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 Visual and Refractive Outcomes following Bilateral Implantation of Extended Range of Vision Intraocular Lens with Micromonovision

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Sri Ganesh ◽  
Sheetal Brar ◽  
Archana Pawar ◽  
Kirti J. Relekar
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Reading Acuity ◽  
Good Tolerance ◽  
Iol Implantation ◽  
Refractive Outcomes ◽  
Intermediate Vision ◽  
Defocus Curve ◽  
Near Visual Acuity

Purpose. To evaluate the outcomes following bilateral ERV intraocular lens implantation with micromonovision.Methods. 25 subjects underwent bilateral Tecnis Symfony IOL implantation with micromonovision. The dominant eye was targeted for emmetropia and the nondominant eye for myopia of −0.75 D. Uncorrected and corrected distance (UDVA, CDVA), intermediate (UIVA, CIVA), and near visual acuity (UNVA, DCNVA); reading performance; defocus curve; and contrast sensitivity were studied. Follow-ups were conducted at 1 week and 1 and 6 months postoperatively.Results. At 6 months postoperatively, the mean binocular UDVA, CDVA, UNVA, and DCNVA were −0.036 ± 0.09, −0.108 ± 0.07, 0.152 ± 0.11, and 0.216 ± 0.10 logMAR, respectively. Binocular UIVA and DCIVA were 0.048 ± 0.09 and 0.104 ± 0.08 logMAR, respectively, at 60 cm and −0.044 ± 0.09 and 0.012 ± 0.09 logMAR, respectively, at 80 cm. All patients had ≥0.2 logMAR UDVA and UNVA. Reading acuity and reading speeds showed improvement over time. Between defocus range of −2.50 and +1.00 D, the visual acuity remained ≥0.2 logMAR. Contrast sensitivity scores were within the normal range. 4 patients used reading glasses for very fine print.Conclusion. Bilateral ERV IOL implantation leads to excellent outcomes for far and intermediate vision, satisfactory outcomes for near vision, and good tolerance to micromonovision at the end of the 6 months. This trial is registered withCTRI/2015/10/006246.

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.

scholarly journals Refractive Lens Exchange with Multifocal Intraocular Lens for Treatment of Chronic Intermittent Spasm of the Near Reflex

2017 ◽  
Vol 8 (3) ◽  
pp. 539-544 ◽  
Author(s):  
Guy Sallet
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Spontaneous Recovery ◽  
Multifocal Intraocular Lens ◽  
Refractive Lens Exchange ◽  
Final Treatment ◽  
Uncorrected Visual Acuity ◽  
Refractive Lens ◽  
Near Visual Acuity ◽  
Near Reflex

We report the case of an emmetropic 32-year-old female with decreased uncorrected visual acuity and diplopia due to intermittent episodes of spasm of the near reflex. Neurologic, general, and ophthalmic examination could not find an organic cause. Attempts at spontaneous recovery, psychogenic therapy, and cycloplegic therapy were unsuccessful and the symptoms persisted for almost 5 years, leading to psychogenic distress. Final treatment with refractive lens exchange and implantation of a toric trifocal intraocular lens resolved the spasm of the near reflex, resulting in an uncorrected distance and near visual acuity of 20/20.

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.

scholarly journals Visual Performance of Tecnis ZM900 Diffractive Multifocal IOL after 2500 Implants: A 3-Year Followup

2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Leonardo Akaishi ◽  
Rodrigo Vaz ◽  
Graziela Vilella ◽  
Rodrigo C. Garcez ◽  
Patrick F. Tzelikis
Keyword(s):  
Visual Acuity ◽  
Visual Performance ◽  
Iol Implantation ◽  
Multifocal Iol ◽  
Uncorrected Distance Visual Acuity ◽  
Quality Of Vision ◽  
Near Visual Acuity ◽  
Minimum Followup ◽  
Second Procedure

Purpose. To evaluate visual performance for near, intermediate, and distant vision; complaints of photic phenomena, and patient satisfaction with the new diffractive multifocal IOL used in eyes which underwent phacoemulsification.Methods. Two thousand and five hundred consecutive eyes undergoing Tecnis ZM900 multifocal IOL implantation were included in this retrospective analysis. The minimum followup of 3 months was required after the surgery. Patients were assessed for uncorrected near visual acuity (UNVA) at a fixed distance (33 cm), uncorrected intermediate visual acuity (UIVA) at 60 cm, and uncorrected distance visual acuity (UDVA). Using a subjective questionnaire, patients satisfaction, their independence from using glasses, and the perception of glare and halo phenomena were also evaluated at the last follow-up.Results. Two thousand and five hundred eyes of 1558 patients underwent cataract surgery and Tecnis ZM900 multifocal IOL implantation. Four hundred and eighty seven patients (31.3%) were men, and 1071 (68.7%) were women. The mean age of the patients was 66.17 years. A UDVA of 20/30 or better was achieved by 85% of eyes. A UNVA of J1 was achieved by 93.7% of eyes and that of J2 or better was achieved by 98%. A UIVA of J4 or better was achieved by 65% and J5 or better was achived by more than 82.8% of the eyes in the study. Glare and halos were reported as severe by only 6.1% and 2.12% of patients, respectively. Ninety seven percent reported complete spectacle independence and 88% stated that they are totally satisfied with their quality of vision and would choose to have the same lens implanted again after the first implant. Five percent of the eyes in the study needed a second procedure (enhancement) to achieve a better visual result. No patient underwent lens exchange.Conclusion. Excellent near, intermediate, and distant vision was observed in patients implanted with the Tecnis ZM900 diffractive multifocal IOL. Spectacle independence and a minimum occurrence of photic phenomena make this IOL an excellent option in patients with cataract.

scholarly journals Rotational Asymmetric Multifocal Intraocular Lens - Use in Patient Undergoing Cataract Surgery

2016 ◽  
Vol 16 (2) ◽  
pp. 23-27
Author(s):  
P Ziak ◽  
J Halicka ◽  
P Mojzis ◽  
M Kralik ◽  
J Nikel
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Statistical Significance ◽  
Visual Rehabilitation ◽  
Distance Visual Acuity ◽  
Multifocal Iol ◽  
Multiple Comparison Test ◽  
Near Visual Acuity

Abstract Introduction: A cataract is a clouding of the lens in the eye leading to a decrease in vision. Cataracts are the cause of half of blindness and 33% of visual impairment worldwide. Surgery with phacoemulsification followed by implantation of intraocular lens (IOL) is gold standard treatment for cataract. In some cases multifocal IOLs are used. This is the first published use of rotational asymmetric multifocal IOL in cataract surgery in Slovakia. Method: In the study 78 eyes of 58 patients (mean age 62.3 years) were implanted for a cataract with the rotational asymmetric multifocal IOL. Corrected and uncorrected distance and near visual acuities were analysed preoperatively, 1 month and 6 months postoperatively. Contrast sensitivity was tested at 6 months postoperatively. The Friedman Two -Way Analysis of Variance and Multiple Comparison Test were used for all parameter comparisons, in all cases, the same level of statistical significance (p < 0.05) was considered significant. Results: Average preoperative uncorrected distance visual acuity has increased from 0.32 to 0.87 and 0.93 respectively in 1 month and 6 months after surgery (p < 0.05, n = 78). Average preoperative uncorrected near visual acuity (UCNVA) has increased from 0.2 to 0.77 and 0.79 respectively in 1 month and 6 months after surgery (p < 0.05). Average preoperative best corrected distance visual acuity has increased from 0.65 to 0.95 and 1.03 respectively in 1 month and 6 months after surgery (p < 0.05). Significant improvement was found also between preoperative best corrected near visual acuity and UCNVA 1 and 6 month after surgery (p < 0.05). In conclusion, the rotational asymmetric multifocal IOL LS-313 MF 30 provides good visual rehabilitation for near and distance vision after cataract surgery. Contrast sensitivity outcomes account for the patient satisfaction with this innovative IOL technology.

scholarly journals Medium-Term Visual Outcomes of Apodized Diffractive Multifocal Intraocular Lens with +3.00 D Addition Power

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Xiaohong Guo ◽  
Yi Sun ◽  
Bowen Zhang ◽  
Danying Zheng
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Full Range ◽  
Text Message ◽  
Life Questionnaire ◽  
Multifocal Intraocular Lens ◽  
Low Contrast ◽  
Near Visual Acuity ◽  
One Year ◽  
Reading Activity

Purpose. To evaluate 2-year visual acuities and questionnaire after bilateral implantation of SN6AD1 multifocal intraocular lens (MIOL) or SN60WF IOL.Methods. Patients randomly scheduled for bilateral implantation of SN6AD1 MIOL and SN60WF IOL with 2-year follow-up were enrolled. Uncorrected/corrected distance and near visual acuity, uncorrected intermediate visual acuity at 63 cm under high and low contrast, reading activity, the defocus curve, and a quality-of-life questionnaire were evaluated.Results. Each group comprised 20 patients. Uncorrected intermediate visual acuities and uncorrected near visual acuity were better in SN6AD1 group than in SN60WF group (P=0.005,P=0.011, andP<0.001). In SN6AD1 group, the uncorrected intermediate and near visual acuities 1 year and 2 years postoperatively were reduced than postoperative 3-month outcomes, respectively. SN6AD1 group reported superior overall spectacle independence and inferior satisfaction. SN6AD1 group had a longer reading newspaper duration than SN60WF group (P=0.036). When using mobile phone, SN6AD1 group had a more comfortable distance than SN60WF group (P<0.001) and higher speed of reading fixed text message (P<0.001).Conclusion. SN6AD1 MIOL provided a satisfactory full range of visual acuities and questionnaire performance 2 years postoperatively. One-year and 2-year uncorrected near and intermediate visual acuities of SN6AD1 MIOL were lower than those 3 months postoperatively.

scholarly journals Clinical Outcomes after Binocular Implantation of a New Trifocal Diffractive Intraocular Lens

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Florian T. A. Kretz ◽  
Detlev Breyer ◽  
Vasilios F. Diakonis ◽  
Karsten Klabe ◽  
Franziska Henke ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Patient Satisfaction ◽  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Iol Implantation ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Trifocal Iol ◽  
Defocus Curve ◽  
Near Visual Acuity

Purpose.To evaluate visual, refractive, and contrast sensitivity outcomes, as well as the incidence of pseudophakic photic phenomena and patient satisfaction after bilateral diffractive trifocal intraocular lens (IOL) implantation.Methods. This prospective nonrandomized study included consecutive patients undergoing cataract surgery with bilateral implantation of a diffractive trifocal IOL (AT LISA tri 839MP, Carl Zeiss Meditec). Distance, intermediate, and near visual outcomes were evaluated as well as the defocus curve and the refractive outcomes 3 months after surgery. Photopic and mesopic contrast sensitivity, patient satisfaction, and halo perception were also evaluated.Results.Seventy-six eyes of 38 patients were included; 90% of eyes showed a spherical equivalent within ±0.50 diopters 3 months after surgery. All patients had a binocular uncorrected distance visual acuity of 0.00 LogMAR or better and a binocular uncorrected intermediate visual acuity of 0.10 LogMAR or better, 3 months after surgery. Furthermore, 85% of patients achieved a binocular uncorrected near visual acuity of 0.10 LogMAR or better.Conclusions.Trifocal diffractive IOL implantation seems to provide an effective restoration of visual function for far, intermediate, and near distances, providing high levels of visual quality and patient satisfaction.

scholarly journals Secondary multifocal intraocular lens implantation: A novel management strategy for white cataracts

2018 ◽  
Vol 6 ◽  
pp. 2050313X1775033
Author(s):  
Jiawen Ling ◽  
Yiyong Qian ◽  
Peirong Lu
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Management Strategy ◽  
Intraocular Lenses ◽  
Intraocular Lens Implantation ◽  
Multifocal Intraocular Lens ◽  
Multifocal Intraocular Lenses ◽  
Lens Implantation ◽  
Near Visual Acuity ◽  
Cataract Patients

Objectives: This study was designed to analyse the outcomes of secondary multifocal intraocular lens implantation in eyes with white cataracts. Methods: White cataract patients undergoing secondary multifocal intraocular lens implantation between June 2014 and January 2015 were evaluated prospectively. As opposed to a conventional primary intraocular lens implantation for an optimal patient, the white cataract was first extracted, followed by optical biometry measurements. Whether or not the patient had adequate visual acuity was identified, and the multifocal intraocular lens was implanted secondarily. A total of five appropriate white cataract patients were enrolled in this secondary multifocal intraocular lens implantation study and were retrospectively reviewed. Results: All five secondary implantations of the multifocal intraocular lenses were successful, without obvious adverse events. The uncorrected near visual acuity LogMAR was 0.4–0.5, and the distance visual acuity was −0.1 to 0.1 after 12 months of the multifocal intraocular lens implantation. All patients achieved satisfactory near and distance visual acuities and spectacle freedom. Conclusion: Two-stage multifocal intraocular lens implantation is a safe and novel technique for the management of white cataract patients to optimise near and distance visual acuities.

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