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Journal of Cataract and Refractive... Jan 2023To analyze the 6-month outcomes of the treatment combination of the monocular bi-aspheric ablation profile (PresbyMAX) and contralateral aspheric monofocal laser in situ...
PURPOSE
To analyze the 6-month outcomes of the treatment combination of the monocular bi-aspheric ablation profile (PresbyMAX) and contralateral aspheric monofocal laser in situ keratomileusis (LASIK) ablation profile for correction of myopia and presbyopia.
SETTING
Yonsei University College of Medicine and Eyereum Eye Clinic, Seoul, South Korea.
DESIGN
Retrospective case series.
METHODS
This was a retrospective case review of 92 patients (184 eyes) diagnosed with myopia who underwent uneventful simultaneous bi-aspheric ablation in the nondominant eye and aspheric monofocal regular LASIK in the dominant eye to correct myopia and presbyopia between January 2017 and August 2020. Monocular and binocular uncorrected distance visual acuity (UDVA) and near visual acuity (UNVA), and corrected distance visual acuity and near visual acuity were analyzed postoperatively.
RESULTS
At 6 months postoperatively, the mean UDVAs (logMAR) in the dominant and nondominant eyes were 0.01 ± 0.02 and 0.26 ± 0.15, respectively. Furthermore, all treated dominant eyes achieved 20/20 or better monocular UDVA, and 84% achieved 20/16 or better monocular UDVA. In the nondominant treated eyes, 89% achieved 20/50 or better monocular UDVA, 78% achieved 20/40 or better, and 34% achieved 20/32 or better. The binocular cumulative UDVA at 6 months postoperatively was 20/20 or better in all patients. All patients achieved J2 or better in binocular cumulative UNVA, and 83% achieved J1.
CONCLUSIONS
Presbyopia correction using the combination of PresbyMAX in the near eye and aspheric monofocal regular LASIK in the distant eye is a safe and effective treatment for presbyopia in patients with myopia.
Topics: Humans; Presbyopia; Retrospective Studies; Vision, Binocular; Corneal Topography; Cornea; Keratomileusis, Laser In Situ; Myopia; Treatment Outcome; Lasers, Excimer; Refraction, Ocular
PubMed: 36026693
DOI: 10.1097/j.jcrs.0000000000001042 -
MMW Fortschritte Der Medizin Sep 2023
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Science Advances Jun 2019As humans age, they gradually lose the ability to accommodate, or refocus, to near distances because of the stiffening of the crystalline lens. This condition, known as...
As humans age, they gradually lose the ability to accommodate, or refocus, to near distances because of the stiffening of the crystalline lens. This condition, known as presbyopia, affects nearly 20% of people worldwide. We design and build a new presbyopia correction, autofocals, to externally mimic the natural accommodation response, combining eye tracker and depth sensor data to automatically drive focus-tunable lenses. We evaluated 19 users on visual acuity, contrast sensitivity, and a refocusing task. Autofocals exhibit better visual acuity when compared to monovision and progressive lenses while maintaining similar contrast sensitivity. On the refocusing task, autofocals are faster and, compared to progressives, also significantly more accurate. In a separate study, a majority of 23 of 37 users ranked autofocals as the best correction in terms of ease of refocusing. Our work demonstrates the superiority of autofocals over current forms of presbyopia correction and could affect the lives of millions.
Topics: Aged; Contrast Sensitivity; Eyeglasses; Female; Humans; Male; Middle Aged; Presbyopia; Task Performance and Analysis; Vision Tests; Visual Acuity
PubMed: 31259239
DOI: 10.1126/sciadv.aav6187 -
JAMA Ophthalmology Nov 2022A bayesian network meta-analysis (NMA) can help compare the various types of multifocal and monofocal intraocular lenses (IOLs) used in clinical practice. (Meta-Analysis)
Meta-Analysis
Visual Outcomes and Optical Quality of Accommodative, Multifocal, Extended Depth-of-Focus, and Monofocal Intraocular Lenses in Presbyopia-Correcting Cataract Surgery: A Systematic Review and Bayesian Network Meta-analysis.
IMPORTANCE
A bayesian network meta-analysis (NMA) can help compare the various types of multifocal and monofocal intraocular lenses (IOLs) used in clinical practice.
OBJECTIVE
To compare outcomes of presbyopia-correcting IOLs frequently recommended in clinical practice through a bayesian NMA based on a systematic review.
DATA SOURCES
Medline (PubMed) and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched on May 15, 2021, from inception.
STUDY SELECTION
Based on the research question, randomized clinical trials assessing multifocal IOLs in patients who underwent bilateral cataract extraction were searched. Nonrandomized studies, studies in patients with unilateral or contralateral cataract extractions, duplicated studies, conference abstracts, and nonpeer-reviewed articles were excluded.
DATA EXTRACTION AND SYNTHESIS
Descriptive statistics and outcomes were extracted. The NMA was conducted to compare different types of IOLs. The mean differences for continuous variables, odds ratios for binary variables, 95% credible intervals (CrIs), and ranks of interventions were estimated.
MAIN OUTCOMES AND MEASURES
The outcomes examined included binocular visual acuities by distance and optical quality, including glare, halos, and spectacle independence.
RESULTS
This NMA included 27 studies comprising 2605 patients. For uncorrected near visual acuity, trifocal IOLs (mean difference, -0.32 [95% CrI, -0.46 to -0.19]) and old bifocal diffractive IOLs (mean difference, -0.33 [95% CrI, -0.50 to -0.14]) afforded better visual acuity than monofocal IOLs. Regarding uncorrected intermediate visual acuity, extended depth-of-focus IOLs provided better visual acuity than monofocal IOLs. However, there were no differences between extended depth-of-focus and trifocal diffractive IOLs in pairwise comparisons. For uncorrected distant visual acuity, all multifocal IOLs were comparable with monofocal IOLs. There were no statistical differences between multifocal and monofocal IOLs regarding contrast sensitivity, glare, or halos.
CONCLUSIONS AND RELEVANCE
For patients considering a multifocal IOL due to presbyopia, bilateral implantation of a trifocal IOL might be an optimal option for patients without compromising distant visual acuity.
Topics: Humans; Presbyopia; Network Meta-Analysis; Bayes Theorem; Lenses, Intraocular; Cataract Extraction; Contrast Sensitivity; Cataract
PubMed: 36136323
DOI: 10.1001/jamaophthalmol.2022.3667 -
American Journal of Ophthalmology Jan 2016
Topics: Contrast Sensitivity; Corneal Stroma; Female; Humans; Lenses, Intraocular; Male; Mesopic Vision; Presbyopia; Prosthesis Implantation
PubMed: 26520671
DOI: 10.1016/j.ajo.2015.10.004 -
Ophthalmology Oct 2021To review the published literature assessing the efficacy and safety of presbyopia-correcting intraocular lenses (IOLs) for the treatment of presbyopia after cataract... (Review)
Review
PURPOSE
To review the published literature assessing the efficacy and safety of presbyopia-correcting intraocular lenses (IOLs) for the treatment of presbyopia after cataract removal.
METHODS
Literature searches were undertaken in January 2018 and September 2020 in the PubMed, Medline, and Cochrane Library databases. This yielded 761 articles, of which 34 met the criteria for inclusion in this assessment and were assigned a level of evidence rating by the panel methodologist. Thirteen studies were rated level I and 21 studies were rated level II.
RESULTS
Presbyopia-correcting lenses were effective at improving distance and near visual acuity after cataract surgery. Near acuity at different focal lengths was related directly to the effective add power of multifocal and extended depth-of-focus (EDOF) IOLs. Most multifocal and EDOF lenses that were compared with a control monofocal lens demonstrated that patient-reported spectacle independence was superior to the monofocal lens. All patients who had multifocal and EDOF lenses implanted showed decreased contrast sensitivity and reported more visual phenomena as compared with control participants who received monofocal lenses.
CONCLUSIONS
Presbyopia-correcting lenses improve uncorrected near and distance visual acuity and decrease spectacle dependence after cataract surgery. Mesopic contrast sensitivity is decreased compared with monofocal lenses, and patient-reported visual phenomena are more likely in patients receiving multifocal or EDOF lenses.
Topics: Academies and Institutes; Accommodation, Ocular; Depth Perception; Humans; Lens Implantation, Intraocular; Multifocal Intraocular Lenses; Ophthalmology; Patient Satisfaction; Presbyopia; Prosthesis Design; Refraction, Ocular; United States; Visual Acuity
PubMed: 33741376
DOI: 10.1016/j.ophtha.2021.03.013 -
Journal of Refractive Surgery... Sep 2023To assess the clinical and aberrometric outcomes of a new Implantable Collamer Lens (EVO Viva ICL; STAAR Surgical) to correct moderate to high myopia and presbyopia.
PURPOSE
To assess the clinical and aberrometric outcomes of a new Implantable Collamer Lens (EVO Viva ICL; STAAR Surgical) to correct moderate to high myopia and presbyopia.
METHODS
The study included 80 eyes of 40 patients who had bilateral EVO Viva ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, presbyopic add power, binocular through-focus visual acuity, total ocular spherical aberration (SA), coma aberration, and root mean square of ocular higher order aberrations (RMS HOAs) (i-Trace Aberrometer; Tracey Technologies) for a 4.5-mm pupil size were evaluated.
RESULTS
The mean binocular postoperative UDVA and CDVA were 0.09 ± 0.19 and 0.02 ± 0.03 logMAR, respectively. The postoperative spherical equivalent was -0.61 ± 0.54 diopters (D). The presbyopic add power reduced from +1.31 ± 0.74 D preoperatively to +0.44 ± 0.58 D after surgery ( < .0001). The mean visual acuity was 0.1 logMAR or better (20/25 or better) across the vergence range from +0.50 to -1.50 D, better than 0.2 logMAR (20/32 or better) up to the vergence of -2.00 D, and remained better than 0.3 logMAR (20/40 or better) up to the vergence of -2.50 D. The total ocular aberrations induced by EVO Viva ICL were -0.34 ± 0.09 µm of SA, 0.24 ± 0.18 µm of coma, and 0.26 ± 0.12 µm of RMS HOAs.
CONCLUSIONS
The outcomes support that the new ICL might be a good alternative for myopia and presbyopia correction in patients aged between 45 and 55 years. Further studies are needed to evaluate the threshold lens misalignment from which the patient´s visual quality would be affected. .
Topics: Humans; Middle Aged; Presbyopia; Coma; Myopia; Lenses, Intraocular; Refraction, Ocular
PubMed: 37675906
DOI: 10.3928/1081597X-20230726-02 -
Expert Review of Medical Devices May 2015Presbyopia, the physiological change in near vision that develops with ageing, gradually affects individuals older than 40 years and is a growing cause of visual... (Review)
Review
Presbyopia, the physiological change in near vision that develops with ageing, gradually affects individuals older than 40 years and is a growing cause of visual disability due to ageing demographics of the global population. The routine use of computers and 'smartphones', combined with the affluence of the 'baby boomers' generation has set high standards for near vision correction. Corneal inlays are a relatively new treatment modality that is effective at compensating for presbyopia. The dimensions of these devices vary from 2 to 3.8 mm in diameter and 5 to 32 μm in thickness. They are implanted in the anterior corneal stroma of the non-dominant eye, most commonly, in a femtosecond laser created corneal pocket. They improve near vision by increasing the depth of focus, creating a hyper-prolate region of increased central cornea power or providing a refractive add power. This article reviews the literature on the efficacy and safety of corneal inlays.
Topics: Aging; Cornea; Corneal Stroma; Humans; Patient Satisfaction; Presbyopia; Prostheses and Implants; Prosthesis Implantation; Treatment Outcome; Visual Acuity
PubMed: 25652889
DOI: 10.1586/17434440.2015.1007124 -
The British Journal of Ophthalmology Jan 2016Presbyopia is an age-related eye condition where one of the signs is the reduction in the amplitude of accommodation, resulting in the loss of ability to change the... (Review)
Review
Presbyopia is an age-related eye condition where one of the signs is the reduction in the amplitude of accommodation, resulting in the loss of ability to change the eye's focus from far to near. It is the most common age-related ailments affecting everyone around their mid-40s. Methods for the correction of presbyopia include contact lens and spectacle options but the surgical correction of presbyopia still remains a significant challenge for refractive surgeons. Surgical strategies for dealing with presbyopia may be extraocular (corneal or scleral) or intraocular (removal and replacement of the crystalline lens or some type of treatment on the crystalline lens itself). There are however a number of limitations and considerations that have limited the widespread acceptance of surgical correction of presbyopia. Each surgical strategy presents its own unique set of advantages and disadvantages. For example, lens removal and replacement with an intraocular lens may not be preferable in a young patient with presbyopia without a refractive error. Similarly treatment on the crystalline lens may not be a suitable choice for a patient with early signs of cataract. This article is a review of the options available and those that are in development stages and are likely to be available in the near future for the surgical correction of presbyopia.
Topics: Accommodation, Ocular; Aging; Humans; Ophthalmologic Surgical Procedures; Presbyopia; Refraction, Ocular
PubMed: 25908836
DOI: 10.1136/bjophthalmol-2015-306663 -
Current Opinion in Ophthalmology Jan 2021Corneal refractive surgery has achieved spectacle-free vision for millions of patients, but this aging population is now developing cataracts. Many of these patients may... (Review)
Review
PURPOSE OF REVIEW
Corneal refractive surgery has achieved spectacle-free vision for millions of patients, but this aging population is now developing cataracts. Many of these patients may wish to avoid reliance on glasses after cataract surgery. Presbyopia-correcting intraocular lenses (IOLs) offer a solution, but corneal changes after refractive surgery may compound higher order aberrations and dysphotopic symptoms associated with these IOLs. This review aims to discuss potential factors that could aid in determining suitable postkeratorefractive candidates for presbyopia-correcting IOLs.
RECENT FINDINGS
Studies investigating which preoperative measures influence outcomes are lacking. The few studies that have examined presbyopia-correcting IOLs in postkeratorefractive patients report that satisfactory outcomes are possible. However, recommendations for preoperative thresholds appear limited to expert opinion and studies involving virgin corneas.
SUMMARY
As the number of presbyopia-correcting IOLs and postkeratorefractive patients grows, continued investigation into relevant preoperative factors and appropriate IOLs is required to make evidence-based decisions. The current literature shows that with rigorous counseling and appropriate patient selection, presbyopia-correcting IOLs can provide postkeratorefractive patients with satisfactory results and spectacle independence. In addition, the development of postoperative modifiable IOLs may prove to be the preferred option.
Topics: Depth Perception; Humans; Keratomileusis, Laser In Situ; Lens Implantation, Intraocular; Multifocal Intraocular Lenses; Photorefractive Keratectomy; Presbyopia; Visual Acuity
PubMed: 33122489
DOI: 10.1097/ICU.0000000000000722