scholarly journals MODERN ASPECTS OF MULTIFOCAL INTRAOCULAR CORRECTION: A REVIEW

2017 ◽  
Vol 72 (4) ◽  
pp. 268-275 ◽  
Author(s):  
T. A. Morozova ◽  
D. F. Pokrovskiy ◽  
I. B. Medvedev ◽  
T. Z. Kerimov
Keyword(s):  
Visual Acuity ◽  
Power Level ◽  
Visual Quality ◽  
Functional Results ◽  
Clinical Results ◽  
Intraocular Lenses ◽  
Multifocal Iol ◽  
Multifocal Intraocular Lenses ◽  
Uncorrected Visual Acuity ◽  
Additional Segment

During the last decade multifocal intraocular lenses (IOL) became widely used in cataract surgery and proved to be effective in recovery of visual functions. Lots of clinical studies with different multifocal IOL models showed high effectiveness of multifocal correction to achieve good visual quality for far, intermediate, and near distances. Uncorrected visual acuity at a distance is equal to multifocal and monofocal correction, while uncorrected near vision is significantly better with multifocal IOLs. Additional segment position in asymmetric multifocal IOL models did not significantly influence on visual acuity. Multiple multifocal IOL designs (bifocal, trifocal) and ADD power level provide different functional results for near and intermediate distances which allows to select the specific IOL model depending on the patient`s needs. The review covers the following aspects of multifocal intraocular correction: update for classification of multifocal IOLs, visual acuity (functional results) at different distances after multifocal IOL implantation, comparison of clinical results with different multifocal IOL designs and add power levels, influence of add segment position in asymmetric multifocal IOLs on visual quality, comparison between multifocal and monofocal correction.

Prevention of Hyperopic Surprise after LASIK in Patients with Refractive Multifocal Intraocular Lenses

2011 ◽  
Vol 21 (6) ◽  
pp. 826-829 ◽  
Author(s):  
César Albarrán-Diego ◽  
Gonzalo Muñoz ◽  
Teresa Ferrer-Blasco ◽  
Santiago García-Lázaro
Keyword(s):  
Intraocular Lenses ◽  
Laser In Situ Keratomileusis ◽  
Simple Method ◽  
Iol Implantation ◽  
Multifocal Iol ◽  
Multifocal Intraocular Lenses ◽  
Uncorrected Visual Acuity ◽  
Defocus Curve ◽  
Refractive Surprise

Purpose. Three cases of patients who developed a similar hyperopic defect in refraction following laser in situ keratomileusis (LASIK) after multifocal intraocular lens (IOL) implantation are described. Methods. Ophthalmologic evaluation including refractive status, corrected and uncorrected visual acuity (both at far and near), and corneal topography in patients presenting similar hyperopic refractive surprise in one eye as a result of LASIK refinement of residual ametropia after refractive multifocal IOL implantation. Results. Laser in situ keratomileusis enhancement for residual ametropia of −1.00 to −1.50 D in patients with a prior implantation of refractive multifocal IOL resulted in a refractive surprise of +2.25 to +2.50 D. After excluding other possible sources of error, an explanation for such a refractive surprise is suggested, and a simple method for avoiding this error is presented. Conclusions. Proper knowledge of the defocus curve and the use of a systematic method for determining subjective refraction in patients implanted with refractive multifocal IOLs will reduce the possibility of refractive surprise after LASIK enhancement in a bioptics procedure.

scholarly journals Comparison of visual performance between monofocal and multifocal intraocular lenses of the same material and basic design

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hirotaka Tanabe ◽  
Hitoshi Tabuchi ◽  
Tomohiro Shojo ◽  
Tomofusa Yamauchi ◽  
Kosuke Takase
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Wald Test ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Basic Design ◽  
Night Time ◽  
Multifocal Iol ◽  
Multifocal Intraocular Lenses ◽  
Near Visual Acuity

Abstract To compare the visual performance of a monofocal intraocular lens (IOL) (ZCB00) and a multifocal IOL (ZMB00) of the same material and basic design, we evaluated postoperative parameters at 10 weeks after the last surgery in cataract patients who underwent bilateral ZCB00 or ZMB00 implantation from December 13, 2010, to July 29, 2019, with the right and left lenses implanted within 3 months of each other. The study enrolled 2,230 eyes of 1,115 patients. The monofocal group comprised 904 eyes of 452 patients (72.3 ± 6.8 years; females/males, 268/184), and the multifocal group comprised 1,326 eyes of 663 patients (67.0 ± 7.8 years; females/males, 518/145). Contrast sensitivity (4.0/2.5/1.6/1.0/0.7 degrees), contrast sensitivity with glare (1.6/1.0/0.7 degrees), and the VFQ-25 score for driving at night were significantly better in the monofocal group (p < 0.00068, Wald test). Uncorrected intermediate/near visual acuity and near spectacle independence were significantly better in the multifocal group (p < 0.00068, Wald test). The two IOL groups had different characteristics in terms of contrast sensitivity, night-time driving, uncorrected intermediate/near visual acuity and near spectacle independence.

scholarly journals Small-Gauge Pars Plana Vitrectomy for the Management of Symptomatic Posterior Vitreous Detachment after Phacoemulsification and Multifocal Intraocular Lens Implantation: A Pilot Study from the Pan-American Collaborative Retina Study Group

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Rodrigo M. Navarro ◽  
Leonardo M. Machado ◽  
Ossires Maia ◽  
Lihteh Wu ◽  
Michel E. Farah ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Posterior Vitreous Detachment ◽  
Case Series ◽  
Intraocular Lenses ◽  
Wilcoxon Test ◽  
Multifocal Iol ◽  
Vitreous Detachment ◽  
Multifocal Intraocular Lenses ◽  
Pars Plana

Purpose.To determine the efficacy of 23-gauge pars plana vitrectomy (PPV) for symptomatic posterior vitreous detachment (PVD) on visual acuity (VA) and quality after multifocal intraocular lenses (IOLs).Methods. In this prospective case series, patients who developed symptomatic PVD and were not satisfied with visual quality due to floaters and halos after multifocal IOL implantation underwent PPV. Examinations included LogMAR uncorrected visual acuity (UCVA), intraocular pressure, biomicroscopy, and indirect ophthalmoscopy at baseline and 1, 7, 30, and 180 days postoperatively. Ultrasonography and aberrometry were performed. The Visual Functioning Questionnaire 25 (VFQ-25) was administered preoperatively and at 30 days postoperatively. Both the postoperative UCVA and questionnaire results were compared to preoperative findings using the Wilcoxon test.Results. Sixteen eyes of 8 patients were included. VA significantly improved from 0.17 to 0.09 postoperatively (P=0.017). All patients reported improvement of halos, glare, and floaters. VFQ-25 scores significantly improved in general vision (P=0.023), near activities (P=0.043), distance activities (P=0.041), mental health (P=0.011), role difficulties (P=0.042), and driving (P=0.016).Conclusion. PPV may increase UCVA and quality of vision in patients with bilateral multifocal IOLs and symptomatic PVD. Larger studies are advised.

scholarly journals Comparison of trifocal or hybrid multifocal-extended depth of focus intraocular lenses: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yueyang Zhong ◽  
Kai Wang ◽  
Xiaoning Yu ◽  
Xin Liu ◽  
Ke Yao
Keyword(s):  
Systematic Review ◽  
Visual Acuity ◽  
Meta Analysis ◽  
Visual Quality ◽  
Intraocular Lenses ◽  
Depth Of Focus ◽  
Refractive Lens Exchange ◽  
Extended Depth Of Focus ◽  
Refractive Lens ◽  
Near Visual Acuity

AbstractThis meta-analysis aimed to evaluate the clinical outcomes following implantation of trifocal intraocular lenses (IOLs) or a hybrid multifocal-extended depth of focus (EDOF) IOL in cataract or refractive lens exchange surgeries. We examined 13 comparative studies with bilateral implantation of trifocal (898 eyes) or hybrid multifocal-EDOF (624 eyes) IOLs published through 1 March 2020. Better uncorrected and corrected near visual acuity (VA) were observed in the trifocal group (MD: − 0.143, 95% CI: − 0.192 to − 0.010, P < 0.001 and MD: − 0.149, 95% CI: − 0.217 to − 0.082, P < 0.001, respectively), while the hybrid multifocal-EDOF group presented better uncorrected intermediate VA (MD: 0.055, 95% CI: 0.016 to 0.093, P = 0.005). Trifocal IOLs were more likely to achieve spectacle independence at near distance (RR: 1.103, 95% CI: 1.036 to 1.152, P = 0.002). The halo photic effect was generated more frequently by the trifocal IOLs (RR: 1.318, 95% CI: 1.025 to 1.696, P = 0.031). Contrast sensitivity and subjective visual quality yielded comparable results between groups. Trifocal IOLs demonstrated better performance at near distance but apparently led to more photic disturbances. Our findings provided the most up-to-date and comprehensive evidence by comparing the benefits of advanced IOLs in clinical practice.

scholarly journals Visual performance in a flight simulator: multifocal intraocular lenses in pilots

2018 ◽  
Vol 3 (1) ◽  
pp. e000139
Author(s):  
Lee Lenton
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Luminance Contrast ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Flight Simulator ◽  
Night Time ◽  
Multifocal Intraocular Lenses ◽  
Low Luminance ◽  
Visual Tasks

ObjectiveTo compare the performance of adults with multifocal intraocular lenses (MIOLs) in a realistic flight simulator with age-matched adults with monofocal intraocular lenses (IOLs).Methods and AnalysisTwenty-five adults ≥60 years with either bilateral MIOL or bilateral IOL implantation were enrolled. Visual function tests included visual acuity and contrast sensitivity under photopic and mesopic conditions, defocus curves and low luminance contrast sensitivity tests in the presence and absence of glare (Mesotest II), as well as halo size measurement using an app-based halometer (Aston halometer). Flight simulator performance was assessed in a fixed-based flight simulator (PS4.5). Subjects completed three simulated landing runs in both daytime and night-time conditions in a randomised order, including a series of visual tasks critical for safety.ResultsOf the 25 age-matched enrolled subjects, 13 had bilateral MIOLs and 12 had bilateral IOLs. Photopic and mesopic visual acuity or contrast sensitivity were not significantly different between the groups. Larger halo areas were seen in the MIOL group and Mesotest values were significantly worse in the MIOL group, both with and without glare. The defocus curves showed better uncorrected visual acuity at intermediate and near distances for the MIOL group. There were no significant differences regarding performance of the vision-related flight simulator tasks between both groups.ConclusionsThe performance of visually related flight simulator tasks was not significantly impaired in older adults with MIOLs compared with age-matched adults with monofocal IOLs. These findings suggest that MIOLs do not impair visual performance in a flight simulator.

scholarly journals Method to quantify the decentration of the multifocal intraocular lenses in relation to the visual axis

2018 ◽  
Vol 17 (4) ◽  
pp. 117-119
Author(s):  
Fernando Eduardo Polit
Keyword(s):  
Intraocular Lens ◽  
Qualitative Method ◽  
Visual Quality ◽  
Intraocular Lenses ◽  
Slit Lamp ◽  
Visual Axis ◽  
Light Reflex ◽  
Multifocal Intraocular Lenses ◽  
Real Value ◽  
Slit Lamp Biomicroscopy

Since position and centration have shown to affect the effectiveness of multifocal intraocular lenses (MFIOLs), some authors have proposed using the "coaxially sighted IOL light reflex" as a landmark to allow consistent centration of MFIOLs. Postoperatively, assessing the location of the intraocular lens with respect to the visual axis is also important. Centration of the MFIOLs can be identified postoperatively by slit lamp biomicroscopy, but it is still a qualitative method. The Nidek OPD Scan III is used. The instrument obtains retro illumination images, which allows the observation of the diffractive rings of the multifocal intraocular lenses implanted following phacoemulsification. The retro illumination image describes the location of the visual axis (white cross with blue borders +), the center of the photopic (pink cross) and mesopic (turquoise cross) pupil, quantifies the distance between the center of the pupil and the visual axis, and places the visual axis in degrees. It is attempted to match the rings of the lens with that of the acetate grid. Once the best possible equidistance between the lens and grid rings has been achieved. This method can be useful to be able to have reference of a real value of decentration of the lenses and thus have a surgical plan and try to center the lenses. We are also creating a technique to properly center the lenses, in addition to performing an analysis of the results in terms of postoperative visual quality in relation to the lens's decentration and thus see how this really affects.

Influence of angle kappa and angle alpha on visual quality after implantation of multifocal intraocular lenses

2019 ◽  
Vol 45 (9) ◽  
pp. 1258-1264 ◽  
Author(s):  
Yana Fu ◽  
Jiaojiao Kou ◽  
Dongjie Chen ◽  
Dandan Wang ◽  
Yinyin Zhao ◽  
...  
Keyword(s):  
Visual Quality ◽  
Intraocular Lenses ◽  
Multifocal Intraocular Lenses ◽  
Angle Alpha ◽  
Angle Kappa

Correlation between optics quality of multifocal intraocular lenses and visual acuity

2010 ◽  
Vol 36 (4) ◽  
pp. 557-562 ◽  
Author(s):  
Adelina Felipe ◽  
Francisco Pastor ◽  
José M. Artigas ◽  
Amparo Diez-Ajenjo ◽  
Andrés Gené ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lenses ◽  
Multifocal Intraocular Lenses

scholarly journals Visual acuity and image quality in 5 diffractive intraocular lenses

2017 ◽  
Vol 28 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Genís Cardona ◽  
Fidel Vega ◽  
Miguel A. Gil ◽  
Consuelo Varón ◽  
José A. Buil ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Image Quality ◽  
Optical Quality ◽  
Intraocular Lenses ◽  
Modulation Transfer ◽  
Multifocal Intraocular Lenses ◽  
Corrected Distance Visual Acuity ◽  
Good For

Purpose: To compare objective image quality at distant, intermediate, and near foci with the corresponding visual acuity (VA) in patients symmetrically implanted with 5 different diffractive multifocal intraocular lenses (IOLs) (ReSTOR SV25T0, Tecnis ZKB00, Tecnis ZLB00, AT LISA 809, and AT LISA Tri 839MP) and a monofocal lens (Tecnis ZA9003) 3 months after cataract intervention. Methods: Objective image quality, measured as the area under the modulation transfer function curve (AMTF), was tested in vitro in an eye model. In addition, corrected distance visual acuity and distance-corrected intermediate and near visual acuities (DCIVA and DCNVA) were assessed in a group of 79 patients, randomly implanted with one of the lenses. Results: Image quality and VA at the distant focus was good for all lens designs, but was similarly compromised at the intermediate focus, where the best DCIVA corresponded to the low add ZKB00. At the near focus, the monofocal lens and the distance dominant SV25T0 had the worst AMTF values, with the ZLB00 presenting the best DCNVA. The relationship between AMTF and VA was found not to be linear, with VA being similarly good for AMTF values over a certain threshold. Conclusions: Visual acuity of pseudophakic patients reflected the optical quality of the specific IOL design within a certain range of measurements, beyond which maximum VA is limited by other ocular, optical, and neuropsychophysical factors.

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