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The Medical Clinics of North America May 2021Cataract surgery is one of the most common surgical procedures performed in the United States. The decision to remove a cataract is determined by the patient's ability... (Review)
Review
Cataract surgery is one of the most common surgical procedures performed in the United States. The decision to remove a cataract is determined by the patient's ability to perform activities of daily living, such as reading, driving, and watching television. Cataract surgery also offers the potential of spectacle independence with a wide array of premium intraocular lens options. In addition, with the continuing advances in ophthalmology, patients now also have the option of selecting between traditional approaches and femtosecond laser-assisted procedures. Cataract surgery continues to be an effective and ever-improving procedure for vision restoration.
Topics: Cataract; Cataract Extraction; Corneal Surgery, Laser; Humans; Hyperopia; Lenses, Intraocular; Myopia; Ophthalmologic Surgical Procedures; Presbyopia
PubMed: 33926640
DOI: 10.1016/j.mcna.2021.01.002 -
Journal of Refractive Surgery... Dec 2023To compare visual outcomes and satisfaction in patients with emmetropia, presbyopia, and greater or lesser residual accommodation who undergo unilateral or bilateral...
PURPOSE
To compare visual outcomes and satisfaction in patients with emmetropia, presbyopia, and greater or lesser residual accommodation who undergo unilateral or bilateral implantation of a trifocal diffractive intraocular lens (IOL).
METHODS
A multicenter, multisurgeon study was performed to evaluate outcomes in patients with emmetropia and presbyopia who underwent refractive lens exchange followed by implantation of a FineVision trifocal IOL (PhysIOL). The inclusion criteria were as follows: emmetropia, sphere -0.25 to +0.50 diopters (D), cylinder less than 0.75 D, and manifest refractive spherical equivalent (MRSE) of -0.25 to +0.25 D. All patients also had to have an uncorrected distance visual acuity (UDVA) of Snellen 0.9 or better in each eye. The sample was divided into different clusters based on two variables: eyes operated on (monocular or binocular) and age either younger than 55 years or 55 years or older. Thus, four possible groups were created. Visual and refractive performance, patient satisfaction, and spectacle independence were assessed.
RESULTS
A total of 690 eyes from 431 patients were evaluated. There was no difference in postoperative uncorrected (UDVA) and corrected (CDVA) distance visual acuity between the groups. Binocular uncorrected near vision (UNVA) was better in patients who underwent surgery on both eyes regardless of age (median [interquartile range]: 0.00 [0.00; 0.10] vs 0.10 [0.00; 0.10] logMAR; < .001). Binocular uncorrected intermediate vision (UIVA) was better in patients who underwent surgery on both eyes aged younger than 55 years than in those who underwent surgery in one eye aged 55 years or older (median [interquartile range]: 0.18 [0.10; 0.18] vs 0.30 [0.18; 0.30] logMAR; < .001). The efficacy and safety indexes were 0.98 ± 0.09 and 1.01 ± 0.06, respectively. A total of 93.3% of eyes were within the 0.50 D range in postoperative MRSE. Visual dysphotopsia was worse in patients with both eyes operated on, although the differences were not statistically significant.
CONCLUSIONS
The study shows that after refractive lens exchange, patients with emmetropia and presbyopia who received a trifocal IOL in one or both eyes achieved good UNVA, UIVA, and UDVA. Regarding near binocular visual acuity, results were better for patients who underwent surgery on both eyes than for those who underwent surgery on one eye. Regarding binocular intermediate visual acuity, patients aged younger than 55 years with both lenses replaced had better results than those 55 years or older with only one lens replaced. However, no significant differences were observed in UDVA or patient satisfaction. .
Topics: Humans; Emmetropia; Presbyopia; Phacoemulsification; Lenses, Intraocular; Refraction, Ocular; Patient Satisfaction; Prosthesis Design
PubMed: 38063834
DOI: 10.3928/1081597X-20231018-01 -
Current Opinion in Ophthalmology Jul 2018To summarize the various extended depth of focus (EDOF) intraocular lenses currently available to patients and to describe visual outcomes and patient satisfaction. (Review)
Review
PURPOSE OF REVIEW
To summarize the various extended depth of focus (EDOF) intraocular lenses currently available to patients and to describe visual outcomes and patient satisfaction.
RECENT FINDINGS
EDOF lenses are a relatively new option for presbyopic correction. Preliminary studies show high levels of spectacle independence and patient satisfaction. The only United States Federal Drug Administration-approved intraocular lens currently on market is the TECNIS Symfony (Johnson and Johnson Vision, Jacksonville, FL).
SUMMARY
Early studies show that EDOF lenses may provide satisfactory near and intermediate vision with reduced incidence of haloes and glares often noted by patients implanted with multifocal lenses. Results are promising, but limited.
Topics: Depth Perception; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Presbyopia; Visual Acuity
PubMed: 29697436
DOI: 10.1097/ICU.0000000000000490 -
BMC Ophthalmology Nov 2023Fuchs endothelial corneal dystrophy (FECD) is the leading indication for EK and may coexist with cataract and presbyopia. Notably, the outcomes of phacoemulsification in... (Review)
Review
Fuchs endothelial corneal dystrophy (FECD) is the leading indication for EK and may coexist with cataract and presbyopia. Notably, the outcomes of phacoemulsification in FECD patients are not as favorable as those in eyes without this condition. Historically, only monofocal intraocular lenses (IOLs) were recommended for these patients. However, recent reports have described the implantation of Premium-IOLs (such as Multifocal IOLs, Enhanced Depth of Focus IOLs, and Toric IOLs) in FECD eyes undergoing cataract surgery and Descemet membrane endothelial keratoplasty (DMEK). While the results are encouraging, they are not as optimal as those from unoperated eyes, especially when comparing simultaneous procedures to sequential ones. It's advised to perform the DMEK first to improve the accuracy of IOL calculations. Still, even successfully operated eyes may experience secondary graft failure or graft rejection after DMEK. The success rate of a secondary DMEK is typically lower than that of the initial procedure. Furthermore, if the postoperative thickness after DMEK is less than anticipated, laser enhancements might not be an option. There's a pressing need for more controlled and randomized clinical trials to ascertain the safety and effectiveness of Premium-IOLs for FECD eyes. This narrative review aims to collate evidence on the use of Premium IOL technologies in eyes receiving EK and to underscore key points for surgeons performing EK combined with cataract surgery.
Topics: Humans; Lens Implantation, Intraocular; Descemet Membrane; Presbyopia; Visual Acuity; Lenses, Intraocular; Corneal Transplantation; Fuchs' Endothelial Dystrophy; Cataract; Descemet Stripping Endothelial Keratoplasty; Retrospective Studies
PubMed: 38007433
DOI: 10.1186/s12886-023-03240-5 -
BMC Ophthalmology Jun 2023Cataract surgery has become a refractive procedure in which emmetropia is the goal, with the implantation of extended depth-of-focus or multifocal intraocular lenses... (Review)
Review
Cataract surgery has become a refractive procedure in which emmetropia is the goal, with the implantation of extended depth-of-focus or multifocal intraocular lenses (IOLs) being the commonly selected option to restore vision beyond the far distance. The selection criteria for implanting these lenses can differ from those for monofocal IOLs and even between technologies, as eye characteristics can affect postoperative visual performance. Corneal astigmatism is an eye characteristic that can affect visual performance differently, depending on the implanted IOL. The magnitude of corneal astigmatism, the tolerance of the IOL to this astigmatism, economic aspects, comorbidities, and the efficacy of astigmatism treatment are factors that can make surgeons' doubt as to what astigmatism treatment should be applied to each patient. This review aims to summarize the current evidence related to low astigmatism tolerance in presbyopia-correcting lenses, the efficacy achieved through corneal incisions, and their comparison with the implantation of toric IOLs.
Topics: Humans; Astigmatism; Lens Implantation, Intraocular; Presbyopia; Visual Acuity; Phacoemulsification; Lenses, Intraocular; Corneal Diseases; Prosthesis Design
PubMed: 37280550
DOI: 10.1186/s12886-023-03003-2 -
Annual International Conference of the... Nov 2021Over 2 billion people across the world are affected by some visual impairment - mostly related to optical issues, and this number is estimated to grow. Often,...
Over 2 billion people across the world are affected by some visual impairment - mostly related to optical issues, and this number is estimated to grow. Often, particularly in the elderly, more than one condition can affect the eyes at the same time, e.g., myopia and presbyopia. Bifocal or multifocal lenses can be used, these however may become uncomfortable or disturbing and are not adapted to the user. There is therefore a need and opportunity for a new type of glasses able to adaptively change the lenses' focus. This paper explores the feasibility of recording the eye accommodation process in a non-invasive way using a wearable device. This can provide a way to measure eye convergence in real-time to determine what a person's eye is focused on. In this study, Electro-oculography (EoG) is used to observe eye muscle activity and estimate eye movement. To assess this, a group of 11 participants we each asked to switch their gaze from a near to far target and vice versa, whilst their EoG was measured. This revealed two distinct waveforms: one for the transition from a far to near target, and one for the transition from a near to far target. This informed the design of a correlation-based classifier to detect which signals are related to a far to near, or near to far transition. This achieved a classification accuracy of 97.9±1.37% across the experimental results gathered from our 11 participants. This pilot data provides a basic starting point to justify future device development.
Topics: Accommodation, Ocular; Aged; Eyeglasses; Humans; Lens, Crystalline; Myopia; Presbyopia
PubMed: 34892819
DOI: 10.1109/EMBC46164.2021.9629844 -
Clinical & Experimental Optometry Jan 2020We live in a three-dimensional world and the human eye can focus images from a wide range of distances by adjusting the power of the eye's lens (accommodation).... (Review)
Review
We live in a three-dimensional world and the human eye can focus images from a wide range of distances by adjusting the power of the eye's lens (accommodation). Progressive senescent changes in the lens ultimately lead to a complete loss of this ability by about age 50, which then requires alternative strategies to generate high-quality retinal images for far and close viewing distances. This review paper highlights the biomimetic properties and underlying optical mechanisms of induced anisometropia, small apertures, dynamic lenses, and multi-optic lenses in ameliorating the visual consequences of presbyopia. Specifically, the advantages and consequences of non-liner neural summation leveraged in monovision treatments are reviewed. Additionally, the value of a small pupil is quantified, and the impact of pinhole pupil location and their effects on neural sensitivity are examined. Different strategies of generating multifocal optics are also examined, and specifically the interaction between ocular and contact or intraocular lens aberrations and their effect on resulting image quality are simulated. Interestingly, most of the novel strategies for aiding presbyopic and pseudophakic eyes (for example, monovision, multifocality, pinhole pupils) have emerged naturally via evolution in a range of species.
Topics: Accommodation, Ocular; Anisometropia; Contact Lenses; Eyeglasses; Humans; Optics and Photonics; Presbyopia; Pupil; Visual Acuity
PubMed: 31734940
DOI: 10.1111/cxo.12987 -
Clinical & Experimental Optometry Mar 2017Soft multifocal simultaneous image contact lenses have boomed in recent years due to the growing number of presbyopic patients demanding visual solutions, allowing them... (Review)
Review
Soft multifocal simultaneous image contact lenses have boomed in recent years due to the growing number of presbyopic patients demanding visual solutions, allowing them to maintain their current standard of living. The concept of 'simultaneous image' is based on blur interpretation and/or blur tolerance of superimposed multiple images on the retina formed by various powers of a contact lens. This is the basis for a specific type of multifocal contact lens developed for the compensation of presbyopia. Manufacturers have released a great variety of soft simultaneous image lens designs to meet different patient needs but their fitting is still unsatisfactory in some cases. Some presbyopes discontinue wearing contact lenses due to some limitations in visual quality and comfort that can be overcome with an appropriate contact lens selection based on a comprehensive pre-fitting evaluation. This paper aims to review the different types of soft multifocal contact lenses that are currently available for presbyopic correction and to define the steps and factors crucial for their fitting, such as pupil, aberrations, accommodation and centring. A discussion about useful tools to achieve a customised fitting leading to a successful outcome, such as the defocus curve, power profile and questionnaires, is performed.
Topics: Adaptation, Physiological; Adolescent; Adult; Aged; Child; Child, Preschool; Contact Lenses, Hydrophilic; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Motivation; Patient Satisfaction; Patient Selection; Presbyopia; Tears; Young Adult
PubMed: 27800638
DOI: 10.1111/cxo.12488 -
Journal of Cataract and Refractive... Feb 2020
Topics: Biometry; Clinical Competence; Depth Perception; Humans; Lens Implantation, Intraocular; Multifocal Intraocular Lenses; Optics and Photonics; Presbyopia; Prosthesis Design
PubMed: 32126026
DOI: 10.1097/j.jcrs.0000000000000128 -
Frontiers in Public Health 2022To estimate the burden of potential productivity losses due to uncorrected and under-corrected presbyopia in LMICs among the working-age population in both the...
OBJECTIVE
To estimate the burden of potential productivity losses due to uncorrected and under-corrected presbyopia in LMICs among the working-age population in both the cross-sectional and longitudinal manner.
METHODS
We extracted data for the prevalence of presbyopia from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2019. Data for the gross domestic product (GDP) per capita were extracted from the World Bank database and Central Intelligence Agency's World Factbook. We introduced life table models to construct age cohorts (in 5-year age groups) of the working-age population (aged from 40 to 64 years old) in LMICs, with simulated follow-up until 65 years old in people with and without uncorrected presbyopia. The differences in productivity-adjusted life years (PALYs) lived and productivity between these two cohorts were calculated. The potential productivity loss was estimated based on GDP per capita. The WHO standard 3% annual discount rate was applied to all years of life and PALYs lived.
RESULTS
In 2019, there were 238.40 million (95% confidence interval [CI]: 150.92-346.78 million) uncorrected and under-corrected presbyopia cases in LMICs, resulting in 54.13 billion (current US dollars) (95% confidence interval [CI]: 34.34-79.02 billion) potential productivity losses. With simulated follow-up until retirement, those with uncorrected and under-corrected presbyopia were predicted to experience an additional loss of 155 million PALYs (an average loss of 0.7 PALYs per case), which was equivalent to a total loss of US$ 315 billion (an average loss of US$ 1453.72 per person).
CONCLUSIONS
Our findings highlight the considerable productivity losses due to uncorrected and under-corrected presbyopia in LMICs, especially in a longitudinal manner. There is a great need for the development of enabling eye care policies and programs to create access to eye care services, and more healthcare investment in the correction of presbyopia in the working-age population in LMICs. This study could provide evidences for some potential health-related strategies for socio-economic development.
Topics: Humans; Adult; Middle Aged; Aged; Presbyopia; Life Tables; Developing Countries; Cross-Sectional Studies; Income
PubMed: 36304252
DOI: 10.3389/fpubh.2022.983423