scholarly journals Correction of High Astigmatism after Penetrating Keratoplasty with Toric Multifocal Intraocular Lens Implantation

2017 ◽  
Vol 8 (2) ◽  
pp. 385-388 ◽  
Author(s):  
Raffaele Nuzzi ◽  
Francesca Monteu
Keyword(s):  
Intraocular Lens ◽  
Penetrating Keratoplasty ◽  
Multifocal Intraocular Lens ◽  
Iol Implantation ◽  
Multifocal Iol ◽  
Therapeutic Choice ◽  
Lens Implantation ◽  
Corneal Leukoma ◽  
Relaxing Incisions

After penetrating keratoplasty (PK), high astigmatism is often induced, being frequently about 4–6 dpt. According to the entity and typology of astigmatism, different methods of correction can be used. Selective suture removal, relaxing incisions, wedge resections, compression sutures, photorefractive keratectomy, and laser-assisted in situ keratomileusis can reduce corneal astigmatism and ametropia, but meanwhile they can cause a reduction in the corneal integrity and cause an over- or undercorrection. In case of moderate-to-high regular astigmatisms, the authors propose a toric multifocal intraocular lens (IOL) implantation to preserve the corneal integrity (especially in PK after herpetic corneal leukoma keratitis). We evaluated a 45-year-old patient who at the age of 30 was subjected to PK in his left eye due to corneal leukoma herpetic keratitis, which led to high astigmatism (7.50 dpt cyl. 5°). The patient was subjected to phacoemulsification and customized toric multifocal IOL implantation in his left eye. The correction of PK-induced residual astigmatism with a toric IOL implantation is an excellent choice but has to be evaluated in relation to patient age, corneal integrity, longevity graft, and surgical risk. It seems to be a well-tolerated therapeutic choice and with good results.

Bioptics for high hyperopia with combined multifocal intraocular lens implantation and excimer ablation in young patients

2018 ◽  
Vol 29 (4) ◽  
pp. 426-430 ◽  
Author(s):  
Omer Trivizki ◽  
David Smadja ◽  
Michael Mimouni ◽  
Samuel Levinger ◽  
Eliya Levinger
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Laser In Situ Keratomileusis ◽  
Intraocular Lens Implantation ◽  
Multifocal Intraocular Lens ◽  
Distance Visual Acuity ◽  
Lens Implantation ◽  
Near Visual Acuity ◽  
High Hyperopia

Purpose:To analyze the visual and refractive outcome of the bioptics procedure combining multifocal intraocular lens implantation and excimer laser surgery in young patients with high hyperopic eyes not suitable for a single surgical procedure.Methods:This retrospective case series included 10 eyes of five patients (age range 18–30 years) with high hyperopia (spherical equivalent +8.51 ± 0.85 diopters (D)). They had been treated with serial multifocal intraocular lens implantation followed 6 weeks later by laser in situ keratomileusis for residual hyperopia. Uncorrected distance visual acuity, uncorrected near visual acuity, corrected distance visual acuity, corrected near visual acuity, and manifest refraction were evaluated before surgeries, after multifocal intraocular lens implantation, and 3 months post laser in situ keratomileusis.Results:No patients were lost to follow-up (6 months). The mean spherical equivalent decreased to +2.05 ± 1.33 D after multifocal intraocular lens implantation and to −0.10 ± 0.58 D after the laser in situ keratomileusis procedure. Success of the procedures was determined by uncorrected visual acuity. LogMAR uncorrected distance visual acuity improved by a total of more than six lines from 1.05 ± 0.18 LogMAR to 0.46 ± 0.12 LogMAR post multifocal intraocular lens implantation and to 0.15 ± 0.06 LogMAR after both surgeries. The LogMAR uncorrected near visual acuity increased by 0.81 ± 0.82 LogMAR after lens implantation due to loss of accommodation, and all eyes reached a LogMAR of 0 at 1 month postoperatively following laser in situ keratomileusis.Conclusions:A bioptics approach involving multifocal intraocular lens followed 6 weeks later by a laser in situ keratomileusis procedure for the correction of very high hyperopia enabled the resolution of the residual refractive error in young very high hyperopic patients.

Visual Outcomes Following Diffractive-Refractive Multifocal Intraocular Lens Implantation : Literature Review

2017 ◽  
Vol 43 (2) ◽  
pp. 112
Author(s):  
Yulinda Arty Laksmita ◽  
Tjahjono D Gondhowiardjo
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Multifocal Intraocular Lens ◽  
Multiple Sources ◽  
Iol Implantation ◽  
Multifocal Iol ◽  
Intermediate Vision ◽  
Visual Phenomenon ◽  
Near Visual Acuity ◽  
The Cost

Purpose: To evaluate the result of diffractive-refractive multifocal intraocular lens (IOL) implantation, regarding the visual acuity, spectacle independency, and also related disturbing visual pnenomenon such as halo and glare. Methods: Seventeen articles collected from multiple sources including Pubmed, Clinical Key, and Ophthalmology Advance were reviewed. Visual acuity. Five types of diffractive-refractive multifocal IOL were found including ReSTOR SA60D3, SN60D3, SA6AD3, SA6DA1, and AT Lisa 809M. Uncorrected and corrected visual acuity, spectacle independency and undesired visual phenomenon data of each IOL were analyzed. Results: For binocular uncorrected distance and intermediate vision, ReSTOR SN6AD1 is better than other IOL. Meanwhile, in binocular uncorrected near visual acuity category, ReSTOR SA60D3 is superior. Highest percentage of patients reporting spectacle independency found in ReSTOR SA60D3 group. Halo was found in each IOL group, ranged from 32 to 65 percent patients. Glare was found in a smaller percentage, ranged from 25 to 61 percent patients. Conclusion: The best option for patients aiming for best visual acuity in distance to intermediate activity without spectacle use is ReSTOR SN6AD1. Meanwhile, the best option for patients aiming for best near visual acuity is ReSTOR SA60D3. Comprehensive preoperative education is crucial, considering the cost and benefit aspects of multifocal IOL implantation.

scholarly journals Comparing prediction accuracy between total keratometry and conventional keratometry in cataract surgery with refractive multifocal intraocular lens implantation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ho Seok Chung ◽  
Jae Lim Chung ◽  
Young Jun Kim ◽  
Hun Lee ◽  
Jae Yong Kim ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Prediction Error ◽  
Prediction Accuracy ◽  
Absolute Error ◽  
Multifocal Intraocular Lens ◽  
Swept Source ◽  
Iol Implantation ◽  
Multifocal Iol ◽  
Refractive Outcomes

AbstractWe aimed to compare refractive outcomes between total keratometry using a swept-source optical biometer and conventional keratometry in cataract surgery with refractive multifocal intraocular lens (IOL) implantation. We included patients who underwent cataract surgery with refractive multifocal IOL implantation. The IOL power was calculated using conventional formulas (Haigis, SRK/T, Holladay 2, and Barrett Universal II) as well as a new formula (Barrett TK Universal II). The refractive mean error, mean absolute error, and median absolute error were compared, as were the proportions of eyes within ± 0.25 diopters (D), ± 0.50 D, and ± 1.00 D of prediction error. In total 543 eyes of 543 patients, the absolute prediction error of total keratometry was significantly higher than that of conventional keratometry using the SRK/T (P = 0.034) and Barrett Universal II (P = 0.003). The proportion of eyes within ± 0.50 D of the prediction error using the SRK/T and Barrett Universal II was also significantly higher when using conventional keratometry than total keratometry (P = 0.010 for SRK/T and P = 0.005 for Barrett Universal II). Prediction accuracy of conventional keratometry was higher than that of total keratometry in cataract surgery with refractive multifocal IOL implantation.

scholarly journals Accuracy of theoretical IOL formulas for Panoptix intraocular lens according to axial length

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ayoung Choi ◽  
Hyunggoo Kwon ◽  
Sohee Jeon
Keyword(s):  
Intraocular Lens ◽  
Axial Length ◽  
Mean Absolute Error ◽  
Visual Quality ◽  
Absolute Error ◽  
Fort Worth ◽  
Iol Implantation ◽  
Multifocal Iol ◽  
Study Results ◽  
Study Population

AbstractThe accuracy of intraocular lens (IOL) calculations is suboptimal for long or short eyes, which results in a low visual quality after multifocal IOL implantation. The purpose of the present study is to evaluate the accuracy of IOL formulas (Barrett Universal II, SRK/T, Holladay 1, Hoffer Q, and Haigis) for the Acrysof IQ Panoptix TFNT IOL (Alcon Laboratories, Inc, Fort Worth, Texas, United States) implantation based on the axial length (AXL) from a large cohort of 2018 cases and identify the factors that are associated with a high mean absolute error (MAE). The Barrett Universal II showed the lowest MAE in the normal AXL group (0.30 ± 0.23), whereas the Holladay 1 and Hoffer Q showed the lowest MAE in the short AXL group (0.32 ± 0.22 D and 0.32 ± 0.21 D, respectively). The Haigis showed the lowest MAE in the long AXL group (0.24 ± 0.19 D). The Barrett Universal II did not perform well in short AXL eyes with higher astigmatism (P = 0.013), wider white-to-white (WTW; P < 0.001), and shorter AXL (P = 0.016). Study results suggest that the Barrett Universal II performed best for the TFNT IOL in the overall study population, except for the eyes with short AXL, particularly when the eyes had higher astigmatism, wider WTW, and shorter AXL.

Quality of vision after AMO Array multifocal intraocular lens implantation

2004 ◽  
Vol 30 (12) ◽  
pp. 2483-2493 ◽  
Author(s):  
Nida H. Sen ◽  
Anna-Ulrika Sarikkola ◽  
Risto J. Uusitalo ◽  
Leila Laatikainen
Keyword(s):  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Multifocal Intraocular Lens ◽  
Quality Of Vision ◽  
Lens Implantation
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