Clinical outcomes of conjunctivochalasis treatment with a new ophthalmic radiofrequency device.

PURPOSE: To investigate the safety and efficacy of a new micro-controlled radiofrequency device for treatment of conjunctivochalasis (Cch). METHODS: Data of 127 patients (230 eyes) who underwent ophthalmic radiofrequency treatment for Cch from January 2020 to June 2023 were analyzed retrospectively. Cch coagulation was performed with a radiofrequency electrode tip (OcuRF®, Ilooda, Korea) and a high-frequency radio-wave electric unit (0.6 ~ 0.8 watts, 2 MHz, Acutron™, Ilooda, Korea). Pre- and postoperative Cch grading, slit-lamp photography, tear film break-up time (TBUT), and bulbar conjunctival hyperemia using Keratograph 5 M (Oculus, Wetzlar, Germany) were evaluated. Cch grade 0 or 1 after surgery was regarded as 'success'. Complications, recurrence, and additional treatment rates were analyzed. RESULTS: In 227 (98.7%) eyes, the radiofrequency treatment led to marked improvement of Cch, with 224 (97.4%) eyes achieving grade 0 or 1 at 2 months postoperatively. Eight eyes (3.5%) received additional treatment. TBUT improved from 3.17 ± 0.82 s to 5.28 ± 1.10 s after surgery (P < 0.001). The total bulbar conjunctival hyperemia value showed an improvement from 1.7 ± 0.6 to 1.4 ± 0.6 postoperatively (P < 0.05). No serious complications were observed. CONCLUSION: The novel ophthalmic radiofrequency device led to a marked improvement of Cch with no serious adverse events during the entire follow-up period. Our results suggest that the radiofrequency device presents a safe and efficacious treatment option for Cch.

Effect of Corneal and Lens Eccentricity Difference on Rigid Corneal Lens Treatment in Patients With Keratoconus.

OBJECTIVE: To evaluate the effects of rigid corneal lenses (RCL) in patients with keratoconus, based on eccentricity. METHODS: Eighty-four eyes from 84 patients were included in this retrospective comparative study. Based on the median value of eccentricity difference between the cornea and back surface of the RCL, the patients were divided into groups 1 (<0.08) and 2 (≥0.08). Visual acuity, refractive index, and corneal topography indices were compared before and three months after lens use. RESULTS: Visual acuity, astigmatism, refractive error, corneal curvature, and corneal thickness improved significantly in both groups. Apical power and anterior elevation improved significantly in group 1, with small differences in eccentricity, but not in group 2. Changes in apical power before and after lens use were significantly different between the two groups. CONCLUSION: The RCL was effective for the cornea of keratoconus, especially when the prescription was made with a small difference in eccentricity.

Simple surgical punctal occlusion with high frequency radiowave electrosurgery.

BACKGROUND: To introduce and evaluate the efficacy of a simple punctal occlusion technique for dry eye patients. METHODS: Medical records of 79 eyes from 40 patients refractory to common dry eye conservative treatment who underwent multiple high-frequency radio-wave electro-punctal occlusion were retrospectively reviewed. Pre- and post-procedural ocular surface indices (Schirmer test, tear break-up time (TBUT), and corneal staining grade (Oxford scheme)) and subjective symptom scores (including frequency of artificial tear use, interval between procedures, and total repeat time) were analyzed. RESULTS: Average Schirmer test result was significantly (P < 0.05) improved from 4.10 ± 1.39 mm to 8.14 ± 3.13 mm at 6 weeks after the procedure (n = 79). A total of 32 eyes from 16 patients underwent repeated procedure with a mean interval of 8.00 ± 4.86 months, while 24 patients had a single procedure. Twenty-five of 30 patients showed improvement for subjective symptom scores. No complications related to the procedure were observed. CONCLUSIONS: A simple, less-invasive punctal occlusion technique using a fine-needle tip with high-frequency radio-wave could significantly relieve subjective symptoms and improve ocular surface indices of patients with aqueous deficient dry eye without causing a major complication. This procedure may play a considerable role in treating dry eye refractory to common practices.

Clinical outcomes of bilateral implantation of new generation monofocal IOL enhanced for intermediate distance and conventional monofocal IOL in a Korean population.

BACKGROUND: To compare the clinical outcomes of bilateral implantation of enhanced intermediate function intraocular lenses (IOLs) and standard monofocal IOLs. METHODS: In this prospective, randomized, comparative controlled study, we compared the visual outcomes of patients who underwent bilateral cataract surgery at the Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, with either enhanced monofocal IOLs (Tecnis Eyhance, ICB00, Johnson and Johnson Vision Care, Inc) (Group 1) or standard monofocal IOLs (Tecnis, ZCB00, Johnson and Johnson Vision Care, Inc) (Group 2). The assessment included monocular and binocular uncorrected distance visual acuity (UDVA), uncorrected intermediate (UIVA at 60 cm) and near (UNVA at 40 cm) visual acuity, uncorrected defocus curves, contrast sensitivity testing (CST), and reading speed test using Quality of vision was evaluated using the Visual Function Questionnaire (VFQ-25). RESULTS: At 3-months postoperatively, monocular and binocular outcomes of UIVA and UNVA were statistically significantly better in Group 1 (P < 0.05). The binocular uncorrected defocus curve of Group 1 showed statistically significantly better outcomes at vergence ranges of -1.5 to -4.0 D (P < 0.05). Significantly higher reading speed test was also observed in Group 1 in all ranges tested (1.0 to 0.1 LogMAR) (P < 0.05). There were no statistically significant differences in CST between groups. CONCLUSIONS: Bilateral implantation of enhanced monofocal IOLs provided better vision at intermediate and near distances compared to standard monofocal IOLs, while maintaining good distance vision and contrast sensitivity.

Efficacy and safety of 1% and 2% rebamipide clear solution in dry eye disease: a multicenter randomized trial.

BACKGROUND: To evaluate the efficacy of 1% and 2% rebamipide clear solution in the treatment of dry eye disease (DED). METHODS: Two hundred twenty patients with DED were randomly assigned to one of three groups: the 1% rebamipide, 2% rebamipide, or placebo (eye drops containing the same ingredients, except for the active components). Each eye drop was instilled four times daily for 12 weeks. Changes in tear film break-up time (TBUT), corneal and conjunctival staining score, Schirmer 1 test, and the Ocular Surface Disease Index (OSDI) from baseline to 12-week visit between the study groups were compared for efficacy assessment. RESULTS: The mean age of study patients was 43.8±14.2 years. The 1% and 2% rebamipide groups showed greater improvement in TBUT (1.99±1.87 and 2.02±2.21 s) at 12 weeks from baseline than the placebo group (1.25±2.93 s). The 2% rebamipide group showed greater improvement in the corneal staining score (- 3.15±2.00) at 12 weeks from baseline than the placebo group (- 2.85±1.80). The 1% and 2% rebamipide groups showed improvement in Schirmer 1 test (1.27±3.86 and 1.50±4.14 mm) at 12 weeks of treatment, but not the placebo group (0.55±2.99 mm). Both the rebamipide groups and the placebo group showed significantly improved OSDI after treatment for 12 weeks; however, there was no significant difference among the three groups. CONCLUSIONS: 1% and 2% rebamipide clear solutions are an effective therapeutic option for improving TBUT and tear volume, and stabilizing the corneal staining score in DED.

Evaluating the Predictability of Postoperative Target Refraction Using the Prototype of a New Intraoperative Aberrometer. / Evaluation des Prototyps eines neuen intraoperativen Aberrometers für die Vorhersage der postoperativen Zielrefraktion.

Despite all the progress in cataract and refractive lens surgery, refractive surprise is common in clinical practice. A significant postoperative refractive error is particularly annoying - and contributes to the patient's dissatisfaction with the procedure and the surgeon - when a multifocal IOL, an EDOF-IOL or a toric IOL has been implanted. The relatively new technology of intraoperative aberrometry offers the surgeon the option to intraoperatively measure the eye and its refraction, either directly after lens extraction and/or following IOL implantation. Currently, three different systems are available. In a number of studies, the technology has shown a better refractive predictability than preoperative biometry. Besides giving an evaluation of the prototype of a new intraoperative aberrometer, the I-O-W-A system, we also present our results on the influence of the kind of anaesthesia chosen and of two different IOL designs on the predictability of intraoperative aberrometry.

Modified argon laser therapy for benign tumor of the eyelid.

BACKGROUND: To report about the therapy of benign eyelid tumors with a modified argon laser technique as an alternative to surgery. METHODS: Nineteen benign tumors of the eyelid were included in this study. After staining the surface of the tumor with a violet marker, low-energy argon laser photoablation was performed. A mean number of 312 spots (spot size ranging from 150 to 500 µm) with a power of 200 to 400 mW, and a duration between 0.1 and 0.2 s were applied. RESULTS: The eyelid tumors were located mainly in the lower eyelid (58%). Dermal nevi and papilloma were the most frequently treated lesions. Over a mean follow-up period of 10.5 months (range 6-18 months), all eyelid tumors were successfully treated by a single session of laser therapy. All patients were satisfied with the laser therapy and the cosmetic result. No postoperative complications were observed. No relapses occurred during follow-up. CONCLUSIONS: Our modified method of argon laser therapy utilizes the staining of the surface of the eyelid tumor to increase the amount of thermal laser energy absorbed by the target. This novel technique is simple and effective for treating benign eyelid tumors.

Clinical outcomes of new multifocal intraocular lenses with hydroxyethyl methacrylate and comparative results of contrast sensitivity, objective scatter, and subjective photic phenomena.

BACKGROUND: We investigate the performance of new hydrophobic diffractive multifocal intraocular lenses (IOL) with hydroxyethyl methacrylate (HEMA) and compare their optical quality, contrast sensitivity, and subjective photic phenomena. METHODS: Medical records of patients who underwent routine simple cataract surgery and insertion of an existing multifocal IOL (TFNT, TF group) or a new multifocal IOL (CNWT, CN group) were retrospectively reviewed. Clinical data was collected 2 months postoperatively and included optical quality analysis system (OQAS) indices, contrast sensitivity, and subjective degrees of photic phenomena. RESULTS: One hundred thirty-five eyes of 135 patients were included (CN group, 71; TF group, 64). There was no significant difference between the two groups in the visual acuity and defocus curve. The indices of OQAS did not show a significant difference between groups. Contrast sensitivity was significantly better in the CN group at all degrees, including the area under the log contrast sensitivity function (p = 0.01). The subjective photic phenomena survey showed better results for the CN group, with the proportion of patients reporting no photic phenomena as 9.9% and 3.1% in the CN and TF groups, respectively. The proportion of patients who reported severe photic phenomena was 11.3% in the CN group and 25.0% in the TF group. Although the follow-up period was only 2 months, glistening, surface scattering, and posterior capsule opacity were not observed in any patient. CONCLUSIONS: The new multifocal IOL with HEMA is safe, and provides stable visual acuity as well as superior contrast sensitivity and lower subjective photic phenomena, over the prior IOL.

Comparative Surface Imaging Study of Multifocal Diffractive Intraocular Lenses. / Vergleich des Oberflächenprofils von multifokalen diffraktiven Intraokularlinsen.

PURPOSE: To analyse and compare the surface topography and roughness of three different types of diffractive multifocal IOLs. METHODS: Using scanning electron microscope (SEM, Inspect F, 5.0 KV, maximum magnification up to 20,000) and atomic force microscope (AFM, Park Systems, XE-100, non-contact, area profile comparison, 10 × 10 µm, 40 × 40 µm), the surface quality of the following diffractive IOLs was studied: the AcrySof IQ PanOptix (Alcon, USA), the AT LARA 829MP (Carl Zeiss Meditec, Germany), and Tecnis Symfony (Johnson&Johnson Vision, USA). The measurements were made over three representative areas (central non-diffractive optic, central diffractive optic, and diffractive step) of each IOL. Roughness profile in terms of mean arithmetic roughness (Ra) and root-mean-squared roughness (Rq) values were obtained and compared statistically. RESULTS: In SEM examination, all IOLs showed a smooth optical surface without any irregularities at low magnification. At higher magnification, Tecnis Symfony showed unique highly regular, concentric, and lineate structures in the diffractive optic area which could not be seen in the other studied diffractive IOLs. The differences in the measured Ra and Rq values of the Tecnis Symfony were statistically significant compared to the other models (p < 0.05). CONCLUSION: Various different topographical traits were observed in three diffractive multifocal IOLs. The Ra values of all studied IOLs were within an acceptable range. Tecnis Symfony showed statistically significant higher surface Ra values at both central diffractive optic and diffractive step areas. Furthermore, compared to its counterparts, Tecnis Symfony demonstrated highly ordered, concentric pattern in its diffractive surfaces.

In-vitro glistening formation in six different foldable hydrophobic intraocular lenses.

BACKGROUND: Glistenings describe small, refractile microvacuoles that may arise within the intraocular lens (IOL) material and reduce the patients' quality of vision. Lenses composed of hydrophobic acrylic material are particularly affected by glistening formation. In this study, we compared the tendency of glistening formation in six different types of hydrophobic acrylic intraocular lenses (IOLs). METHODS: We used a well-established accelerated laboratory method to develop glistenings in the following IOLs: Vivinex XY1 (Hoya), AcrySof SN60WF (Alcon), Tecnis ZCB00 (AMO), Avansee PN6A (Kowa), Aktis SP NS-60YG (Nidek), and CT Lucia 601P (Zeiss). IOLs were first immersed in saline at 45 °C for 24 h and then at 37 °C for 2.5 h in a water bath. Microvacuole (MV) density and size (Miyata grading) were documented and calculated using an image analysis program. RESULTS: The mean glistening density [MV/mm2] and mean Miyata grading (in brackets) were: Vivinex: 11.6 ± 5.7 (0), SN60WF: 264.4 ± 110.3 (2.6), Tecnis: 6.0 ± 2.8 (0), Avansee: 2.2 ± 0.7 (0), Aktis: 851.4 ± 59.4 (3+) and CT Lucia: 71.0 ± 71.6 (1). CONCLUSIONS: While all tested IOLs showed glistenings with the accelerated laboratory method, the Aktis and SN60WF showed the highest microvacuole density, followed by the CT Lucia. In comparison, the Vivinex, Tecnis, and Avansee IOLs showed far fewer number of glistenings.

Chronic and Recurrent Herpes Zoster Ophthalmicus.

Background and Objectives: This study sought to investigate the natural course, the chronicity and recurrence rate, and the risk factors of chronic and recurrent herpes zoster ophthalmicus (HZO). We also evaluated the effects of long-term treatment for HZO. Materials and Methods: Patients diagnosed and treated for HZO were included in the retrospective medical chart review. Multivariable-adjusted logistic and Cox regression models were used to show risk factors for chronic and recurrent HZO along with hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Among a total 130 of HZO patients, 31 patients (23.85%) had chronic disease and 19 patients (14.62%) had recurrent disease. The rate of chronic disease was higher in HZO with conjunctivitis, epithelial keratitis, and stromal keratitis. The recurrence rate increased in patients with chronic HZO (HR: 34.4, 95% CI: 3.6-324.6), epithelial keratitis (HR: 5.5, 95% CI: 1.3-30.0), stromal keratitis (HR: 18.8, 95% CI: 3.0-120.8), and increased intraocular pressure (IOP) (HR: 7.3, 95% CI: 1.6-33.2). Length of systemic antiviral therapy and anti-inflammatory eyedrop treatment were not associated with recurrent HZO (p = 0.847 and p = 0.660, respectively). The most common ocular manifestation for recurrent HZO was stromal keratitis. Conclusions: This study demonstrated a considerable frequency of chronic and recurrent HZO. Chronic HZO in the form of epithelial or stromal keratitis with increased IOP provoked a significant rise in the risk of recurrence.

Comparative analysis of in vitro accelerated glistening formation in foldable hydrophobic intraocular lenses.

PURPOSE: To analyse and compare the propensity to form glistenings in 4 different types of hydrophobic acrylic intraocular lenses (IOLs): Alcon AcrySof ® MA60AC, HOYA iSert® PC-60AD, Bausch&Lomb enVista, and Kowa Avansee™ PU6A. METHODS: We used an accelerated laboratory method to create glistenings. IOLs were first immersed in saline at 45 °C for 24 h and then at 37 °C for 2.5 h. Microvacuole (MV) density and size were documented and calculated using an image analysis program. RESULTS: Median density of glistenings [MV/mm2] for Alcon AcrySof ® MA60AC was 623 (range 507-804), for HOYA iSert® PC-60AD 1358 (range 684-2699), for Bausch&Lomb enVista 2 (range 1-2), and for Kowa Avansee™ PU6A 1 (range 1-4). The prevailing MV size was: 0-5 µm for Hoya IOLs, 5-10 µm for Alcon IOLs, 20-50 µm for Bausch&Lomb IOLs, and 5-50 µm for Kowa IOLs. CONCLUSIONS: Glistenings could be induced in all studied IOLs using the accelerated laboratory method. The Alcon AcrySof ® MA60AC and HOYA iSert® PC-60AD IOLs showed MV of high density, while the glistenings in the Hoya IOLs were smaller in size compared to the Alcon IOLs. The MV density was minimal in the Bausch&Lomb enVista and Kowa Avansee™ PU6A IOLs. The propensity of the Alcon AcrySof ® MA60AC IOLs to form glistenings in vitro correlated with the findings of clinical results that are already published.

Comparison of refractive outcomes after photorefractive keratectomy with different optical zones using Mel 90 excimer laser.

BACKGROUND: A larger optical zone for photorefractive keratectomy may improve optical quality and stability. However, there is need for limiting ablation diameter in that a larger ablation diameter requires greater ablation depth, and minimizing ablation depth may reduce adverse effects on postoperative wound healing, haze and keratoectasia. In this study, we compared the changes in clinical outcomes and the degree of regression between a 6.0 mm optical zone and 6.5 mm optical zone following PRK. METHODS: The records of 95 eyes that had undergone PRK with a 6.0 OZ (n = 40) and a 6.5 OZ (n = 55) were retrospectively reviewed. We compared data including the spherical equivalent of manifest refraction (SE of MR), simulated K (Sim K), thinnest corneal thickness, change in thinnest corneal thickness (the initial value divided by corrected diopter [ΔTCT/CD]), Q value, corneal higher order aberrations (HOAs) and spherical aberration (SA) pre-operation, at 3 and 6 months postoperative and at the last follow-up visit (Mean; 20.71 ± 10.52, 17.47 ± 6.57 months in the 6.0 and 6.5 OZ group, respectively). RESULTS: There were no significant differences in the SE of MR, Sim K and UDVA between the 6.0 OZ group and the 6.5 OZ group over 1 year of follow-up after PRK, and the 6.0 OZ group required less ΔTCT/CD than the 6.5 OZ group. The 6.5 OZ group showed better results in terms of post-operative HOAs of RMS, SA and Q value. When comparing that pattern of change in Sim K, there was no significant difference between the 6.0 OZ group and the 6.5 OZ group. CONCLUSIONS: The clinical refractive outcomes and regression after PRK using Mel 90 excimer laser with a 6.0 OZ were comparable to those with a 6.5 OZ.

Laboratory evaluation of the optical properties of two extended-depth-of-focus intraocular lenses.

BACKGROUND: To experimentally compare the optical performance of two different Extended-Depth-of-Focus (EDOF) intraocular lenses (IOLs) using a standardized optical bench set-up. METHODS: In this experimental study, following IOLs were assessed: the TECNIS® Symfony ZXR00 (Johnson&Johnson, Santa Ana, USA) and the AT LARA 829MP (Carl Zeiss Meditec, Jena, Germany) IOLs. The through-focus modulation transfer function (MTF) values were measured at a spatial frequency of 50 lp/mm and at aperture sizes of 2, 3, and 4.5 mm. Each IOL was measured while centered using ISO 11979-2 Model 1 (aberration-free) and Model 2 (+ 0.28 µm spherical aberration) corneas. United States Air Force (USAF) target images were also recorded for a qualitative evaluation. RESULTS: At 2 mm pupil with ISO1 cornea, the primary and secondary foci of both IOLs appeared to merge, providing an elongated depth of focus. At 3 and 4.5 mm pupil sizes, the through-focus MTF curves of both IOLs showed a bifocal-like V-pattern. While the Symfony IOL showed an overall superior MTF values when measured with the ISO2 cornea, the opposite propensity could be observed with the AT LARA IOL. This optical behavior could be qualitatively confirmed by the USAF target images. CONCLUSIONS: Although the two EDOF IOLs share similarities in their optical properties, the main difference lies in their optical design and performance with respect to spherical aberration. Such characteristics should be taken into account during IOL and patient selection.

Retraction Note: Comparison of 0.05% cyclosporine and 3% diquafosol solution for dry eye patients: a randomized, blinded, multicenter clinical trial.

An amendment to this paper has been published and can be accessed via the original article.

Prospective comparative study of tolerance to refractive errors after implantation of extended depth of focus and monofocal intraocular lenses with identical aspheric platform in Korean population.

BACKGROUND: To evaluate the clinical outcomes of extended depth of focus (EDOF) and monofocal intraocular lenses (IOLs) that share identical aspheric platform and compare their visual acuity tolerance to postoperative refractive errors. METHODS: This non-randomized, prospective comparative study included 120 eyes undergoing cataract surgery with implantation of either Tecnis ZCB00 IOL (Abbott Medical Optics Inc., Santa Ana, CA) (monofocal group: 60 eyes of 30 patients) or Tecnis Symfony IOL (Abbott Medical Optics, Inc.) (EDOF group: 60 eyes of 30 patients). Monocular and binocular visual outcomes, changes in refraction, defocus curve, contrast sensitivity, and perception of photic phenomena (Halo & Glare Simulator; Eyeland Design Network, Vreden, Germany) were evaluated 3 months postoperatively. To compare the refractive tolerance, each group was divided into three subgroups according to the postoperative uncorrected distance visual acuity (UDVA) and postoperative spherical equivalent (SE). RESULTS: In the EDOF group, the mean 3-months postoperative monocular UDVA, intermediate (UIVA), and near (UNVA) visual acuities were 0.03 ± 0.07, 0.09 ± 0.15, and 0.24 ± 0.16 logMAR, respectively. A total of 100, 96.55, and 68.97% of eyes in the EDOF group achieved binocular UDVA, UIVA, and UNVA values of 0.20 logMAR or better, respectively. In respect to refractive tolerance, the EDOF group showed higher SE values and statistically significantly better mean UDVA than the monofocal group in all subgroups, with UDVA of - 0.013 and 0.028 logMAR for EDOF and monofocal groups (p = 0.037), respectively, in the subgroup where SE was within ±0.50 D, UDVA of 0.004 and 0.048 logMAR for EDOF and monofocal groups (p = 0.046), respectively, in the subgroup where SE was within - 1.00 D, and UDVA of 0.020 and 0.083 logMAR for EDOF and monofocal groups (p = 0.026), respectively, in the subgroup where SE was more than - 1.00 D. The mean patient satisfaction scores for spectacle-free distance, intermediate, and near visual acuities were 86.0, 85.0, and 66.0, respectively. CONCLUSIONS: The EDOF IOL provided excellent postoperative visual outcomes in far and intermediate distances, with high patient satisfaction rate. Regarding the postoperative refractive tolerance to SE, the Tecnis Symfony IOL showed better tolerance to residual postoperative refractive error than the monofocal IOL with the same material and optical platform.

Comparison of 0.05% cyclosporine and 3% diquafosol solution for dry eye patients: a randomized, blinded, multicenter clinical trial.

BACKGROUND: This study is aim to compare the clinical effectiveness between the two most prominent dry eye disease (DED)-specific eye drops, 0.05% cyclosporine (CN) and 3% diquafosol (DQ). METHODS: This is a multi-centered, randomized, masked, prospective clinical study. A total of 153 DED patients were randomly allocated to use CN twice per day or DQ six times daily. Cornea and conjunctival staining scores (NEI scale), tear break-up time (TBUT), Schirmer test scores, and ocular surface disease index (OSDI) score were measured at baseline, 4 and 12 weeks after treatment. RESULTS: At 12 weeks after treatment, NEI scaled scores were significantly reduced from the baseline by - 6.60 for CN and - 6.63 for DQ group (all P < 0.0001, P = 0.9739 between groups). TBUT and Schirmer values for CN were significantly improved from the baseline at 4 and 12 weeks (P = 0.0034, P < 0.0001 for TBUT, P = 0.0418, P = 0.0031 for Schirmer test). However, for DQ, TBUT showed significant improvement at 12 weeks only (P = 0.0281). Mean OSDI score differences from the baseline to 12 weeks were improved by - 13.03 ± 19.63 for CN and - 16.11 ± 20.87 for DQ, respectively (all P < 0.0001, P = 0.854 between groups). Regarding drug compliance, the mean instillation frequency of CN was less than that of DQ (P < 0.001). There were no statistically significant intergroup differences in safety evaluation. CONCLUSIONS: The level of improvement regarding NEI, TBUT, and OSDI scores were not significantly different between the two treatment groups. However, with regards to the early improvement of TBUT and patient compliance, patients using CN improved faster and with greater adherence to drug usage than did those treated with DQ. TRIAL REGISTRATION: KCT0002180 , retrospectively registered on 23 December 2016.

[In Vitro Evaluation of the Optical Quality of Segmental Refractive Multifocal Intraocular Lenses]. / In-vitro-Untersuchung zur optischen Qualität segmental refraktiver multifokaler Intraokularlinsen.

OBJECTIVES: In customised patient care, it is important to know the optical quality of different intraocular lenses (IOL). In this study, the optical quality of three segmental intraocular lenses were compared. MATERIALS AND METHODS: The LENTIS Comfort LS-313 MF15, LENTIS Mplus X LS-313 MF30 and LENTIS High Add IOL LS-313 MF80 (Oculentis, Berlin, Germany) with a far power of + 21 D were analysed at the optical bench OptiSpheric IOL PRO (Trioptics GmbH, Wedel, Germany). The lenses have almost the same optical design but differ in the power of the near segment. The MF15 has a + 1.5 D addition to improve vision in intermediate distances, the MF30 has a near addition of + 3 D and the MF80 has a near addition of + 8 D. The modulation transfer function area (MTFa) and the Strehl ratio were examined for apertures of 3 mm (photopic) and 4.5 mm (mesopic). RESULTS: The MTFa values for the far focus are 33.34/30.80/51.53 (MF15/MF30/MF80) with an aperture of 3 mm and 25.38/22.52/43.15 for 4.5 mm. The MTFa values for the intermediate focus are 29.85/16.21/6.25 for a 3 mm aperture and 23.92/8.05/3.08 for 4.5 mm. The MTFa values for the near focus are 9.75/21.49/33.12 for an aperture of 3 mm and 4.95/22.70/31.68 for 4.5 mm. The Strehl ratio of the far focus is 0.34/0.30/0.52 for an aperture of 3 mm and 0.24/0.22/0.43 for 4.5 mm. For the intermediate focus, the Strehl ratio is 0.30/0.17/0.07 for an aperture of 3 mm and 0.24/0.08/0.03 for 4.5 mm. The Strehl ratio of the near focus is 0.10/0.22/0.33 for an aperture of 3 mm and 0.05/0.23/0.32 for 4.5 mm. CONCLUSION: We confirmed that the addition influences the optical quality of segmental bifocal intraocular lenses. For the far focus, the results of the MF15 and MF30 are similar. In intermediate distances, the MF15 achieves the best results. For near distances, the MF30 achieves better optical values than the MF15. The lens MF80, which has been designed for patients with maculopathies, achieves good results for far and near distances.

In vitro optical quality measurements of three intraocular lens models having identical platform.

BACKGROUND: With recent advances in technology and introduction of new intraocular lens (IOL) models, surgeons today have the opportunity to choose from various optical designs, which can influence the postoperative quality of vision. In our laboratory study, we compared the optical quality of three different IOLs that use the identical platform and are produced by the same manufacturer. The study included two diffractive multifocal IOLs, a bifocal and a trifocal one, as well as a monofocal IOL. METHODS: Three IOL models: monofocal CT ASPHINA 409 M, diffractive bifocal AT LISA 809 M, and diffractive trifocal AT LISA Tri 839MP (Carl Zeiss Meditec AG, Germany) were assessed for optical quality by measuring modulation transfer function (MTF) and Strehl Ratio (SR) values at pupil sizes of 3.0 and 4.5 mm on the OptiSpheric® IOL PRO (Trioptics GmbH, Germany). The United States Air Force (USAF) Target images were also recorded to comfirm the optical performance qualitatively. RESULTS: For far focus at 50 lp/mm and 3.0 mm pupil size, MTF value of the monofocal lens (MTF = 0.798) was 1.8-fold and 2.1-fold better than the bifocal (MTF = 0.446) and the trifocal (MTF = 0.382) IOLs, respectively. For near focus, bifocal IOL (MTF = 0.265) was 1.4-fold better than trifocal IOL (MTF = 0.187), while for intermediate focus, the trifocal IOL (MTF = 0.148) was 1.7-fold better than the bifocal IOL (MTF = 0.086). For the same pupil size, total sum of light loss amounted to 5.2% for the monofocal, 16.0% for the bifocal and 6.0% for the trifocal IOL. For a larger pupil, the amount of light loss increased significantly for the multifocal IOLs. CONCLUSIONS: The monofocal IOL performed the best for far, the bifocal IOL for near and the trifocal IOL for intermediate focus. While the monofocal IOL created the least amount of light loss for both pupil sizes, the trifocal IOL created less than half the amount of light loss than the bifocal IOL for small pupil. For large pupil, however, less light scatter was observed for the bifocal than the trifocal IOL.

[Impact of Near Addition on the Optical Quality of Diffractive Multifocal Intraocular Lenses - a Laboratory Study Using an Optical Bench]. / Auswirkungen der Nahaddition auf die optische Qualität von diffraktiven multifokalen Intraokularlinsen ­ eine Laborstudie an der optischen Bank.

Purpose To analyse the optical quality of diffractive multifocal intraocular lenses (IOLs) with different near additions in a laboratory study. Methods We analysed the AcrySof® IQ ReSTOR® + 2.5 D SV25T0 (Alcon Laboratories inc., Fort Worth, USA), the AcrySof® IQ ReSTOR® + 3.0 D SN6AD1 (Alcon, USA) and the TECNIS® ZMA00 and ZMB00 (Abbott Medical Optics, USA) with a power of 21D for the distance, using the OptiSpheric® IOL PRO optical bench (TRIOPTICS, Wedel, Germany). The lenses have a similar optical design but different near additions: The ReSTOR + 2.5 D has a near addition of + 2.5 D, the ReSTOR + 3.0 D has a near addition of + 3.0 D and both TECNIS IOLs have a near addition of + 4.0 D. We evaluated the modulation transfer function area (MTFA) and the Strehl ratio. Additionally the optical qualities of the IOL were compared using USAF (United States Air Force)-Target pictures. Results The MTFA at the far focus (ReSTOR + 2.5 D/ReSTOR + 3.0 D/TECNIS) was 47.85/42.06/33.57. The MTFA was 11.05/9.54/8.60 for intermediate distances. MTFA at the near focus was 20.11/29.50/33.39. The Strehl ratio was 0.48/0.42/0.29 at the far focus, 0.11/0.10/0.09 at the intermediate focus and 0.20/0.30/0.34 at the near focus. The USAF Target pictures correlated with these measurements. Conclusion At the near focus, the TECNIS ZMA00 and ZMB00 performed the best, while the ReSTOR + 2.5 D performed the worst. At the intermediate distance, all IOLs achieved similar results. At the far focus, the ReSTOR + 2.5 D performed the best. Surgeons can choose the right IOL for the patients' individual needs, because a broad range of near additions in diffractive multifocal IOLs is available these days.