 mo postoperatively. The logMAR CDVA at 3 d, 1, 3 and mean 9 mo postoperatively improved by a mean of 1.69, 2.50, 3.01 and 3.00 lines and gained more than 2 lines accounted for 23.08%(3 eyes), 41.67%(5 eyes), 63.63%(7 eyes) and 55.56%(5 eyes), respectively. The contrast sensitivity of amblyopic eyes was significantly increased after surgery. Four patients partially recovered near stereopsis(400" to 100"). There was no severe complications were observed. ICL implantation alone can improve vision, contrast sensitivity, and partial restoration of binocular vision in adult patients with high myopic anisometropia.
文摘AIM: To evaluate the accuracy of three commonly used biometric formulae across different axial lengths(ALs) at one United States Veterans Affairs teaching hospital.METHODS: A retrospective chart review was conducted from November 2013 to May 2018. One eye of each patient who underwent cataract surgery with a monofocal intraocular lens(IOL) was included. The range of postoperative follow-up period was from 3 wk to 4 mo. The Holladay 2, Barrett Universal II, and Hill-Radial Basis Function(Hill-RBF) formulae were used to predict the postoperative refraction for all cataract surgeries. For each formula, we calculated the prediction errors [including mean absolute prediction error(MAE)] and the percentage of eyes within ±0.25 diopter(D) and ±0.5 D of predicted refraction. We performed subgroup analyses for short(AL<22.0 mm), medium(AL 22.0-25.0 mm), and long eyes(AL>25.0 mm).RESULTS: A total of 1131 patients were screened, and 909 met the inclusion criteria. Resident ophthalmologists were the primary surgeons in 710(78.1%) cases. We found no statistically significant difference in predictive accuracy among the three formulae over the entire AL range or in the short, medium, and long eye subgroups. Across the entire AL range, the Hill-RBF formula resulted in the lowest MAE(0.384 D) and the highest percentage of eyes with postoperative refraction within ±0.25 D(42.7%) and ±0.5 D(75.5%) of predicted. All three formulae had the highest MAEs(>0.5 D) and lowest percentage within ±0.5 D of predicted refraction(<55%) in short eyes.CONCLUSION: In cataract surgery patients at our teaching hospital, three commonly used biometric formulae demonstrate similar refractive accuracy across all ALs. Short eyes pose the greatest challenge to predicting postoperative refractive error.
