AIM:To investigate the characteristics and associated factors of intraocular lens(IOL)tilt and decentration after transscleral suture-fixated IOL surgery in congenital ectopia lentis(CEL).METHODS:CEL patients undergoi...AIM:To investigate the characteristics and associated factors of intraocular lens(IOL)tilt and decentration after transscleral suture-fixated IOL surgery in congenital ectopia lentis(CEL).METHODS:CEL patients undergoing transscleral suture-fixated IOL surgery were divided into two groups based on implanted IOL type(three-piece IOL or one-piece IOL).The IOL tilt and decentration at 3-month and 1-year postoperative were measured.Multivariate regression analyses were performed to identify the associated factors of IOL tilt and decentration as well as longitudinal changes.RESULTS:The 61 CEL patients(mean age 9.07±5.05y)in three-piece IOL(M/F:14/7)group had a greater tilt than those with one-piece IOL(M/F:28/12)group both at 3-month postoperative(horizontal:P=0.024;vertical:P=0.048)and 1-year postoperative(horizontal:P=0.011;vertical:P=0.001).Three-piece IOL group had a greater longitudinal change between 3-month postoperative to 1-year postoperative in IOL tilt(horizontal:P=0.028;vertical:P=0.026)and a greater longitudinal change in horizontal IOL decentration than one-piece IOL group(P<0.05).The longer axial length(AL)was associated with the longitudinal changes in IOL tilt(P=0.039),while the three-piece IOL was associated with the longitudinal changes in horizontal IOL decentration 1-year postoperatively(P=0.011).CONCLUSION:IOL tilt is greater in the three-piece IOL group than that in the one-piece IOL group 1-year postoperatively.The three-piece IOL is associated with greater longitudinal changes of IOL decentration,while longer AL is associated with longitudinal changes of IOL tilt.For CEL patients,more stable IOL type should be selected and patients with longer AL warrant closer monitoring.展开更多
AIM:To evaluate and compare alterations in the effective lens position(ELP)and refractive outcomes among three distinct intraocular lens(IOL)types.METHODS:Patients with cataracts were enrolled and allocated to 3 group...AIM:To evaluate and compare alterations in the effective lens position(ELP)and refractive outcomes among three distinct intraocular lens(IOL)types.METHODS:Patients with cataracts were enrolled and allocated to 3 groups:Group A(implanted with the SN6CWS),Group B(implanted with the MI60),and Group C(implanted with the Aspira-aA).ELP measurements were obtained with swept-source optical coherence tomography(SS-OCT)at 1d,1wk,1mo,and 3mo postoperatively.Subjective refraction assessments were conducted at 1wk,1mo,and 3mo following surgery.RESULTS:The study included 189 eyes of 150 cataract patients(66 males).There were 77 eyes in Group A,55 eyes in Group B,and 57 eyes in Group C.The root mean square of the ELP(ELPRMS)within the initial 3mo was significantly lower for Group A than for Groups B and C.Refractive changes within Group A were not significant across the time points of 1wk,1mo,and 3mo.Conversely,both Group B and Group C demonstrated statistically significant shifts toward hyperopia from 1wk to 3mo postsurgery.CONCLUSION:Among the three IOLs examined,the SN6CWS IOL showes the greatest stability during the first 3mo postoperatively.Between 1wk and 3mo after surgery,notable hyperopic shifts are evident in eyes implanted with the MI60 and Aspira-aA IOLs,whereas refractive outcomes remain relatively constant in eyes implanted with SN6CWS IOLs.展开更多
Background:The Akreos®AO60 intraocular lens(IOL)has been employed for scleral fixation in eyes without capsular support,although surgical complications,including IOL opacification,have been reported.This study ai...Background:The Akreos®AO60 intraocular lens(IOL)has been employed for scleral fixation in eyes without capsular support,although surgical complications,including IOL opacification,have been reported.This study aims to evaluate the outcomes and complications associated with scleral fixation of the Akreos®AO60 IOL in vitrectomized eyes,with a particular focus on IOL opacification.Methods:Electronic medical records of consecutive eyes that underwent scleral-fixation of the Akreos®AO60 lens using Gore-tex®sutures from 2017 to 2022 were reviewed.The following parameters were collected:age,sex,laterality,past ocular/medical history,surgical indication,pre-operative visual acuity(VA)and intraocular pressure(IOP),surgical procedure,and post-operative VA and IOP.The types of complications,onset,management,and outcomes were also documented.Descriptive statistics,Wilcoxon signed-rank test,and Fisher’s exact test were employed for statistical analysis.Results:Eighty-nine eyes of 86 patients aged 31-100 years were included.The most common surgical indication was non-traumatic IOL displacement.Retinal tears and localized choroidal hemorrhage were found intraoperatively in 7.9%and 1.1%,respectively.The most common post-operative complications were vitreous hemorrhage(13.5%),corneal edema(12.4%),ocular hypotony(11.2%),and IOL opacification(11.2%).IOL opacification was associated with intra-/post-operative exposure to air/gas[odds ratio(OR):12.24;95%confidence interval(CI),1.46-103.0;P=0.006].Mean logarithm of the minimum angle of resolution(logMAR)best-reported VA(BRVA)improved from 1.22±0.77 pre-operatively to 0.56±0.67 on latest follow-up(P<0.001).Conclusions:The majority of the complications from scleral-fixation of the Akreos®AO60 lens in vitrectomized eyes were mild and transient;however,a proportion required surgical intervention.A significant risk for opacification was found in IOLs exposed to air/gas,although VA was often maintained.展开更多
Background:To evaluate efficacy and safety of combined pars plana vitrectomy(PPV)and scleral fixated intraocular lens(SFIOL)surgery as a single procedure.Methods:Retrospective interventional case series done at a tert...Background:To evaluate efficacy and safety of combined pars plana vitrectomy(PPV)and scleral fixated intraocular lens(SFIOL)surgery as a single procedure.Methods:Retrospective interventional case series done at a tertiary eye care center in Northern India.Eleven patients who underwent combined PPV and SFIOL surgery were included and analyzed retrospectively.Results:Mean age of the patients was 43.36±15.12 years(range,22-64 years).Eight were male.Mean baseline best corrected visual acuity(BCVA)was 0.78±0.63 logMAR units while the mean post-operative BCVA at 6 months follow-up was 0.37±0.29 logMAR units,the visual gain being statistically significant(P=0.021).None of the patients had a drop in BCVA with nine patients having final BCVA better than 0.48 logMAR units.Choroidal detachment(CD)was the only notable complication,seen in three patients.Other complications included two cases of intraoperative retinal breaks,a case each of reversible corneal edema,ocular hypertension and cystoid macular edema.Conclusions:Combined PPV and SFIOL is an efficacious procedure for managing IOL/lens dislocation and aphakia in a single surgery.There may be short-term reversible complications with no impact on final visual gain.展开更多
As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL pow...As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL power calculation methods have evolved and innovated throughout time, from early theoretical and regression formulas to nonlinear formulas for estimating effective lens position (ELP), multivariable formulas, and innovative formulas that use optical principles and AI-based online formulas. This paper thoroughly discusses the development and iteration of traditional IOL calculation formulas, the emergence of new IOL calculation formulas, and the selection of IOL calculation formulas for different patients in the era of refractive cataract surgery, serving as a reference for “personalized” IOL implantation in clinical practice.展开更多
AIM:To assess whether the implantation of a posterior chamber phakic intraocular lens produces changes in optical coherence tomography(OCT)measurements of macular thickness(MT)and two parameters that define the struct...AIM:To assess whether the implantation of a posterior chamber phakic intraocular lens produces changes in optical coherence tomography(OCT)measurements of macular thickness(MT)and two parameters that define the structure of the optic nerve,the peripapillary nerve fiber layer(RNFL)and the Bruch’s membrane opening-minimum rim width(BMO-MRW).METHODS:This nonrandomized prospective pre-post study included 86 eyes of 48 patients(age,20-47y;axial length:23.10-28.95 mm)scheduled for myopia or myopic astigmatism correction with implantation of the implantable collamer lens(ICL).Eyes with glaucoma or any other ocular disease that could alter OCT results were excluded.RNFL,BMO-MRW and MT were measured preoperatively,and at 1 and 6mo after surgery using spectral-domain OCT.Changes between preoperative and postoperative values were evaluated.RESULTS:There was a significant increase in BMOMRW at 1mo(mean change:3.48±15.07μm,P=0.041).No significant changes were found during the rest of followup(1-6mo postop.,P=0.623).There was also a significant increase in RNFL thickness at 1mo af ter surger y(1.45±2.18μm,P<0.001),but with a significant reduction from 1 to 6mo postoperatively(P=0.002).Regarding MT,it increased significantly at 1mo(2.46±3.76μm,P<0.001),with a significant decrease afterwards(P=0.048).Measurements of the three parameters at 6mo were slightly superior to preoperative values(P<0.01).CONCLUSION:Minimal changes are induced in BMOMRW,RNFL and MT after ICL implantation in healthy eyes,confirming the safety of the surgical procedure regarding the structure of the optic nerve head and the macula,and indicating that this phakic intraocular lens seems to have a slight impact on OCT measurements.展开更多
AIM:To report incidence,indications,and visual outcomes of intraocular lens(IOL)exchange/explantation surgery.METHODS:Retrospective analysis of 60 eyes requiring IOL exchange/explantation surgery between 1^(st) Januar...AIM:To report incidence,indications,and visual outcomes of intraocular lens(IOL)exchange/explantation surgery.METHODS:Retrospective analysis of 60 eyes requiring IOL exchange/explantation surgery between 1^(st) January 2017 and 31^(st) December 2022.The overall outcomes as well as comparison between the trainee versus experienced surgeons were analyzed.RESULTS:Out of 39778 cataract surgeries(with no preexisting ocular co-morbidities)during a six-year period(2017-2022),60(0.15%)needed IOL exchange/explantation.Surgeons-under-training performed 36/60 cases(60%)while 24/60(40%)were by experienced surgeons.The commonest indication was subluxated IOL in 26(43.3%),followed by dislocated IOL in 20(33.3%),postoperative refractive surprise in 7(11.6%),IOL induced uveitis in five and broken haptic in two eyes.Twenty-four(40%)eyes had intraoperative complications during primary surgery.Posterior chamber IOL(PCIOL)was the commonest secondary IOL in 21(35%)eyes,scleral fixated in 20(31.6%),anterior chamber IOL(ACIOL)in 13(21.6%),iris fixated IOL in three(5%)and three eyes(5%)were left aphakic.The mean time between primary and secondary surgery was 168d(168±338.8).Best corrected visual acuity(BCVA)of>20/60 was obtained in 43 eyes(71.66%),20/80-20/200 in 14(23.33%),20/250 in two and hand movements in one.No statistically significant difference in visual outcome was noted at post-op one month between trainees versus experienced surgeons(UCVA 0.45±0.29 vs 0.53±0.32,P=0.20,BCVA 0.34±0.25 vs 0.37±0.26,P=0.69).CONCLUSION:IOL subluxation as the commonest indication and posterior capsular rupture is the commonest intraoperative risk factor.This complication can be effectively addressed with selection of the appropriate secondary IOL achieving good visual outcomes in over 70% of patients.展开更多
AIM:To evaluate the visual and refractive outcomes in cases after sutured scleral fixation of existing subluxated or dislocated acrylic one-piece intraocular lenses(IOLs).METHODS:This study retrospectively enrolled a ...AIM:To evaluate the visual and refractive outcomes in cases after sutured scleral fixation of existing subluxated or dislocated acrylic one-piece intraocular lenses(IOLs).METHODS:This study retrospectively enrolled a consecutive series of patients who underwent a surgery of sutured existing subluxated or dislocated IOLs from October 2018 to June 2020.All patients underwent comprehensive preoperative and postoperative ophthalmologic examination,and data were collected including age,sex,surgical indications,best-corrected visual acuity,refractive error,intraocular pressure.Presence of intraoperative and postoperative surgical complications was documented.RESULTS:A total of 20 consecutive cases were enrolled for analysis with mean final follow-up period 9.8±5.3mo.Visual acuity improved from a mean of 0.35(0.46±0.32 logMAR)preoperatively to 0.61(0.21±0.18 logMAR)at the 3-month follow-up(P=0.002).The mean amount of preoperative keratometric astigmatism and total postoperative refractive astigmatism was-1.24±0.80 diopters(D)and-1.42±0.97 D,respectively.There was no statistically significant difference between preoperative and postoperative astigmatism(P=0.156).The mean IOL-induced astigmatism was-0.23±0.53 D.The mean spherical equivalent at the 3-month follow-up was-0.1±0.94 D.No major complications were noted during the follow-up period.CONCLUSION:Surgical techniques using sutured scleral fixation of existing subluxated or dislocated acrylic one-piece IOLs result in favorable visual and refractive outcomes without major complications.展开更多
AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who...AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who received sulcus-placed SPA-IOLs between 2006 and 2009 were reviewed. None of the patients underwent IOL exchange. Charts of six age-matched patients who received sulcus placed 3P-IOLs were reviewed as a control group. RESULTS: Mean follow up was 16 mo for SPA-IOL and 23 mo for 3P-IOL. Five of 8 patients in the SPA-IOL group required chronic use of IOP lowering medications at final follow up. Of these, one patient needed glaucoma implant surgery for uncontrolled IOP. One patient in the 3P-IOL group used chronic aqueous suppression pre- and postoperatively. Four of eight eyes with SPAIOL were treated with chronic topical steroids and or non-steroidal anti-inflammatory drugs for cystoid macu-la edema, chronic uveitis, pigment dispersion syndrome or a combination of the above, compared to none in the control group. Mean best-corrected visual acuity was 20/35 in the SPA-IOL group and 20/47 in the 3PIOL group.CONCLUSION: Sulcus placed SPA-IOLs are associated with increased ocular morbidity. In select cases good visual acuity may be achieved. Due to postoperative rotation of sulcus placed toric SPA-IOLs stable astigmatism correction cannot be achieved. Alternative intraocular lenses should be considered when in-the-bag placement of SPA-IOL is not possible.展开更多
Advances in intraocular lens(IOL)design have rendered cataract surgery a refractive procedure.Newer IOL types include bifocal,trifocal and extended depth of focus(EDOF)IOLs.Their basic difference nestles in the number...Advances in intraocular lens(IOL)design have rendered cataract surgery a refractive procedure.Newer IOL types include bifocal,trifocal and extended depth of focus(EDOF)IOLs.Their basic difference nestles in the number of focal points that each lens provides,which in turn leads to different visual outcomes.Familiarity of surgeons with the various characteristics of each lens is of utmost importance for accurate IOL selection to match each patient’s needs.In this review,we aim to compare the clinical outcomes after implantation of multifocal and EDOF IOLs in terms of distance,intermediate and near vision,contrast sensitivity,and reading performance.Finally,we discuss the defocus curve and the optical and photic phenomena associated with each type of IOL.展开更多
AIM:To evaluate the accuracy of eight different intraocular lens(IOL)power calculation formulas for a segmented multifocal IOL.METHODS:A total of 53 eyes of 41 adult cataract patients who underwent phacoemulsification...AIM:To evaluate the accuracy of eight different intraocular lens(IOL)power calculation formulas for a segmented multifocal IOL.METHODS:A total of 53 eyes of 41 adult cataract patients who underwent phacoemulsification and implantation with the SBL-3 segmented multifocal IOL between January 1,2017 and January 31,2019 were included in this retrospective study.Preoperative biometry measurements were obtained using an IOL Master.Manifest refraction was performed at least 4 wk postoperatively.Accuracy of the eight formulas[Barrett Universal II,Emmetropia Verifying Optical(EVO),Haigis,Hill-RBF 2.0,Hoffer Q,Holladay 1,Kane,and SRK/T]was analyzed.RESULTS:Using current lens constants,all formulas exhibited errors of slight myopic shift in refractive prediction.The Barrett Universal II formula had a significantly lower median absolute error(MedAE)than did Holladay 1(P=0.02),Kane(P=0.001)and Hill-RBF 2.0(P<0.001)formulas.The Haigis formula had a lower MedAE value than did the Hill-RBF 2.0 formula(P=0.005).Differences in MedAE values among SRK/T,EVO and Hoffer Q formulas were not significant.After optimizing lens constants,the MedAE values of all formulas were reduced;significant changes were noted for EVO(P=0.022),Haigis(P=0.048);Hill-RBF 2.0(P=0.014),Holladay 1(P=0.045)and Kane(P=0.022)formulas.All formulas performed equally well after optimization of lens constants(P=0.203).CONCLUSION:All eight formulas tend to result in a myopic shift when using current lens constants.Optimized lens constants improve the accuracy of these formulas among adult Chinese patients.展开更多
AIM:To compare the clinical outcomes of extended depth-of-focus intraocular lenses(EDOF IOLs)using either micromonovision implantation or mixed implantation of EDOF and diffractive bifocal IOLs.METHODS:This retrospect...AIM:To compare the clinical outcomes of extended depth-of-focus intraocular lenses(EDOF IOLs)using either micromonovision implantation or mixed implantation of EDOF and diffractive bifocal IOLs.METHODS:This retrospective clinical trial included 130 patients(260 eyes),who were divided into two groups.Group RR comprised 70 patients(140 eyes)bilaterally implanted with ZXR00 IOLs(Tecnis ZXR00,where one target was-0.5 D to-0.75 D and the other was 0 to-0.25 D).Group RM comprised 60 patients(120 eyes)unilaterally implanted with both ZXR00 and ZMB00 IOLs(Tecnis ZMB00,0 to-0.25 D).Postoperative outcomes were compared after 3 mo,including visual acuity,defocus curves,stereoacuity,modulation transfer functions(MTFs),higher-order aberrations,and Visual Function-14(VF-14)questionnaire responses.RESULTS:Group RR had superior bilateral intermediate vision,while the group RM had superior bilateral near vision(both P<0.05).Group RM also exhibited superior MTFs and reduced higher-order aberrations(both P<0.05).Stereoacuity and VF-14 questionnaire results showed no statistically significant difference between groups(P>0.05).CONCLUSION:The implantation of micromonovision has significantly improved near vision.IOLs and their collocation can be customized according to individual patient needs to achieve precise treatment and provide cataract patients with high-quality vision.展开更多
AIM : To evaluate the prediction error in intraocular lens(IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation...AIM : To evaluate the prediction error in intraocular lens(IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position(ELP).METHODS: Retrospective study including a total of 25 eyes of 13 patients(age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL(Oculentis Gmb H, Germany). In all cases, an adjusted IOL power(P IOLadj) was calculated based on Gaussian optics using a variable keratometric index value(n kadj) for the estimation of the corneal power(P kadj) and on a new value for ELP(ELP adj) obtained by multiple regression analysis.This P IOLadj was compared with the IOL power implanted(P IOLReal) and the value proposed by three conventional formulas(Haigis, Hoffer Q and Holladay Ⅰ).RESULTS: P IOLReal was not significantly different than P IOLadj and Holladay IOL power(P 】0.05). In the Bland and Altman analysis, P IOLadj showed lower mean difference(-0.07 D) and limits of agreement(of 1.47 and-1.61 D)when compared to P IOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELP adj was significantly lower than ELP calculated with other conventional formulas(P 【0.01) and was found to be dependent on axial length, anterior chamber depth and P kadj. CONCLUSION: Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing thekeratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors.展开更多
AIM:To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses(IOL)and to compare the surgical outcomes with the four-haptics posterior chamber(PC)-IOL technique.METHODS:We retrospectiv...AIM:To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses(IOL)and to compare the surgical outcomes with the four-haptics posterior chamber(PC)-IOL technique.METHODS:We retrospectively analyzed 16 eyes of 16 patients who underwent transscleral fixation of C-loop PCIOLs using a flapless one-knot suture technique,which were followed up for longer than 17mo.In this technique,the capsulorless IOL was suspended using a single suture for transscleral fixation of four feet.Then we compared its surgical outcomes and complications with the four-haptics PC-IOLs using the Student's t test and Chi-square test.RESULTS:Sixteen patients of 16 eyes with a mean age of 58.3±10.1y(42-76y)who received transscleral C-loop IOL implantation due to trauma,vitrectomy,or cataract surgery with inadequate capsule support showed improved visual acuity.The difference was not significant between two IOLs except the surgery time(P>0.05).The mean operation times of C-loop IOL surgery was 24.1±1.83min and 31.3±4.47min of the four-haptics PC-IOL method(P<0.0001).In the C-loop IOLs group,there was statistical difference between the preoperative and the postoperative UCVA(log MAR,1.20±0.50 vs 0.57±0.32,P=0.0003).There was no statistical difference between the preoperative and the postoperative BCVA(log MAR,0.66±0.46 vs 0.40±0.23,P=0.056).However,there was no statistically significant difference in postoperative UCVA and BCVA between the two IOLs(P>0.05).We did not detect any optic capture,IOL decentration or dislocation,suture exposed,or cystoid macular edema in patients underwent C-loop IOLs surgery.CONCLUSION:The novel flapless one-knot suture technique for transscleral fixation of C-loop IOL is a simple,reliable,and stable technique.展开更多
Objective: To analyze the clinical manifestations of intraocular lens (IOL) opacity after cataract surgery through case reports, and to explore its pathogenesis and diagnosis and treatment ideas, so as to provide a ba...Objective: To analyze the clinical manifestations of intraocular lens (IOL) opacity after cataract surgery through case reports, and to explore its pathogenesis and diagnosis and treatment ideas, so as to provide a basis for the early diagnosis and correct treatment of IOL opacity. Methods: The clinical data of one patient diagnosed with IOL opacity and underwent intraocular lens replacement in the Department of Ophthalmology, Affiliated Hospital of Youjiang Medical College for Nationalities in December 2023 were reported. The characteristics of IOL opacity were observed, and the research progress and pathogenesis of IOL opacity were understood by consulting the literature. Results: This patient is the first case of IOL opacity in our hospital. The specific reason is unclear. It is considered to be related to the IOL material. Conclusion: Hydrophilic acrylic IOL is widely used in clinic because of its good histocompatibility. However, due to its hydrophilicity, there are more cases of IOL opacity than other types of IOL. At present, there is no unified conclusion on the etiology and mechanism of IOL opacity. IOL opacity can seriously affect vision and is easily misdiagnosed as a posterior cataract. We should fully disperse the large pupil and carefully observe under the slit lamp. The most effective treatment for this disease is IOL replacement.展开更多
AIM:To assess visual outcomes and satisfaction of a non-diffractive extended depth of focus(EDOF)intraocular lens(IOL)in individuals with ocular hypertension(OHT)and well-controlled mild glaucoma undergoing cataract s...AIM:To assess visual outcomes and satisfaction of a non-diffractive extended depth of focus(EDOF)intraocular lens(IOL)in individuals with ocular hypertension(OHT)and well-controlled mild glaucoma undergoing cataract surgery.METHODS:An investigator-initiated,single-center,prospective,interventional,noncomparative study conducted in Montreal,Canada.The study enrolled 31 patients(55 eyes)with OHT or mild glaucoma who received a non-diffractive EDOF IOL(Acrysof IQ Vivity).Participants underwent sequential cataract surgery with the Vivity IOL.Follow-up evaluations occurred at 1d,1,and 3mo postoperatively,assessing uncorrected distance,intermediate,and near visual acuity.Questionnaires(QUVID:Questionnaire for visual disturbances and IOLSAT:Intraocular lens satisfaction)were administered pre and post-operatively to measure visual disturbances and spectacle independence in various lighting.Safety parameters included intraocular pressure(IOP),glaucoma medications,spherical equivalence,mean deviation and pattern standard deviation or square root of lost variance on Octopus visual field.RESULTS:At 1 and 3mo postoperatively,significant improvements were observed in uncorrected distance and intermediate visual acuity.Spectacle independence was enhanced for distance and intermediate vision,especially in bright light settings.Spectacle-free intermediate vision was improved even in dim lighting.Visual disturbances,particularly glare symptoms,were reduced,and there was a notable decrease in IOP and glaucoma medication burden at 3mo.There was more hazy vision postoperatively with no impact on visual acuity and visual satisfaction.CONCLUSION:The non-diffractive EDOF lens improves distance and intermediate spectacle-free visual function in patients with OHT and well-controlled glaucoma.The findings highlight significant improvements in visual acuity,reduced glare,enhanced spectacle independence,and improved visual performance in different lighting conditions.展开更多
AIM:To investigate the effect of pharmacological pupil alterations on intraocular lens(IOL)power calculations.METHODS:A systematic review and Meta-analysis of studies published before December 2023 in the PubMed,Embas...AIM:To investigate the effect of pharmacological pupil alterations on intraocular lens(IOL)power calculations.METHODS:A systematic review and Meta-analysis of studies published before December 2023 in the PubMed,Embase,and Cochrane library databases on the accuracy of pharmacological pupil changes on IOL power calculation was performed.The primary outcome was the results of IOL power calculations before and after the use of medications.Subgroup analyses were performed based on participants’basic characteristics,such as age,axial length(AL),and whether miosis or mydriasis were used as classification criteria for further analyses.Each eligible study was evaluated for potential risk of bias by the AHRQ assessment scale.The study was registered on PROSPERO(CRD 42024497535).RESULTS:A total of 3062 eyes from 21 studies were eligible.There was no significant difference in the IOL power calculation before and after pharmacological pupil changes using any of the Hoffer Q(WMD=0.055,95%CI=-0.046–0.156;P=0.29),SRK/T(WMD=0.003,95%CI=-0.073–0.080;P=0.93),Haigis(WMD=-0.030,95%CI=-0.176–0.116;P=0.69),Holladay 2(WMD=-0.042,95%CI=-0.366–0.282;P=0.80),and Barrett Universal Ⅱ(WMD=0.033,95%CI=-0.061–0.127;P=0.49)formulas.On the measurement of parameters related to IOL power calculation,for either miosis or mydriasis AL(P=0.98 and 0.29,respectively),lens thickness(P=0.96 and 0.13,respectively),and mean keratometry(P=0.90 and 0.86,respectively)did not present significant differences,while anterior chamber depth(P=0.07 and<0.01,respectively)and white-to-white distance(P=0.01 and 0.04,respectively)changed significantly between the two measurements prior and posterior.At the same time,despite there being some participants with the difference between the before and after calculations greater than 0.5 diopter,there was no significant difference in the incidence rate between these formulas.CONCLUSION:There is no significant effect of pharmacological pupil changes on the IOL power calculation.It will considerably reduce the visit time burden for patients who require cataract surgery.展开更多
AIM:To investigate the influence of postoperative intraocular lens(IOL)positions on the accuracy of cataract surgery and examine the predictive factors of postoperative biometry prediction errors using the Barrett Uni...AIM:To investigate the influence of postoperative intraocular lens(IOL)positions on the accuracy of cataract surgery and examine the predictive factors of postoperative biometry prediction errors using the Barrett Universal II(BUII)IOL formula for calculation.METHODS:The prospective study included patients who had undergone cataract surgery performed by a single surgeon from June 2020 to April 2022.The collected data included the best-corrected visual acuity(BCVA),corneal curvature,preoperative and postoperative central anterior chamber depths(ACD),axial length(AXL),IOL power,and refractive error.BUII formula was used to calculate the IOL power.The mean absolute error(MAE)was calculated,and all the participants were divided into two groups accordingly.Independent t-tests were applied to compare the variables between groups.Logistic regression analysis was used to analyze the influence of age,AXL,corneal curvature,and preoperative and postoperative ACD on MAE.RESULTS:A total of 261 patients were enrolled.The 243(93.1%)and 18(6.9%)had postoperative MAE<1 and>1 D,respectively.The number of females was higher in patients with MAE>1 D(χ^(2)=3.833,P=0.039).The postoperative BCVA(logMAR)of patients with MAE>1 D was significantly worse(t=-2.448;P=0.025).After adjusting for gender in the logistic model,the risk of postoperative refractive errors was higher in patients with a shallow postoperative anterior chamber[odds ratio=0.346;95% confidence interval(CI):0.164,0.730,P=0.005].CONCLUSION:Risk factors for biometry prediction error after cataract surgery include the patient’s sex and postoperative ACD.Patients with a shallow postoperative anterior chamber are prone to have refractive errors.展开更多
AIM:To assess the refractive and functional outcomes of a novel trifocal intraocular lens(IOL)with smooth micro phase technology.METHODS:This prospective,single-arm,single-center,observational study included patients ...AIM:To assess the refractive and functional outcomes of a novel trifocal intraocular lens(IOL)with smooth micro phase technology.METHODS:This prospective,single-arm,single-center,observational study included patients who underwent cataract surgery with the implantation of the AT ELANA 841P(Carl Zeiss Meditec,Berlin,Germany)IOL.Visual acuity(VA)at distance,intermediate,and near were evaluated 1-and 3-month postop as well as refractive outcomes.Monocular and binocular defocus curve,binocular contrast sensitivity(M&S^(■)Technologies)and patient satisfaction with the Catquest-9SF questionnaire were measured at 3-month postop.RESULTS:In total,46 eyes(23 patients)were bilaterally implanted with the IOL.Mean patient age was 59.86±5.55y.At 1-month postop,monocular corrected VA for distance,intermediate,and near were-0.15±0.09,0.11±0.10,and 0.15±0.12 logMAR,respectively.These outcomes remained stable at the 3-month follow-up(P>0.05).Spherical equivalent(SE)at 1-and 3-month postop remained stable(P>0.05).Following surgery,91%of the eyes at 1mo and 95%of the eyes at 3mo were within±0.5 D of SE.Monocular defocus curve showed that the lens can be categorized as a steep transition IOL.The contrast sensitivity function revealed high values at low spatial frequencies and decreased values at high spatial frequencies.The results of the Catquest-9SF questionnaire showed that all patients were fairly or very satisfied with their vision after surgery.CONCLUSION:The AT ELANA 841P IOL offers excellent visual outcomes across distance,intermediate,and near ranges,along with satisfactory contrast sensitivity.Additionally,the lens is associated with high patient satisfaction and minimal visual difficulties during daily activities.展开更多
BACKGROUND Phakic intraocular lens(IOL)implantation is a common treatment for high myopia.However,pre-and postoperative psychological changes,particularly anxiety and depression,are noteworthy concerns.Multiple studie...BACKGROUND Phakic intraocular lens(IOL)implantation is a common treatment for high myopia.However,pre-and postoperative psychological changes,particularly anxiety and depression,are noteworthy concerns.Multiple studies have indicated a close relationship between ophthalmic diseases,including high myopia,glaucoma,anxiety,and depression.AIM To evaluate the impact of phakic IOL implantation on anxiety and depression in patients with high myopia.METHODS Data from 136 patients with high myopia,who underwent phakic IOL implantation at the authors’hospital between June 2024 and December 2024,were retrospectively analyzed.Clinical data were collected from the hospital’s electronic medical records system.Preoperative and one-month postoperative data were compared.Anxiety,depression,sleep quality,and quality of life were evaluated using the Hamilton anxiety scale,Hamilton depression scale,Pittsburgh Sleep Quality Index,and 36-item Short Form Health Survey,respectively.RESULTS Of 136 patients,67.65%(n=92)were female and 32.35%(n=44)were male,with a mean±SD age of 28.02±5.72 years.The mean uncorrected visual acuity before and 1 month after treatment was 1.83±0.24 log minimum angle of resolution(MAR)and 0.03±0.07 log MAR,respectively.The mean best corrected visual acuity before and 1 month after treatment was 0.04±0.07 log MAR and 0.01±0.02 log MAR,respectively.All differences were statistically significant(P<0.05).Compared with pretreatment,Hamilton anxiety scale and Hamilton depression scale scores significantly decreased 1 month post-treatment(P<0.05).Furthermore,the Pittsburgh Sleep Quality Index score was significantly lower after than that before treatment(P<0.05).The 36-item Short Form Health Survey quality of life score significantly improved after treatment(P<0.05).CONCLUSION Phakic IOL implantation significantly reduces anxiety and depression and improves sleep quality and quality of life in patients with high myopia.This study provides new concepts for treating high myopia.展开更多
基金Supported by the National Natural Science Foundation of China(No.81900841)the Guangzhou Major Difficult and Rare Diseases Project(No.2024MDRD05)+2 种基金the Guangdong Basic and Applied Basic Research Foundation(No.2021A1515011673No.2022A1515011181)the Guangzhou Basic Research Program,City&University(Institute)Joint Funding Project(No.SL2023A03J00514).
文摘AIM:To investigate the characteristics and associated factors of intraocular lens(IOL)tilt and decentration after transscleral suture-fixated IOL surgery in congenital ectopia lentis(CEL).METHODS:CEL patients undergoing transscleral suture-fixated IOL surgery were divided into two groups based on implanted IOL type(three-piece IOL or one-piece IOL).The IOL tilt and decentration at 3-month and 1-year postoperative were measured.Multivariate regression analyses were performed to identify the associated factors of IOL tilt and decentration as well as longitudinal changes.RESULTS:The 61 CEL patients(mean age 9.07±5.05y)in three-piece IOL(M/F:14/7)group had a greater tilt than those with one-piece IOL(M/F:28/12)group both at 3-month postoperative(horizontal:P=0.024;vertical:P=0.048)and 1-year postoperative(horizontal:P=0.011;vertical:P=0.001).Three-piece IOL group had a greater longitudinal change between 3-month postoperative to 1-year postoperative in IOL tilt(horizontal:P=0.028;vertical:P=0.026)and a greater longitudinal change in horizontal IOL decentration than one-piece IOL group(P<0.05).The longer axial length(AL)was associated with the longitudinal changes in IOL tilt(P=0.039),while the three-piece IOL was associated with the longitudinal changes in horizontal IOL decentration 1-year postoperatively(P=0.011).CONCLUSION:IOL tilt is greater in the three-piece IOL group than that in the one-piece IOL group 1-year postoperatively.The three-piece IOL is associated with greater longitudinal changes of IOL decentration,while longer AL is associated with longitudinal changes of IOL tilt.For CEL patients,more stable IOL type should be selected and patients with longer AL warrant closer monitoring.
基金Supported by the Zhejiang Medical Health Science and Technology Project(No.2021KY217)the Basic Public Welfare Research Project of Wenzhou Municipal Science and Technology Bureau(No.2024Y1221).
文摘AIM:To evaluate and compare alterations in the effective lens position(ELP)and refractive outcomes among three distinct intraocular lens(IOL)types.METHODS:Patients with cataracts were enrolled and allocated to 3 groups:Group A(implanted with the SN6CWS),Group B(implanted with the MI60),and Group C(implanted with the Aspira-aA).ELP measurements were obtained with swept-source optical coherence tomography(SS-OCT)at 1d,1wk,1mo,and 3mo postoperatively.Subjective refraction assessments were conducted at 1wk,1mo,and 3mo following surgery.RESULTS:The study included 189 eyes of 150 cataract patients(66 males).There were 77 eyes in Group A,55 eyes in Group B,and 57 eyes in Group C.The root mean square of the ELP(ELPRMS)within the initial 3mo was significantly lower for Group A than for Groups B and C.Refractive changes within Group A were not significant across the time points of 1wk,1mo,and 3mo.Conversely,both Group B and Group C demonstrated statistically significant shifts toward hyperopia from 1wk to 3mo postsurgery.CONCLUSION:Among the three IOLs examined,the SN6CWS IOL showes the greatest stability during the first 3mo postoperatively.Between 1wk and 3mo after surgery,notable hyperopic shifts are evident in eyes implanted with the MI60 and Aspira-aA IOLs,whereas refractive outcomes remain relatively constant in eyes implanted with SN6CWS IOLs.
文摘Background:The Akreos®AO60 intraocular lens(IOL)has been employed for scleral fixation in eyes without capsular support,although surgical complications,including IOL opacification,have been reported.This study aims to evaluate the outcomes and complications associated with scleral fixation of the Akreos®AO60 IOL in vitrectomized eyes,with a particular focus on IOL opacification.Methods:Electronic medical records of consecutive eyes that underwent scleral-fixation of the Akreos®AO60 lens using Gore-tex®sutures from 2017 to 2022 were reviewed.The following parameters were collected:age,sex,laterality,past ocular/medical history,surgical indication,pre-operative visual acuity(VA)and intraocular pressure(IOP),surgical procedure,and post-operative VA and IOP.The types of complications,onset,management,and outcomes were also documented.Descriptive statistics,Wilcoxon signed-rank test,and Fisher’s exact test were employed for statistical analysis.Results:Eighty-nine eyes of 86 patients aged 31-100 years were included.The most common surgical indication was non-traumatic IOL displacement.Retinal tears and localized choroidal hemorrhage were found intraoperatively in 7.9%and 1.1%,respectively.The most common post-operative complications were vitreous hemorrhage(13.5%),corneal edema(12.4%),ocular hypotony(11.2%),and IOL opacification(11.2%).IOL opacification was associated with intra-/post-operative exposure to air/gas[odds ratio(OR):12.24;95%confidence interval(CI),1.46-103.0;P=0.006].Mean logarithm of the minimum angle of resolution(logMAR)best-reported VA(BRVA)improved from 1.22±0.77 pre-operatively to 0.56±0.67 on latest follow-up(P<0.001).Conclusions:The majority of the complications from scleral-fixation of the Akreos®AO60 lens in vitrectomized eyes were mild and transient;however,a proportion required surgical intervention.A significant risk for opacification was found in IOLs exposed to air/gas,although VA was often maintained.
文摘Background:To evaluate efficacy and safety of combined pars plana vitrectomy(PPV)and scleral fixated intraocular lens(SFIOL)surgery as a single procedure.Methods:Retrospective interventional case series done at a tertiary eye care center in Northern India.Eleven patients who underwent combined PPV and SFIOL surgery were included and analyzed retrospectively.Results:Mean age of the patients was 43.36±15.12 years(range,22-64 years).Eight were male.Mean baseline best corrected visual acuity(BCVA)was 0.78±0.63 logMAR units while the mean post-operative BCVA at 6 months follow-up was 0.37±0.29 logMAR units,the visual gain being statistically significant(P=0.021).None of the patients had a drop in BCVA with nine patients having final BCVA better than 0.48 logMAR units.Choroidal detachment(CD)was the only notable complication,seen in three patients.Other complications included two cases of intraoperative retinal breaks,a case each of reversible corneal edema,ocular hypertension and cystoid macular edema.Conclusions:Combined PPV and SFIOL is an efficacious procedure for managing IOL/lens dislocation and aphakia in a single surgery.There may be short-term reversible complications with no impact on final visual gain.
文摘As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL power calculation methods have evolved and innovated throughout time, from early theoretical and regression formulas to nonlinear formulas for estimating effective lens position (ELP), multivariable formulas, and innovative formulas that use optical principles and AI-based online formulas. This paper thoroughly discusses the development and iteration of traditional IOL calculation formulas, the emergence of new IOL calculation formulas, and the selection of IOL calculation formulas for different patients in the era of refractive cataract surgery, serving as a reference for “personalized” IOL implantation in clinical practice.
文摘AIM:To assess whether the implantation of a posterior chamber phakic intraocular lens produces changes in optical coherence tomography(OCT)measurements of macular thickness(MT)and two parameters that define the structure of the optic nerve,the peripapillary nerve fiber layer(RNFL)and the Bruch’s membrane opening-minimum rim width(BMO-MRW).METHODS:This nonrandomized prospective pre-post study included 86 eyes of 48 patients(age,20-47y;axial length:23.10-28.95 mm)scheduled for myopia or myopic astigmatism correction with implantation of the implantable collamer lens(ICL).Eyes with glaucoma or any other ocular disease that could alter OCT results were excluded.RNFL,BMO-MRW and MT were measured preoperatively,and at 1 and 6mo after surgery using spectral-domain OCT.Changes between preoperative and postoperative values were evaluated.RESULTS:There was a significant increase in BMOMRW at 1mo(mean change:3.48±15.07μm,P=0.041).No significant changes were found during the rest of followup(1-6mo postop.,P=0.623).There was also a significant increase in RNFL thickness at 1mo af ter surger y(1.45±2.18μm,P<0.001),but with a significant reduction from 1 to 6mo postoperatively(P=0.002).Regarding MT,it increased significantly at 1mo(2.46±3.76μm,P<0.001),with a significant decrease afterwards(P=0.048).Measurements of the three parameters at 6mo were slightly superior to preoperative values(P<0.01).CONCLUSION:Minimal changes are induced in BMOMRW,RNFL and MT after ICL implantation in healthy eyes,confirming the safety of the surgical procedure regarding the structure of the optic nerve head and the macula,and indicating that this phakic intraocular lens seems to have a slight impact on OCT measurements.
文摘AIM:To report incidence,indications,and visual outcomes of intraocular lens(IOL)exchange/explantation surgery.METHODS:Retrospective analysis of 60 eyes requiring IOL exchange/explantation surgery between 1^(st) January 2017 and 31^(st) December 2022.The overall outcomes as well as comparison between the trainee versus experienced surgeons were analyzed.RESULTS:Out of 39778 cataract surgeries(with no preexisting ocular co-morbidities)during a six-year period(2017-2022),60(0.15%)needed IOL exchange/explantation.Surgeons-under-training performed 36/60 cases(60%)while 24/60(40%)were by experienced surgeons.The commonest indication was subluxated IOL in 26(43.3%),followed by dislocated IOL in 20(33.3%),postoperative refractive surprise in 7(11.6%),IOL induced uveitis in five and broken haptic in two eyes.Twenty-four(40%)eyes had intraoperative complications during primary surgery.Posterior chamber IOL(PCIOL)was the commonest secondary IOL in 21(35%)eyes,scleral fixated in 20(31.6%),anterior chamber IOL(ACIOL)in 13(21.6%),iris fixated IOL in three(5%)and three eyes(5%)were left aphakic.The mean time between primary and secondary surgery was 168d(168±338.8).Best corrected visual acuity(BCVA)of>20/60 was obtained in 43 eyes(71.66%),20/80-20/200 in 14(23.33%),20/250 in two and hand movements in one.No statistically significant difference in visual outcome was noted at post-op one month between trainees versus experienced surgeons(UCVA 0.45±0.29 vs 0.53±0.32,P=0.20,BCVA 0.34±0.25 vs 0.37±0.26,P=0.69).CONCLUSION:IOL subluxation as the commonest indication and posterior capsular rupture is the commonest intraoperative risk factor.This complication can be effectively addressed with selection of the appropriate secondary IOL achieving good visual outcomes in over 70% of patients.
文摘AIM:To evaluate the visual and refractive outcomes in cases after sutured scleral fixation of existing subluxated or dislocated acrylic one-piece intraocular lenses(IOLs).METHODS:This study retrospectively enrolled a consecutive series of patients who underwent a surgery of sutured existing subluxated or dislocated IOLs from October 2018 to June 2020.All patients underwent comprehensive preoperative and postoperative ophthalmologic examination,and data were collected including age,sex,surgical indications,best-corrected visual acuity,refractive error,intraocular pressure.Presence of intraoperative and postoperative surgical complications was documented.RESULTS:A total of 20 consecutive cases were enrolled for analysis with mean final follow-up period 9.8±5.3mo.Visual acuity improved from a mean of 0.35(0.46±0.32 logMAR)preoperatively to 0.61(0.21±0.18 logMAR)at the 3-month follow-up(P=0.002).The mean amount of preoperative keratometric astigmatism and total postoperative refractive astigmatism was-1.24±0.80 diopters(D)and-1.42±0.97 D,respectively.There was no statistically significant difference between preoperative and postoperative astigmatism(P=0.156).The mean IOL-induced astigmatism was-0.23±0.53 D.The mean spherical equivalent at the 3-month follow-up was-0.1±0.94 D.No major complications were noted during the follow-up period.CONCLUSION:Surgical techniques using sutured scleral fixation of existing subluxated or dislocated acrylic one-piece IOLs result in favorable visual and refractive outcomes without major complications.
基金Supported by NIH Center Core,No.P30EY014801Research to Prevent Blindness Unrestricted Grant,Department of Defense,No.DOD-Grant#W81XWH-09-1-0675
文摘AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who received sulcus-placed SPA-IOLs between 2006 and 2009 were reviewed. None of the patients underwent IOL exchange. Charts of six age-matched patients who received sulcus placed 3P-IOLs were reviewed as a control group. RESULTS: Mean follow up was 16 mo for SPA-IOL and 23 mo for 3P-IOL. Five of 8 patients in the SPA-IOL group required chronic use of IOP lowering medications at final follow up. Of these, one patient needed glaucoma implant surgery for uncontrolled IOP. One patient in the 3P-IOL group used chronic aqueous suppression pre- and postoperatively. Four of eight eyes with SPAIOL were treated with chronic topical steroids and or non-steroidal anti-inflammatory drugs for cystoid macu-la edema, chronic uveitis, pigment dispersion syndrome or a combination of the above, compared to none in the control group. Mean best-corrected visual acuity was 20/35 in the SPA-IOL group and 20/47 in the 3PIOL group.CONCLUSION: Sulcus placed SPA-IOLs are associated with increased ocular morbidity. In select cases good visual acuity may be achieved. Due to postoperative rotation of sulcus placed toric SPA-IOLs stable astigmatism correction cannot be achieved. Alternative intraocular lenses should be considered when in-the-bag placement of SPA-IOL is not possible.
文摘Advances in intraocular lens(IOL)design have rendered cataract surgery a refractive procedure.Newer IOL types include bifocal,trifocal and extended depth of focus(EDOF)IOLs.Their basic difference nestles in the number of focal points that each lens provides,which in turn leads to different visual outcomes.Familiarity of surgeons with the various characteristics of each lens is of utmost importance for accurate IOL selection to match each patient’s needs.In this review,we aim to compare the clinical outcomes after implantation of multifocal and EDOF IOLs in terms of distance,intermediate and near vision,contrast sensitivity,and reading performance.Finally,we discuss the defocus curve and the optical and photic phenomena associated with each type of IOL.
基金Supported by National Key Research and Development Program of China(No.2017YFC1104600)National Natural Science Foundation of China(No.81770909)。
文摘AIM:To evaluate the accuracy of eight different intraocular lens(IOL)power calculation formulas for a segmented multifocal IOL.METHODS:A total of 53 eyes of 41 adult cataract patients who underwent phacoemulsification and implantation with the SBL-3 segmented multifocal IOL between January 1,2017 and January 31,2019 were included in this retrospective study.Preoperative biometry measurements were obtained using an IOL Master.Manifest refraction was performed at least 4 wk postoperatively.Accuracy of the eight formulas[Barrett Universal II,Emmetropia Verifying Optical(EVO),Haigis,Hill-RBF 2.0,Hoffer Q,Holladay 1,Kane,and SRK/T]was analyzed.RESULTS:Using current lens constants,all formulas exhibited errors of slight myopic shift in refractive prediction.The Barrett Universal II formula had a significantly lower median absolute error(MedAE)than did Holladay 1(P=0.02),Kane(P=0.001)and Hill-RBF 2.0(P<0.001)formulas.The Haigis formula had a lower MedAE value than did the Hill-RBF 2.0 formula(P=0.005).Differences in MedAE values among SRK/T,EVO and Hoffer Q formulas were not significant.After optimizing lens constants,the MedAE values of all formulas were reduced;significant changes were noted for EVO(P=0.022),Haigis(P=0.048);Hill-RBF 2.0(P=0.014),Holladay 1(P=0.045)and Kane(P=0.022)formulas.All formulas performed equally well after optimization of lens constants(P=0.203).CONCLUSION:All eight formulas tend to result in a myopic shift when using current lens constants.Optimized lens constants improve the accuracy of these formulas among adult Chinese patients.
文摘AIM:To compare the clinical outcomes of extended depth-of-focus intraocular lenses(EDOF IOLs)using either micromonovision implantation or mixed implantation of EDOF and diffractive bifocal IOLs.METHODS:This retrospective clinical trial included 130 patients(260 eyes),who were divided into two groups.Group RR comprised 70 patients(140 eyes)bilaterally implanted with ZXR00 IOLs(Tecnis ZXR00,where one target was-0.5 D to-0.75 D and the other was 0 to-0.25 D).Group RM comprised 60 patients(120 eyes)unilaterally implanted with both ZXR00 and ZMB00 IOLs(Tecnis ZMB00,0 to-0.25 D).Postoperative outcomes were compared after 3 mo,including visual acuity,defocus curves,stereoacuity,modulation transfer functions(MTFs),higher-order aberrations,and Visual Function-14(VF-14)questionnaire responses.RESULTS:Group RR had superior bilateral intermediate vision,while the group RM had superior bilateral near vision(both P<0.05).Group RM also exhibited superior MTFs and reduced higher-order aberrations(both P<0.05).Stereoacuity and VF-14 questionnaire results showed no statistically significant difference between groups(P>0.05).CONCLUSION:The implantation of micromonovision has significantly improved near vision.IOLs and their collocation can be customized according to individual patient needs to achieve precise treatment and provide cataract patients with high-quality vision.
文摘AIM : To evaluate the prediction error in intraocular lens(IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position(ELP).METHODS: Retrospective study including a total of 25 eyes of 13 patients(age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL(Oculentis Gmb H, Germany). In all cases, an adjusted IOL power(P IOLadj) was calculated based on Gaussian optics using a variable keratometric index value(n kadj) for the estimation of the corneal power(P kadj) and on a new value for ELP(ELP adj) obtained by multiple regression analysis.This P IOLadj was compared with the IOL power implanted(P IOLReal) and the value proposed by three conventional formulas(Haigis, Hoffer Q and Holladay Ⅰ).RESULTS: P IOLReal was not significantly different than P IOLadj and Holladay IOL power(P 】0.05). In the Bland and Altman analysis, P IOLadj showed lower mean difference(-0.07 D) and limits of agreement(of 1.47 and-1.61 D)when compared to P IOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELP adj was significantly lower than ELP calculated with other conventional formulas(P 【0.01) and was found to be dependent on axial length, anterior chamber depth and P kadj. CONCLUSION: Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing thekeratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors.
基金Supported by the Gongli Hospital of Pudong New Area,Shanghai(No.2017YQNJJ-13)。
文摘AIM:To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses(IOL)and to compare the surgical outcomes with the four-haptics posterior chamber(PC)-IOL technique.METHODS:We retrospectively analyzed 16 eyes of 16 patients who underwent transscleral fixation of C-loop PCIOLs using a flapless one-knot suture technique,which were followed up for longer than 17mo.In this technique,the capsulorless IOL was suspended using a single suture for transscleral fixation of four feet.Then we compared its surgical outcomes and complications with the four-haptics PC-IOLs using the Student's t test and Chi-square test.RESULTS:Sixteen patients of 16 eyes with a mean age of 58.3±10.1y(42-76y)who received transscleral C-loop IOL implantation due to trauma,vitrectomy,or cataract surgery with inadequate capsule support showed improved visual acuity.The difference was not significant between two IOLs except the surgery time(P>0.05).The mean operation times of C-loop IOL surgery was 24.1±1.83min and 31.3±4.47min of the four-haptics PC-IOL method(P<0.0001).In the C-loop IOLs group,there was statistical difference between the preoperative and the postoperative UCVA(log MAR,1.20±0.50 vs 0.57±0.32,P=0.0003).There was no statistical difference between the preoperative and the postoperative BCVA(log MAR,0.66±0.46 vs 0.40±0.23,P=0.056).However,there was no statistically significant difference in postoperative UCVA and BCVA between the two IOLs(P>0.05).We did not detect any optic capture,IOL decentration or dislocation,suture exposed,or cystoid macular edema in patients underwent C-loop IOLs surgery.CONCLUSION:The novel flapless one-knot suture technique for transscleral fixation of C-loop IOL is a simple,reliable,and stable technique.
文摘Objective: To analyze the clinical manifestations of intraocular lens (IOL) opacity after cataract surgery through case reports, and to explore its pathogenesis and diagnosis and treatment ideas, so as to provide a basis for the early diagnosis and correct treatment of IOL opacity. Methods: The clinical data of one patient diagnosed with IOL opacity and underwent intraocular lens replacement in the Department of Ophthalmology, Affiliated Hospital of Youjiang Medical College for Nationalities in December 2023 were reported. The characteristics of IOL opacity were observed, and the research progress and pathogenesis of IOL opacity were understood by consulting the literature. Results: This patient is the first case of IOL opacity in our hospital. The specific reason is unclear. It is considered to be related to the IOL material. Conclusion: Hydrophilic acrylic IOL is widely used in clinic because of its good histocompatibility. However, due to its hydrophilicity, there are more cases of IOL opacity than other types of IOL. At present, there is no unified conclusion on the etiology and mechanism of IOL opacity. IOL opacity can seriously affect vision and is easily misdiagnosed as a posterior cataract. We should fully disperse the large pupil and carefully observe under the slit lamp. The most effective treatment for this disease is IOL replacement.
文摘AIM:To assess visual outcomes and satisfaction of a non-diffractive extended depth of focus(EDOF)intraocular lens(IOL)in individuals with ocular hypertension(OHT)and well-controlled mild glaucoma undergoing cataract surgery.METHODS:An investigator-initiated,single-center,prospective,interventional,noncomparative study conducted in Montreal,Canada.The study enrolled 31 patients(55 eyes)with OHT or mild glaucoma who received a non-diffractive EDOF IOL(Acrysof IQ Vivity).Participants underwent sequential cataract surgery with the Vivity IOL.Follow-up evaluations occurred at 1d,1,and 3mo postoperatively,assessing uncorrected distance,intermediate,and near visual acuity.Questionnaires(QUVID:Questionnaire for visual disturbances and IOLSAT:Intraocular lens satisfaction)were administered pre and post-operatively to measure visual disturbances and spectacle independence in various lighting.Safety parameters included intraocular pressure(IOP),glaucoma medications,spherical equivalence,mean deviation and pattern standard deviation or square root of lost variance on Octopus visual field.RESULTS:At 1 and 3mo postoperatively,significant improvements were observed in uncorrected distance and intermediate visual acuity.Spectacle independence was enhanced for distance and intermediate vision,especially in bright light settings.Spectacle-free intermediate vision was improved even in dim lighting.Visual disturbances,particularly glare symptoms,were reduced,and there was a notable decrease in IOP and glaucoma medication burden at 3mo.There was more hazy vision postoperatively with no impact on visual acuity and visual satisfaction.CONCLUSION:The non-diffractive EDOF lens improves distance and intermediate spectacle-free visual function in patients with OHT and well-controlled glaucoma.The findings highlight significant improvements in visual acuity,reduced glare,enhanced spectacle independence,and improved visual performance in different lighting conditions.
基金Supported by Beijing Natural Science Foundation from Beijing Municipal Government(No.7202030).
文摘AIM:To investigate the effect of pharmacological pupil alterations on intraocular lens(IOL)power calculations.METHODS:A systematic review and Meta-analysis of studies published before December 2023 in the PubMed,Embase,and Cochrane library databases on the accuracy of pharmacological pupil changes on IOL power calculation was performed.The primary outcome was the results of IOL power calculations before and after the use of medications.Subgroup analyses were performed based on participants’basic characteristics,such as age,axial length(AL),and whether miosis or mydriasis were used as classification criteria for further analyses.Each eligible study was evaluated for potential risk of bias by the AHRQ assessment scale.The study was registered on PROSPERO(CRD 42024497535).RESULTS:A total of 3062 eyes from 21 studies were eligible.There was no significant difference in the IOL power calculation before and after pharmacological pupil changes using any of the Hoffer Q(WMD=0.055,95%CI=-0.046–0.156;P=0.29),SRK/T(WMD=0.003,95%CI=-0.073–0.080;P=0.93),Haigis(WMD=-0.030,95%CI=-0.176–0.116;P=0.69),Holladay 2(WMD=-0.042,95%CI=-0.366–0.282;P=0.80),and Barrett Universal Ⅱ(WMD=0.033,95%CI=-0.061–0.127;P=0.49)formulas.On the measurement of parameters related to IOL power calculation,for either miosis or mydriasis AL(P=0.98 and 0.29,respectively),lens thickness(P=0.96 and 0.13,respectively),and mean keratometry(P=0.90 and 0.86,respectively)did not present significant differences,while anterior chamber depth(P=0.07 and<0.01,respectively)and white-to-white distance(P=0.01 and 0.04,respectively)changed significantly between the two measurements prior and posterior.At the same time,despite there being some participants with the difference between the before and after calculations greater than 0.5 diopter,there was no significant difference in the incidence rate between these formulas.CONCLUSION:There is no significant effect of pharmacological pupil changes on the IOL power calculation.It will considerably reduce the visit time burden for patients who require cataract surgery.
基金Supported by the Innovation&Transfer Fund of Peking University Third Hospital(No.BYSYZHKC2021108).
文摘AIM:To investigate the influence of postoperative intraocular lens(IOL)positions on the accuracy of cataract surgery and examine the predictive factors of postoperative biometry prediction errors using the Barrett Universal II(BUII)IOL formula for calculation.METHODS:The prospective study included patients who had undergone cataract surgery performed by a single surgeon from June 2020 to April 2022.The collected data included the best-corrected visual acuity(BCVA),corneal curvature,preoperative and postoperative central anterior chamber depths(ACD),axial length(AXL),IOL power,and refractive error.BUII formula was used to calculate the IOL power.The mean absolute error(MAE)was calculated,and all the participants were divided into two groups accordingly.Independent t-tests were applied to compare the variables between groups.Logistic regression analysis was used to analyze the influence of age,AXL,corneal curvature,and preoperative and postoperative ACD on MAE.RESULTS:A total of 261 patients were enrolled.The 243(93.1%)and 18(6.9%)had postoperative MAE<1 and>1 D,respectively.The number of females was higher in patients with MAE>1 D(χ^(2)=3.833,P=0.039).The postoperative BCVA(logMAR)of patients with MAE>1 D was significantly worse(t=-2.448;P=0.025).After adjusting for gender in the logistic model,the risk of postoperative refractive errors was higher in patients with a shallow postoperative anterior chamber[odds ratio=0.346;95% confidence interval(CI):0.164,0.730,P=0.005].CONCLUSION:Risk factors for biometry prediction error after cataract surgery include the patient’s sex and postoperative ACD.Patients with a shallow postoperative anterior chamber are prone to have refractive errors.
文摘AIM:To assess the refractive and functional outcomes of a novel trifocal intraocular lens(IOL)with smooth micro phase technology.METHODS:This prospective,single-arm,single-center,observational study included patients who underwent cataract surgery with the implantation of the AT ELANA 841P(Carl Zeiss Meditec,Berlin,Germany)IOL.Visual acuity(VA)at distance,intermediate,and near were evaluated 1-and 3-month postop as well as refractive outcomes.Monocular and binocular defocus curve,binocular contrast sensitivity(M&S^(■)Technologies)and patient satisfaction with the Catquest-9SF questionnaire were measured at 3-month postop.RESULTS:In total,46 eyes(23 patients)were bilaterally implanted with the IOL.Mean patient age was 59.86±5.55y.At 1-month postop,monocular corrected VA for distance,intermediate,and near were-0.15±0.09,0.11±0.10,and 0.15±0.12 logMAR,respectively.These outcomes remained stable at the 3-month follow-up(P>0.05).Spherical equivalent(SE)at 1-and 3-month postop remained stable(P>0.05).Following surgery,91%of the eyes at 1mo and 95%of the eyes at 3mo were within±0.5 D of SE.Monocular defocus curve showed that the lens can be categorized as a steep transition IOL.The contrast sensitivity function revealed high values at low spatial frequencies and decreased values at high spatial frequencies.The results of the Catquest-9SF questionnaire showed that all patients were fairly or very satisfied with their vision after surgery.CONCLUSION:The AT ELANA 841P IOL offers excellent visual outcomes across distance,intermediate,and near ranges,along with satisfactory contrast sensitivity.Additionally,the lens is associated with high patient satisfaction and minimal visual difficulties during daily activities.
文摘BACKGROUND Phakic intraocular lens(IOL)implantation is a common treatment for high myopia.However,pre-and postoperative psychological changes,particularly anxiety and depression,are noteworthy concerns.Multiple studies have indicated a close relationship between ophthalmic diseases,including high myopia,glaucoma,anxiety,and depression.AIM To evaluate the impact of phakic IOL implantation on anxiety and depression in patients with high myopia.METHODS Data from 136 patients with high myopia,who underwent phakic IOL implantation at the authors’hospital between June 2024 and December 2024,were retrospectively analyzed.Clinical data were collected from the hospital’s electronic medical records system.Preoperative and one-month postoperative data were compared.Anxiety,depression,sleep quality,and quality of life were evaluated using the Hamilton anxiety scale,Hamilton depression scale,Pittsburgh Sleep Quality Index,and 36-item Short Form Health Survey,respectively.RESULTS Of 136 patients,67.65%(n=92)were female and 32.35%(n=44)were male,with a mean±SD age of 28.02±5.72 years.The mean uncorrected visual acuity before and 1 month after treatment was 1.83±0.24 log minimum angle of resolution(MAR)and 0.03±0.07 log MAR,respectively.The mean best corrected visual acuity before and 1 month after treatment was 0.04±0.07 log MAR and 0.01±0.02 log MAR,respectively.All differences were statistically significant(P<0.05).Compared with pretreatment,Hamilton anxiety scale and Hamilton depression scale scores significantly decreased 1 month post-treatment(P<0.05).Furthermore,the Pittsburgh Sleep Quality Index score was significantly lower after than that before treatment(P<0.05).The 36-item Short Form Health Survey quality of life score significantly improved after treatment(P<0.05).CONCLUSION Phakic IOL implantation significantly reduces anxiety and depression and improves sleep quality and quality of life in patients with high myopia.This study provides new concepts for treating high myopia.
