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Advances in Ophthalmology Practice and... 2022Presbyopia has become a global disease affecting the world's aging population. Among various treatments, cataract extraction and intraocular lens (IOL) implantation have... (Review)
Review
BACKGROUND
Presbyopia has become a global disease affecting the world's aging population. Among various treatments, cataract extraction and intraocular lens (IOL) implantation have become the most popular and common methods of presbyopia correction. During the twentieth century, IOLs have underwent significant innovation and advancements to meet the patients' high demands for functional vision at all distances.
MAIN TEXT
To meet the increasing needs for excellent near and intermediate vision for daily activities, some premium IOLs with more than one focus have been developed, for example, the refractive MfIOLs, diffractive MfIOLs, extended depth of field (EDOF) IOLs, and accommodating IOLs (AIOLs) were introduced to meet this need. In addition, the add-on MfIOLs have been explored as promising supplementary IOLs for pseudophakic presbyopia. When selecting the MfIOLs, the IOLs' features, patients' characteristics, preoperative eye conditions, and treatment expectations should be considered.
CONCLUSIONS
In this review, we focus on the multifocal IOLs (MfIOLs) commonly used for presbyopia correction and systematically summarized their optical designs and clinical outcomes. More evidence-based studies are required to provide guidelines for MfIOL selection, provide maximum visual benefits, and develop personalized visual solutions in the future.
PubMed: 37846220
DOI: 10.1016/j.aopr.2022.100042 -
International Ophthalmology Feb 2022To review all case series of refractive corneal inlay implantation: Flexivue (Presbia, Netherlands), Invue (BioVision, Brügg, Switzerland) and Icolens (Neoptics,... (Review)
Review
PURPOSE
To review all case series of refractive corneal inlay implantation: Flexivue (Presbia, Netherlands), Invue (BioVision, Brügg, Switzerland) and Icolens (Neoptics, Hünenberg, Switzerland) performed in presbyopia patients and to evaluate the reported visual outcomes. In addition, our aim is to provide assessment for complications and to report the satisfaction rates.
METHODS
PubMed, Web of Science and Scopus databases were consulted using "refractive corneal inlay", "Flexivue Inlay", "Invue Inlay" and "Icolens inlay" as keywords. 147 articles were found, and they were assessed considering the inclusion and exclusion criteria. After filtering, this systemic review included ten articles, published between 2011 and 2020.
RESULTS
308 eyes from 308 participants were enrolled in this systematic review. Mean maximum follow-up was 13.9 months. Nine of the ten case series included used femtosecond laser for the corneal pocket creation. Mean pocket depth was 293.75 µm. 77.5% of the eyes reported a postoperative uncorrected near visual acuity of 20/32 or better, and 19.20% of the inlay-implanted eyes achieved an uncorrected distance visual acuity of 20/20 or better. The most prominent complications were halos, pain, photophobia, and poor distance visual acuity. 27 eyes (8.7%) had to be explanted due to complications, such as near-distance spectacle dependence or blurred distance vision.
CONCLUSION
Refractive corneal inlay outcomes demonstrated high efficacy, safety, and satisfaction rates. Furthermore, it is a reversible technique. However, the findings must be viewed with caution due potential conflict of interest. Further research with higher sample size is needed to validate these findings.
Topics: Corneal Stroma; Corneal Topography; Eye, Artificial; Humans; Presbyopia; Prospective Studies; Prostheses and Implants; Prosthesis Implantation; Refraction, Ocular
PubMed: 34599717
DOI: 10.1007/s10792-021-02024-4 -
Vestnik Oftalmologii 2022The article reviews the findings on the anatomy, morphological and biomechanical features of the accommodation apparatus. Modern methods of imaging and biometry confirm... (Review)
Review
The article reviews the findings on the anatomy, morphological and biomechanical features of the accommodation apparatus. Modern methods of imaging and biometry confirm the validity of the Helmholtz lenticular theory of accommodation, according to which its mechanism involves three main components: the ciliary body, the zonular fibres and the lens capsule, the lens itself. Based on this, there is certain interest in studying the degree of participation of each of these components in the development of age-related changes in accommodation (presbyopia).
Topics: Accommodation, Ocular; Aging; Ciliary Body; Humans; Lens Capsule, Crystalline; Lens, Crystalline; Presbyopia
PubMed: 36004600
DOI: 10.17116/oftalma2022138041117 -
Journal of Clinical Medicine Jan 2023The subject of presbyopia has accompanied clinical ophthalmic practices around the world for centuries [...].
The subject of presbyopia has accompanied clinical ophthalmic practices around the world for centuries [...].
PubMed: 36769442
DOI: 10.3390/jcm12030794 -
Contact Lens & Anterior Eye : the... Aug 2023The purpose of this manuscript is to describe how vision influences contact lens discomfort and review the evidence supporting the hypothesis that contact lens... (Review)
Review
The purpose of this manuscript is to describe how vision influences contact lens discomfort and review the evidence supporting the hypothesis that contact lens discomfort can be caused by vision and vision-related disorders. Contact lens discomfort is a misunderstood and difficult to manage clinical condition. Most treatments and strategies aimed at alleviating discomfort focus on optimizing the contact lens fit and its relationship with the ocular surface, but these strategies commonly fail at relieving discomfort symptoms. Many vision and vision-related disorders share symptoms with those reported by uncomfortable contact lens wearers. This paper will review evidence and literature that describes how these vision and vision-related disorders may influence comfort in contact lens wearers. Acknowledging how vision influences contact lens discomfort will improve future research intended to better understand the condition, allow for more effective clinical management, and reduce rates of discontinuation.
Topics: Humans; Contact Lenses; Vision Disorders; Vision, Ocular; Contact Lenses, Hydrophilic
PubMed: 37277259
DOI: 10.1016/j.clae.2023.101872 -
Ophthalmology and Therapy Dec 2021Presbyopia is a progressive, age-related visual condition that is characterized by reduced ability to focus on near/close objects, causing impacts on individuals' daily...
INTRODUCTION
Presbyopia is a progressive, age-related visual condition that is characterized by reduced ability to focus on near/close objects, causing impacts on individuals' daily function and health-related quality of life. The Presbyopia Impact and Coping Questionnaire (PICQ) is a new patient-reported outcome (PRO) instrument that assesses presbyopia impact and use of coping behaviors among presbyopic individuals.
METHODS
To document the impacts of presbyopia and associated coping behaviors, concept elicitation (CE) interviews were conducted with 20 presbyopic participants. Results from the CE interviews were used to develop draft items for additional testing. Following item generation, the draft PICQ was cognitively debriefed with 20 participants. Data from a phase 2 controlled clinical trial were used for psychometric analyses of the PICQ. The PICQ was administered at site visits throughout a 28-day treatment period. Confirmatory factor analysis (CFA) methods were used to guide the development of the scoring algorithm. The reliability (internal consistency, test-retest), construct validity (convergent and discriminant validity, known-groups methods), and responsiveness (Guyatt's responsiveness statistic [GRS]) of the PICQ scores were evaluated. Finally, anchor-based and distribution-based methods were used to inform thresholds for interpreting meaningful within-patient change.
RESULTS
CE interviews identified the important and relevant presbyopia-related impacts and coping behaviors and 22 items were drafted and cognitively debriefed. Following minor revisions and item addition/deletion, a version of the PICQ including 23 items was subjected to psychometric testing. The analysis sample included 151 participants. The CFA established two PICQ domain scores, Coping and Impact, on 0-to-4 scales that demonstrate good model fit (root mean square error of approximation = 0.06, comparative fit index = 0.98, Tucker-Lewis index = 0.98, standardized root mean square = 0.07). Cronbach's alphas for the Coping and Impact scores were 0.89 and 0.84, respectively. Test-retest intraclass correlation coefficients were 0.77 for Coping and 0.67 for Impact. The pattern of results assessing construct validity was acceptable for the PICQ Coping and Impact scores, with the magnitude of correlations and effect sizes generally meeting a priori expectations. The corresponding GRS effect sizes for the PICQ Coping scores were -1.23 (i.e., large) for Patient Global Impression of Change (PGIC) and -0.72 (i.e., medium) for uncorrected near visual acuity (UNVA). The GRS effect sizes for the PICQ Impact scores were -0.60 (i.e., medium) for PGIC and -0.35 (i.e., small) for UNVA. Across three sets of anchor-based analyses for interpreting individual-level change, a responder threshold of -1.00 was identified for both PICQ Coping and PICQ Impact scores.
CONCLUSIONS
The totality of evidence from the qualitative and quantitative research establishes that the PICQ scores produced are valid and reliable measures of presbyopia impacts and coping behaviors that are important and relevant for assessing presbyopia treatment outcomes. CLINICALTRIALS.
GOV IDENTIFIER
NCT02780115; date of registration May 19, 2016.
PubMed: 34643894
DOI: 10.1007/s40123-021-00391-w -
IEEE Transactions on Bio-medical... Jan 2022Presbyopia, an age-related ocular disorder, is characterized by the loss in the accommodative abilities of the human eye. Conventional methods of correcting presbyopia...
OBJECTIVE
Presbyopia, an age-related ocular disorder, is characterized by the loss in the accommodative abilities of the human eye. Conventional methods of correcting presbyopia divide the field of view, thereby resulting in significant vision impairment. We demonstrate the design, assembly and evaluation of autofocusing eyeglasses for restoration of accommodation without dividing the field of view.
METHODS
The adaptive optics eyeglasses comprise of two variable-focus liquid lenses, a time-of-flight range sensor and low-power, dual microprocessor control electronics, housed within an ergonomic frame. Subject-specific accommodation deficiency models were utilized to demonstrate high-fidelity accommodative correction. The abilities of this system to reduce accommodation deficiency, its power consumption, response time, optical performance and MTF were evaluated.
RESULTS
Average corrected accommodation deficiencies for 5 subjects ranged from -0.021 D to 0.016 D. Each accommodation correction calculation was performed in ∼67 ms which consumed 4.86 mJ of energy. The optical resolution of the system was 10.5 cycles/degree, and featured a restorative accommodative range of 4.3 D. This system was capable of running for up to 19 hours between charge cycles and weighed ∼132 g.
CONCLUSION
The design, assembly and performance of an autofocusing eyeglasses system to restore accommodation in presbyopes has been demonstrated.
SIGNIFICANCE
The new autofocusing eyeglasses system presented in this article has the potential to restore pre-presbyopic levels of accommodation in subjects diagnosed with presbyopia.
Topics: Accommodation, Ocular; Eyeglasses; Humans; Optics and Photonics; Presbyopia; Visual Acuity
PubMed: 34232861
DOI: 10.1109/TBME.2021.3094964 -
Taiwan Journal of Ophthalmology 2024Lamellar surgeries with SMILE lenticules are an evolving field of refractive surgery. This chapter intends to discuss the reported clinical results of using SMILE...
PURPOSE
Lamellar surgeries with SMILE lenticules are an evolving field of refractive surgery. This chapter intends to discuss the reported clinical results of using SMILE derived lenticules in terms of feasibility, safety and predictability; or the potential management of hyperopia, keratoconus, SMILE ectasia and presbyopia.
MATERIALS AND METHODS
Donor SMILE lenticules were prepared under microscope tocreate doughnut shaped lenticules. For hyperopia, this tissue was then inserted into afemtosecond laser enabled pocket created using VisuMax FS Laser at a depth of 160µm. For ectasia induced by keratoconus and post refractive procedure (SMILE), 0.23% riboflavin dye was instilled into the interface and then lenticule was inserted followed by exposure to UV-A radiation with total energy of 6.3 J.
RESULTS
Spherical equivalent (S.E.) of within ± 0.5 D was observed in 50% (n=21) eyes and within 1 D was seen in 71% eyes treated for hyperopia. A significant increase in the K mean anterior, central corneal thickness, Q-value and corneal aberrations was seen 2 weeks post-op. Clinical improvement in terms of S.E. and uncorrected distance visual acuity in eyes treated for ectasia after keratoconus and post refractive procedure (SMILE) was seen.
CONCLUSION
With the ample availability of SMILE- derived lenticules, researchers are exploring the possibility of using this tissue for the treatment of various refractive and corneal conditions.
PubMed: 38654992
DOI: 10.4103/tjo.TJO-D-23-00171 -
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