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Community Eye Health 2024
PubMed: 38827964
DOI: No ID Found -
Journal of Refractive Surgery... Jan 2024To determine the visual outcomes and safety 12 months after implantation of the Presbia Flexivue Microlens refractive corneal inlay. (Clinical Trial)
Clinical Trial
PURPOSE
To determine the visual outcomes and safety 12 months after implantation of the Presbia Flexivue Microlens refractive corneal inlay.
METHODS
In this prospective, non-randomized trial, 22 patients with a mean age of 52.54 ± 2.86 years were implanted with the Flexivue Microlens refractive corneal inlay in the non-dominant eye at the Department of Ophthalmology, Goethe University, Frankfurt, Germany. Corrected near, intermediate, and distance (CNVA, CIVA, and CDVA) visual acuity and uncorrected near, intermediate, and distance (UNVA, UIVA, and UDVA) visual acuity, manifest refraction, subjective quality of vision, endothelial cell count, and contrast sensitivity were measured 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively.
RESULTS
For binocular CDVA, no patient lost two or more lines and 30% lost only one line at the 12-month visit. In the eye that had surgery, 85% of the patients lost two or more lines of UDVA, which was statistically significant. Sixty-five percent of the patients gained one or more lines in binocular UIVA, and 80% achieved 20/40 or better in DCIVA. UNVA showed a statistically significant improvement, with 90% of the patients achieving 20/40 or better 12 months after implantation. A total of 85% gained two or more lines in binocular UNVA.
CONCLUSIONS
This refractive corneal inlay showed an improvement in binocular UNVA, UIVA, CNVA, and CIVA, whereas binocular CDVA and UDVA were not statistically affected. .
Topics: Humans; Middle Aged; Presbyopia; Prospective Studies; Refraction, Ocular; Vision Tests; Visual Acuity
PubMed: 38190559
DOI: 10.3928/1081597X-20231204-02 -
Turkish Journal of Ophthalmology Apr 2024To evaluate the clinical results of a new trifocal intraocular lens (IOL) with sinusoidal design by comparing with a traditional trifocal IOL. (Comparative Study)
Comparative Study
OBJECTIVES
To evaluate the clinical results of a new trifocal intraocular lens (IOL) with sinusoidal design by comparing with a traditional trifocal IOL.
MATERIALS AND METHODS
A total of 79 patients undergoing uneventful microincisional cataract surgery with bilateral implantation of one of two types of trifocal IOLs, the Acriva Trinova IOL (VSY) or Acrysof IQ PanOptix IOL (Alcon), were enrolled in this prospective study. Visual and refractive outcomes, contrast sensitivity (CS), and defocus curve were assessed at 3 months after surgery. Patient satisfaction and incidence of photic phenomena were also evaluated.
RESULTS
The number of patients/eyes were 48/96 in the Trinova group and 31/62 in the PanOptix group. There were no significant differences between the groups for monocular and binocular corrected/uncorrected distance or intermediate (at 60 cm) and near visual acuities (VA) postoperatively. The Trinova group had statistically significantly better intermediate VA at 80 cm than the PanOptix group (p<0.05). The CS results of both groups were within the normal limits. In the binocular defocus curve of both IOLs, we observed a peak of good VA at 0.0 diopters defocus and a useful wide range for intermediate distances. The incidence of photic phenomena in the Trinova group was lower at postoperative 1 month (p<0.05) but this difference disappeared at 3 months. A total of 47 patients (97.9%) in the Trinova group and 30 patients (96.7%) in the PanOptix group stated that they would recommend the same IOL.
CONCLUSION
Both trifocal IOLs provide good visual quality outcomes and patient satisfaction.
Topics: Humans; Prospective Studies; Female; Male; Visual Acuity; Aged; Middle Aged; Multifocal Intraocular Lenses; Prosthesis Design; Presbyopia; Refraction, Ocular; Vision, Binocular; Patient Satisfaction; Contrast Sensitivity; Phacoemulsification; Follow-Up Studies; Lens Implantation, Intraocular; Lenses, Intraocular
PubMed: 38644781
DOI: 10.4274/tjo.galenos.2024.27657 -
BMC Ophthalmology Mar 2024To investigate the correlation of angles α and κ with the refractive and biological parameters in children.
AIM
To investigate the correlation of angles α and κ with the refractive and biological parameters in children.
METHODS
This case-series study included 438 eyes of 219 children (males/females = 105/114, age: 3-15 years). Ocular biometric parameters, including axial length, corneal radius of curvature (CR), white-to-white distance (WTW), angle κ and angle α, were measured using IOL Master 700; auto-refraction were assessed under cycloplegia. The eyes were assigned to different groups based on CR, WTW, and gender to compare the angles α and κ, and analyze the correlations between the differences of biological parameters on angles α and κ.
RESULTS
The means of axial length, CR, WTW, angle α, and angle κ were 23.24 ± 1.14 mm, 7.79 ± 0.27 mm, 11.68 ± 0.41 mm, 0.45 ± 0.25 mm, and 0.27 ± 0.22 mm, respectively. Angle α was correlated with CR and WTW (fixed effect coefficient [FEC] = 0.237, p = 0.015; FEC = -0.109, p = 0.003; respectively), and angle κ also correlated with CR and WTW (FEC = 0.271, p = 0.003; FEC = -0.147, p < 0.001, respectively). Comparing subgroups, the large CR and small WTW group had larger angles α (0.49 ± 0.27 vs. 0.41 ± 0.21, p < 0.001; 0.46 ± 0.27 vs. 0.44 ± 0.21, p < 0.05, respectively) and κ (0.29 ± 0.25 vs. 0.24 ± 0.15, p < 0.01; 0.29 ± 0.25 vs. 0.26 ± 0.19, p < 0.05, respectively). The differences in interocular angles α and κ showed correlation with interocular WTW (r = - 0.255, p < 0.001; r = - 0.385, p < 0.001). Eyes with smaller WTW tended to have larger angle κ (0.28 ± 0.27 vs. 0.25 ± 0.15, p < 0.05).
CONCLUSION
The size of angle α/κ may be correlated to CR and WTW, and a larger WTW eye may suggest a smaller angle κ compared with the fellow eye.
Topics: Child; Humans; Female; Male; Child, Preschool; Adolescent; Refraction, Ocular; Vision Tests; Cornea; Presbyopia; Biometry; Axial Length, Eye
PubMed: 38549060
DOI: 10.1186/s12886-024-03409-6 -
Clinical Ophthalmology (Auckland, N.Z.) 2023To investigate the visual acuity and satisfaction of patients after Zhang & Zheng's corneal laser-enhanced accommodation refraction Q (ZZ-CLEAR-Q) surgery utilizing... (Clinical Trial)
Clinical Trial
PURPOSE
To investigate the visual acuity and satisfaction of patients after Zhang & Zheng's corneal laser-enhanced accommodation refraction Q (ZZ-CLEAR-Q) surgery utilizing differential modulation of binocular longitudinal spherical aberration and determine its clinical significance.
PATIENTS AND METHODS
This prospective observational study enrolled a consecutive cohort of patients with presbyopia who underwent ZZ-CLEAR-Q surgery between December 2020 and January 2023. The study assessed visual acuity, distance-corrected defocus curve, satisfaction, Q factor, manifest spherical equivalent, and primary spherical aberration, among others, at 3 months postoperatively. Additionally, the study conducted a binocular comparison to analyze the clinical significance of setting the different longitudinal spherical aberrations.
RESULTS
A total of 232 eyes of 116 patients were included. The binocular uncorrected distance visual acuity was 20/20 for all patients. At 3 months postoperatively, the binocular uncorrected near visual acuity was Jaeger 1 for 96% of the patients and Jaeger 2 for 100% of the patients. Furthermore, 93.1% of the patients expressed satisfaction. The monocular distance-corrected defocus curve revealed that the dominant eyes had significantly better visual acuity at 0 D (P<0.001), while the non-dominant eyes had significantly better visual acuity across various defocus levels except 0 and -0.50 D (All P<0.05). At 3 months, there were no significant differences between the expected and achieved manifest spherical equivalents, corneal Q factor values, and ocular primary spherical aberration values of both groups.
CONCLUSION
Patients with presbyopia who underwent ZZ-CLEAR-Q surgery were likely to achieve normal uncorrected visual acuity and be satisfied. The increased depth of field has clinical significance for assisting near vision.
PubMed: 38026604
DOI: 10.2147/OPTH.S437324 -
Clinical Ophthalmology (Auckland, N.Z.) 2023To compare the work intensity of postoperative care following implantation of presbyopia-correcting intraocular lenses (IOLs) to that of standard monofocal IOLs.
PURPOSE
To compare the work intensity of postoperative care following implantation of presbyopia-correcting intraocular lenses (IOLs) to that of standard monofocal IOLs.
PATIENTS AND METHODS
This open-label, multicenter, comparative study retrospectively reviewed the case records of cataract surgery patients who underwent bilateral implantation of either presbyopia-correcting IOLs (presby-IOL group; N=177) or standard monofocal IOLs (monofocal group; N=177). Outcome measures included the total time the patient spent in the office, number of visits, mean duration of visits, and the number of procedures and diagnostic tests during the first postoperative year. Outcome measures were compared between the first 90 days and days 91-365 after surgery.
RESULTS
Mean (±SD) time spent in the office during the first postoperative year was 5:50 ± 3:35 hours (H:MM) over 6.6 ± 2.9 visits in the presby-IOL group, compared to 3:38 ± 1:36 hours over 4.9 ± 1.6 visits in the monofocal IOL group (p <0.001). During the first 90 days, a presby-IOL patient spent 40 minutes longer in the office than a monofocal IOL patient (3:39 ± 1:38 hours vs 2.59 ± 1:13 hours) (p <0.001). During days 91-365, time in the office was 1:32 hours longer (p <0.001), and the mean visit duration was 8 minutes longer for the presby-IOL patients (p=0.002) than those with monofocal IOL. In addition, the presby-IOL patients underwent more procedures and diagnostic tests (p ≤0.001) as compared with standard monofocal cataract surgery patients.
CONCLUSION
Patients implanted with presbyopia-correcting IOLs require significantly more clinic time, diagnostic testing, and procedures postoperatively as compared with standard monofocal cataract surgery patients.
PubMed: 37483840
DOI: 10.2147/OPTH.S418128 -
Scientific Reports Apr 2024This prospective single-arm study aimed to evaluate the clinical efficacy and safety of a refractive multifocal contact lens for the correction of presbyopia in 22...
This prospective single-arm study aimed to evaluate the clinical efficacy and safety of a refractive multifocal contact lens for the correction of presbyopia in 22 patients. The participants underwent clinical examinations before and 1 week after wearing a refractive multifocal contact lens (OptaCon ZOOM). The primary endpoints were the corrected distance visual acuity (CDVA) and distance-corrected near visual acuity (DCNVA). Defocus curve, contrast sensitivity, and ocular surface disease index (OSDI) were analyzed. A slit-lamp examination was performed for safety analysis. Contact lens comfort and patient satisfaction were assessed using a questionnaire. No significant difference in CDVA was observed before and 1 week after refractive multifocal contact lens use (p = 0.127), whereas DCNVA was significantly improved after 1 week (p < 0.001). The contrast sensitivity was not significantly affected at any spatial frequency under mesopic or photopic conditions. OSDI was significantly increased (p = 0.023). The patient-reported satisfaction scores were 96.2, 91.9, and 85.0 out of 100 at far, intermediate, and near distances, respectively. No significant adverse events were observed. Refractive multifocal contact lenses improved near vision while maintaining distance vision in presbyopic patients, without compromising contrast sensitivity. The study results suggest that OptaCon ZOOM can be considered safe and effective for the correction of presbyopia.
Topics: Humans; Presbyopia; Prospective Studies; Refraction, Ocular; Visual Acuity; Contact Lenses
PubMed: 38632261
DOI: 10.1038/s41598-024-55918-5 -
Sensors (Basel, Switzerland) Jun 2024The objective of this study was to assess the effect of sustained reading on the temporal changes in the wavefront error in the presbyopic eye. The wavefront aberration...
The objective of this study was to assess the effect of sustained reading on the temporal changes in the wavefront error in the presbyopic eye. The wavefront aberration of the eyes was measured using an IRX3 Shack-Hartmann aberrometer before and after (immediately, 5 min, and 10 min after) a reading task. Temporal changes in C20, C40, and C3-1 coefficient values of the eyes were plotted, showing a predominant number of V-shaped patterns (for C40 and C3-1) and inverse V-shaped patterns (for C20) among the study group, and the percentages (between 27 and 73%) were reported. The median of the total RMS of aberrations and the RMS of HOA (higher-order aberrations), which included comatic (3rd order) and spherical-like aberrations (4th and 6th order), increased immediately after finishing the near-vision reading task and then decreased. The median of RMS of comatic aberrations had a similar pattern of variations, while the median of RMS of spherical-like aberrations displayed an opposite pattern. Simulating the aberration changes due to lens decentration caused by relaxed zonules during 4 D accommodation in an eye model demonstrated that the expected range of changes for the vertical coma and spherical aberrations are in the order of 0.001 and 0.01 μm, respectively, which could justify why the observed changes were not statistically significant. The observed dynamic changes in HOA might be linked to the biomechanical characteristics and alterations in the displacement of the crystalline lens following prolonged near-vision tasks in presbyopic people. Although some predominant patterns under some conditions were shown, they exhibit considerable inter-subject and inter-ocular variability. This might be due to slight misalignments while fixating on the internal extended object in the aberrometer.
Topics: Humans; Reading; Presbyopia; Male; Female; Middle Aged; Aberrometry; Accommodation, Ocular; Corneal Wavefront Aberration; Aged
PubMed: 38931650
DOI: 10.3390/s24123866 -
BMC Ophthalmology Nov 2023To prospectively evaluate visual functions and patient satisfaction after bilateral implantation of diffractive continuous depth-of-focus intraocular lens (CDF IOL)... (Clinical Trial)
Clinical Trial
BACKGROUND
To prospectively evaluate visual functions and patient satisfaction after bilateral implantation of diffractive continuous depth-of-focus intraocular lens (CDF IOL) compared with trifocal IOLs.
METHODS
This investigator-initiated study was approved by a certified local review board (registered: jRCTs032210305). CDF IOL (Synergy, J&J, group S) and trifocal IOL (AcrySof PanOptix, Alcon, group P) were implanted bilaterally in 30 patients each. Three months postoperatively, binocular outcomes of uncorrected (BUCVA) and distance-corrected (BDCVA) visual acuities at distances of 0.3, 0.4, 0.5, 0.7, and 5 m were measured. Contrast sensitivities were binocularly measured using CSV-1000 (2.5 m) and Pelli-Robson charts at distances of 0.4 and 1 m. Symptoms of glare, halo, starburst, and waxy vision, and satisfaction for near, intermediate, and far visions were assessed with questionnaires. Differences between the two groups were examined.
RESULTS
Twenty-seven patients each completed the follow-up. The mean age of the group S was lower than that of the group P (P < 0.001). The BUCVA at 0.4 m was better in the S group, while the mean manifest refraction of the P group showed a significant hyperopic shift (P < 0.001). BDCVA was significantly better in the S group. The contrast sensitivity results at three distances showed no discernible differences. Although more patients in the S group reported significant glare and halo, their satisfaction with near vision was higher.
CONCLUSIONS
The binocular visual function of patients with CDF IOLs was comparable to or better than that of patients with trifocal IOLs. The patients were satisfied with near vision, despite the enhanced glare and halo. Understanding the differences between the two types of presbyopia-correcting IOLs is important to ensure patient satisfaction.
TRIAL REGISTRATION
This clinical trial was registered in the Japan Registry for Clinical Research (identifier: jRCTs032210305) on September 13, 2021.
Topics: Humans; Contrast Sensitivity; Lenses, Intraocular; Myopia; Patient Satisfaction; Prospective Studies; Prosthesis Design; Pseudophakia; Refraction, Ocular; Vision, Binocular; Visual Acuity
PubMed: 37990206
DOI: 10.1186/s12886-023-03207-6 -
Journal of Vision Mar 2024Accommodation is the process of adjusting the eye's optical power so as to focus at different distances. Uncorrected refractive error and/or functional presbyopia mean...
Accommodation is the process of adjusting the eye's optical power so as to focus at different distances. Uncorrected refractive error and/or functional presbyopia mean that sharp focus may not be achievable for some distances, so observers experience sustained defocus. Here, we identify a problem with current models of accommodative control: They predict excessive internal responses to stimuli outside accommodative range, leading to unrealistic adaptation effects. Specifically, after prolonged exposure to stimuli outside range, current models predict long latencies in the accommodative response to stimuli within range, as well as unrealistic dynamics and amplitudes of accommodative vergence innervation driven by the accommodative neural controller. These behaviors are not observed empirically. To solve this issue, we propose that the input to blur-driven accommodation is not retinal defocus, but correctable defocus. Predictive models of accommodative control already estimate demand from sensed defocus, using a realistic "virtual plant" to estimate accommodation. Correctable defocus can be obtained by restricting this demand to values physically attainable by the eye. If we further postulate that correctable defocus is computed using an idealized virtual plant that retains a young accommodative range, we can explain why accommodative-convergence responses are observed for stimuli that are too near-but not too far-to focus on. We model cycloplegia as a change in gain, and postulate a form of neural myopia to explain the additional relaxation of accommodation often seen with cycloplegia. This model produces plausible predictions for the accommodative response and accommodative convergence signal in a wide range of clinically relevant situations.
Topics: Humans; Presbyopia; Refractive Errors; Accommodation, Ocular; Myopia; Retina
PubMed: 38488409
DOI: 10.1167/jov.24.3.4