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Journal of Clinical Medicine May 2024Presbyopia, a common age-related refractive error, affects over a billion people globally and significantly impacts daily life. This retrospective study analyzed 288...
Outcomes of Corneal Compound Myopic Astigmatism with Presbyopia by Zeiss PRESBYOND Laser Blended Vision LASIK Using Default CRS-Master Target Refractions for Reduced Anisometropia.
Presbyopia, a common age-related refractive error, affects over a billion people globally and significantly impacts daily life. This retrospective study analyzed 288 eyes of 144 patients undergoing LBV PRESBYOND treatment for myopic presbyopia with astigmatism, aiming to evaluate precision, efficacy, safety, and stability over six months. Key findings include high efficacy, with 99% of distance-eyes achieving uncorrected distance visual acuity (UDVA) of 20/25 or better, and 85% of near-eyes achieving UDVA of 20/32 or better. The results show excellent refractive outcomes, with 99% of long-sighted eyes and 97% of near-sighted eyes having a postoperative spherical equivalent within ±1.00 D. Safety was demonstrated by no loss of two or more Snellen lines after treatment, with 94% of patients maintaining corrected distance visual acuity (CDVA) before and after surgery. Overall, LBV PRESBYOND proved effective, safe, and well tolerated for myopic presbyopia correction, offering satisfactory visual outcomes and potential spectacle independence for various distances. This study underscores the importance of individualized treatment based on patient age, highlighting the positive impact of binocular summation on visual function. This study contributes to the growing body of evidence supporting LBV PRESBYOND as a viable option for addressing presbyopic myopia, offering insights into its efficacy and safety profile. Further research could explore postoperative stereopsis and long-term outcomes to enhance understanding and refine treatment protocols.
PubMed: 38792550
DOI: 10.3390/jcm13103011 -
RECOGNITION VERSUS RESOLUTION CHARTS FOR DEFOCUS CURVE DETERMINATION IN TRIFOCAL INTRAOCULAR LENSES.Journal of Cataract and Refractive... May 2024To determine the impact of optotype choice on the determination of defocus curve in cataract patients implanted with presbyopia-correcting intraocular lens (IOL).
PURPOSE
To determine the impact of optotype choice on the determination of defocus curve in cataract patients implanted with presbyopia-correcting intraocular lens (IOL).
SETTING
Oftalvist Alicante, Alicante, Spain.
DESIGN
Observational case-control study.
METHODS
Patients implanted with Asqelio Trifocal IOL (AST Products, Inc., Billerica, MA, USA) participated in this study. Uncorrected and distance corrected visual acuity and subjective refraction were determined. Monocular defocus curves were obtained 6 months after surgery with the CTS system using either ETDRS or Landolt C charts under photopic conditions (85 cd/m2), and range of vergence from +2.00D to -5.00D in 0.50D steps.
RESULTS
A total of 49 patients were enrolled in the study, 24 in the EDTRS group (7 male, 17 female) and 25 in the Landolt C group (5 male, 20 female). Non-significant differences were found between patients conforming both groups, except for preoperative intraocular pressure and white-to-white distance. All patients were within ±1.00D from intended refraction after surgery. 75% of patients in the EDTRS group and 84% in the Landolt C group were within ±0.50D. Average difference between the groups across vergences provided by the defocus curve was 0.12±0.05 logMAR units, significant for all vergences (p<0.05). Differences in VA were significant for distance, intermediate and near between both groups, except for uncorrected distance VA.
CONCLUSION
Defocus curves created using Landolt C charts yield significantly lower through-focus outcomes than those created with standard EDTRS charts. This should be taken into account when comparing the performance of presbyopia-correcting systems accross studies where recognition charts might have been used due to patient characteristics.
PubMed: 38780434
DOI: 10.1097/j.jcrs.0000000000001491 -
Vestnik Oftalmologii 2024Extended depth of focus (EDOF) intraocular lenses (IOLs) are the latest IOL designs. In recent years, several models of EDOF IOLs have become available in Russia, two of... (Comparative Study)
Comparative Study
UNLABELLED
Extended depth of focus (EDOF) intraocular lenses (IOLs) are the latest IOL designs. In recent years, several models of EDOF IOLs have become available in Russia, two of which (Tecnis Symfony and Acrysof IQ Vivity) are implanted in our clinic. Comparative studies devoted to the results of implantation of the new EDOF IOLs are rare in the available literature.
PURPOSE
This article compares the outcomes of implantation of two EDOF IOLs in patients with presbyopia and/or cataract.
MATERIAL AND METHODS
The prospective study included 60 patients (81 eyes) after implantation of EDOF IOL Tecnis Symfony (32 patients, 45 eyes; group 1) or EDOF IOL AcrySof IQ Vivity (28 patients, 36 eyes; group 2). The mean follow-up period was 3.9±1.3 months.
RESULTS
All groups showed a significant (<0.05) increase in uncorrected near visual acuity (UCNVA), intermediate visual acuity (UCIVA), and distance visual acuity (UCDVA) at the maximum follow-up time compared to preoperative values. In group 1, the best corrected near visual acuity (BCNVA) increased from 0.61±0.10 to 0.82±0.16 at the maximum follow-up time, and in group 2 - from 0.58±0.08 to 0.67±0.12 (>0.05). Both groups showed a significant increase in best corrected intermediate and distance visual acuity (BCIVA and BCDVA) at the maximum follow-up time. The increase in the indicator compared to the preoperative period was not significant in both groups (>0.05). The frequency of side optical phenomena was low in both groups. No significant differences were found between the groups (>0.05).
CONCLUSION
This study presents a comparative analysis of the results of implantation of two different EDOF IOLs. Both lenses were comparable in most of the studied parameters, including providing good distance and intermediate vision, functional near vision, as well as a low frequency of side optical phenomena. In all cases the patients were satisfied with the results of the surgical intervention.
Topics: Humans; Male; Female; Lens Implantation, Intraocular; Visual Acuity; Lenses, Intraocular; Middle Aged; Presbyopia; Prosthesis Design; Prospective Studies; Aged; Treatment Outcome; Cataract; Refraction, Ocular; Depth Perception; Russia
PubMed: 38742497
DOI: 10.17116/oftalma202414002140 -
International Journal of Molecular... Apr 2024Age-related macular degeneration (AMD) is an age-related disorder that is a global public health problem. The non-enzymatic Maillard reaction results in the formation of...
Age-related macular degeneration (AMD) is an age-related disorder that is a global public health problem. The non-enzymatic Maillard reaction results in the formation of advanced glycation end products (AGEs). Accumulation of AGEs in drusen plays a key role in AMD. AGE-reducing drugs may contribute to the prevention and treatment of AGE-related disease. Fructosamine oxidase (FAOD) acts on fructosyl lysine and fructosyl valine. Based upon the published results of fructosamine 3-kinase (FN3K) and FAOD obtained in cataract and presbyopia, we studied ex vivo FAOD treatment as a non-invasive AMD therapy. On glycolaldehyde-treated porcine retinas, FAOD significantly reduced AGE autofluorescence ( = 0.001). FAOD treatment results in a breakdown of AGEs, as evidenced using UV fluorescence, near-infrared microspectroscopy on stained tissue sections of human retina, and gel permeation chromatography. Drusen are accumulations of AGEs that build up between Bruch's membrane and the retinal pigment epithelium. On microscopy slides of human retina affected by AMD, a significant reduction in drusen surface to 45 ± 21% was observed following FAOD treatment. Enzymatic digestion followed by mass spectrometry of fructose- and glucose-based AGEs (produced in vitro) revealed a broader spectrum of substrates for FAOD, as compared to FN3K, including the following: fructosyllysine, carboxymethyllysine, carboxyethyllysine, and imidazolone. In contrast to FN3K digestion, agmatine (4-aminobutyl-guanidine) was formed following FAOD treatment in vitro. The present study highlights the therapeutic potential of FAOD in AMD by repairing glycation-induced damage.
Topics: Macular Degeneration; Humans; Glycation End Products, Advanced; Animals; Swine; Retina; Amino Acid Oxidoreductases
PubMed: 38732004
DOI: 10.3390/ijms25094779 -
Annals of Surgery May 2024
PubMed: 38716663
DOI: 10.1097/SLA.0000000000006323 -
Archivos de La Sociedad Espanola de... Apr 2024Presbyopia affects between 1.7 and 2 billion people worldwide. Presbyopia significantly impacts productivity and quality of life in both developed and developing... (Review)
Review
Presbyopia affects between 1.7 and 2 billion people worldwide. Presbyopia significantly impacts productivity and quality of life in both developed and developing countries. During accommodation, the human eye changes its dioptric power by altering the shape of the lens, but the exact nature of this change has not been fully explained. Recently, topical treatments have been marketed for the treatment of presbyopia and others are under investigation. In order to prepare a review of these novel therapies, we searched the major biomedical search engines. We found 15 randomized clinical trials and 12 reviews that met our review criteria. There are two different strategies for this purpose, the pinhole effect that increases depth of focus and "crystalline lens relaxation" for which parasympathetic mimetics and lens oxidation intermediates have been used. The results are generally favorable in terms of improvement of near visual acuity, although the follow-up period of the studies is short. These are novel strategies in the early stages of research that could be useful in the treatment of presbyopia.
PubMed: 38663714
DOI: 10.1016/j.oftale.2024.04.008 -
Ophthalmology and Therapy Jun 2024The phase 3, randomized, vehicle-controlled, 14-day VIRGO study evaluated the efficacy and safety of twice-daily dosing of pilocarpine hydrochloride ophthalmic solution...
INTRODUCTION
The phase 3, randomized, vehicle-controlled, 14-day VIRGO study evaluated the efficacy and safety of twice-daily dosing of pilocarpine hydrochloride ophthalmic solution 1.25% (Pilo) in presbyopia. On VIRGO exit, a companion study was conducted to assess the patient experience with presbyopia and satisfaction with Pilo.
METHODS
Recruited individuals completed the Presbyopia Patient Satisfaction Questionnaire (PPSQ) plus a three-part exit survey, or a live interview. The PPSQ evaluated respondents' experience with Pilo. Survey parts 1 and 2 evaluated experience managing presbyopia before and during VIRGO, respectively; part 3 assessed future possibilities of using Pilo in real-world situations. The interview further informed the interviewees' experience with presbyopia and Pilo. The primary endpoint was responders (%) in each rating category of the PPSQ items 1-7; the secondary endpoints were summary of categorical (survey) and qualitative (interviews) responses.
RESULTS
The PPSQ and survey included 62 participants who received Pilo (N = 28) or vehicle (N = 34) in VIRGO; the interview included ten participants (Pilo, N = 4; vehicle, N = 6). Per the PPSQ, 64.3% of Pilo users reported vision improvement, including 17.9% with complete improvement; ≥ 46.4% were satisfied/very satisfied with their ability to perform daily activities, see up close unaided, and read in dim light. Among vehicle users, these percentages were 35.3%, 0%, and ≤ 23.5%, respectively. In both subgroups, ≥ 67.9% were interested in using Pilo or Pilo and eyeglasses/contact lenses in the future. Per the interview, vehicle users (n = 6/6) found the eyedrop easy to use but none experienced meaningful near-vision improvements, stopped using other correction method(s) part of the day, were satisfied with the eyedrop, preferred it over their previous correction method(s), or would continue using it if prescribed. Conversely, 75% (n = 3/4) of Pilo users responded positively to each of these six criteria.
CONCLUSIONS
Findings validate the VIRGO results and improve our understanding of the patient experience, demonstrating improved vision and satisfaction with Pilo (vs. vehicle) when performing daily activities.
PubMed: 38662193
DOI: 10.1007/s40123-024-00935-w -
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 -
Klinische Monatsblatter Fur... Apr 2024Performance and symptoms in completing a visual search task on a PC monitor and using a head-mounted display (HMD) were compared for different viewing conditions and...
BACKGROUND
Performance and symptoms in completing a visual search task on a PC monitor and using a head-mounted display (HMD) were compared for different viewing conditions and between users of different ages.
PATIENTS AND METHODS
Twenty-three young (M = 30 y, SD = 7 y) and 23 older (M = 52 y, SD = 5 y) participants performed a visual search task presented on a PC monitor. The task was repeated using an HMD for a near and a far virtual viewing distance. Reaction times (RT), detection sensitivity (d'), and symptoms were recorded for the three different viewing conditions.
RESULTS
RT and d' were not affected by the viewing condition (p > 0.05). In contrast, symptoms significantly depended on the viewing condition but were, in part, not significantly affected by age. It is interesting to note that although not significant, young participants reported more ocular symptoms than older participants in the near vision task carried out using the HMD.
DISCUSSION
HMD increases visual symptoms. However, HMD could be, in part, a remedy to problems when using visual aids for near work, in particular for presbyopes.
Topics: Humans; Presbyopia; Male; Virtual Reality; Female; Adult; Middle Aged; Accommodation, Ocular; Convergence, Ocular; Young Adult; Reaction Time
PubMed: 38653312
DOI: 10.1055/a-2237-2840 -
Klinische Monatsblatter Fur... Apr 2024In cataract surgery, intraocular lenses (IOLs) with enhanced depth of focus are an option to correct presbyopia. The purpose of this quality assurance analysis was to... (Clinical Trial)
Clinical Trial
BACKGROUND
In cataract surgery, intraocular lenses (IOLs) with enhanced depth of focus are an option to correct presbyopia. The purpose of this quality assurance analysis was to evaluate visual acuity and patient satisfaction after implantation of the Hoya Vivinex Impress IOL.
METHODS
The Hoya Vivinex Impress IOL was implanted in patients undergoing cataract surgery at the Pallas Klinik, Olten, Switzerland. Five weeks postoperatively, a clinical examination and a survey on patient satisfaction were conducted.
RESULTS
A total of 17 eyes (9 patients; mean age 64 years) underwent cataract surgery with implantation of a Hoya Vivinex Impress IOL. Five weeks postoperatively, mean uncorrected distance visual acuity (UDVA) was 0.2 logMAR, uncorrected intermediate visual acuity (UIVA) was 0.0 logMAR, and uncorrected near visual acuity (UNVA) was 0.2 logMAR. The mean distance-corrected visual acuity results were 0.0 logMAR, 0.1 logMAR, and 0.3 logMAR, respectively. Reading the newspaper without glasses was possible for 33.4% of patients. Visual disturbances such as halos and glares were not reported.
CONCLUSION
Cataract surgery with Hoya Vivinex Impress IOL implantation revealed good distance and intermediate vision and, in some patients, functional near vision as well as a high patient satisfaction.
Topics: Humans; Female; Middle Aged; Patient Satisfaction; Male; Visual Acuity; Lenses, Intraocular; Prosthesis Design; Treatment Outcome; Aged; Lens Implantation, Intraocular; Depth Perception; Equipment Failure Analysis; Cataract Extraction
PubMed: 38653291
DOI: 10.1055/a-2220-0620