Evaluation of clinical outcomes following implantation of a sub-2-mm hydrophilic acrylic MICS intraocular lens.

PURPOSE: To evaluate clinical outcomes following sub-2-mm microincision cataract surgery (MICS) and intraocular lens (IOL) implantation. SETTING: Five EU clinical sites. DESIGN: Prospective, multicenter, open-label, single-arm, non-randomized. METHODS: Preoperative assessment involved visual acuity (VA), intraocular pressure and biometry measurements. 1.4-mm wound-assisted or 1.8-mm MICS was performed. Follow-up visits were made 1 day, 1-2 weeks, 1-2 and 4-6 months after surgery. The incision size, corrected distance VA (CDVA), uncorrected distance VA, manifest refraction spherical equivalent (MRSE), refraction predictability/stability and IOL decentration were assessed. At 12-, 18-, and 24-month, long-term centration, posterior capsular opacification (PCO) and Nd:YAG capsulotomy rates were investigated. RESULTS: A total of 103 eyes were implanted with the study IOL (INCISE, Bausch & Lomb), 96 of which were included in visual outcome analysis. A mean 6-month CDVA of - 0.02 logMAR (20/20 + 1) was observed and 75 eyes (79.8%) and 93 eyes (98.3%) achieved a visual acuity of at least 20/20 or 20/40. Mean MRSE was - 0.20 ± 0.60 D. Mean absolute predictive error was 0.44 ± 0.36 D, with 90.4% within 1.00 D of target. Mean total decentration was 0.35 ± 0.36 mm at 6 months and 0.32 ± 0.14 mm at 24 months (p > 0.05). 24-month evaluation of posterior capsular opacification score was 0.03 for the central area. A Nd:YAG rate of 3.4% was observed at 24 months. CONCLUSIONS: The new MICS IOL provided excellent visual outcomes and was safe and effective for the sub-2-mm procedure. The MICS IOL demonstrated long-term centration, stability and a low rate of PCO development.

Clinical outcomes with a trifocal intraocular lens: a multicenter study.

PURPOSE: To evaluate the clinical results and safety obtained with a new type of multifocal intraocular lens (IOL) using a trifocal design to achieve pseudoaccommodation. METHODS: A pilot observational study of patients with a trifocal IOL (FineVision; PhysIOL, Liege, Belgium) implanted by 1 of 12 surgeons between March and December 2010. Visual outcomes that were assessed postoperatively included uncorrected and corrected distance, intermediate, and near visual acuity. RESULTS: One hundred ninety-eight eyes of 99 patients were analyzed. Patients were observed for an average of 6.44 ± 4.67 months (range: 0.2 to 17 months). Preoperative corrected distance visual acuity was 0.22 ± 0.26 logMAR. At the final follow-up visit, corrected distance visual acuity was 0.01 ± 0.10 logMAR, uncorrected distance visual acuity was 0.01 ± 0.06 logMAR, uncorrected intermediate visual acuity was 0.08 ± 0.10 logMAR, and mean uncorrected near visual acuity was 0.00 ± 0.04 logMAR. Postoperative binocular uncorrected distance visual acuity was 0.01 ± 0.07 logMAR, uncorrected intermediate visual acuity was 0.06 ± 0.08 logMAR, and uncorrected near visual acuity was -0.03 ± 0.04 logMAR. Postopeative mean residual sphere was 0.21 ± 0.48 diopters (D), with a residual cylinder of -0.24 ± 0.31 D. Postoperative spherical equivalent was 0.11 ± 0.36 D. CONCLUSIONS: The results demonstrated that the trifocal FineVision IOL is able to restore near, intermediate, and distance visual function.

A comparative evaluation of three extended depth of focus intraocular lenses.

PURPOSE: To compare the refractive and visual performance of three Extended Depth of Focus (EDOF) intraocular lenses (IOLs) after uncomplicated cataract surgery. SETTING: Centre IRIDIS, Albi, France. DESIGN: Comparative retrospective study. METHODS: Patients with cataracts and without other eye diseases were enrolled for monocular implantation of EDOF IOLs on the dominated eye by the same surgeon between 2018 and 2021, using either the IsoPure (BVI-PhysIOL, Belgium), the Synthesis+ (Cutting Edge, France), or the Lucidis (SAV-IOL, Swiss). Refraction, Uncorrected Distance Visual Acuity (UDVA), Corrected Distance VA (CDVA), Uncorrected Near VA (UNVA), Distance-Corrected Near VA (DCNVA), 25% Contrast CDVA, and Defocus Curve were assessed 3-months postoperatively. RESULTS: A total of 64 eyes of 64 patients were included in this study (IsoPure n = 22; Synthesis+ n = 20, Lucidis n = 22). CDVA, 25% Contrast CDVA and DCNVA were significantly better for Lucidis than IsoPure or Synthesis+. No significant difference was observed for CDVA and 25% Contrast CDVA between IsoPure and Synthesis+. DCNVA was significantly better for Lucidis and Synthesis+ with respectively 0.08 LogMAR ± 0,09 and 0.29 LogMAR ± 0.13, compared to 0.40 LogMAR ± 0.17 for IsoPure (p < 0.05). CONCLUSIONS: Lucidis showed more efficient distance, low contrast, and near vision than IsoPure and Synthesis+. Synthesis+ seems to be more efficient in intermediate vision than other groups. Each EDOF IOLs provided good distance vision without creating spontaneous complaints of photic phenomena. Refractive EDOF IOLs, especially Lucidis, are efficient for patients wishing to improve their vision without dysphotopsia.

Microincision cataract surgery with implantation of a bitoric intraocular lens using an enhanced program for intraocular lens power calculation.

PURPOSE: To evaluate the potential benefit of a new version of an online toric intraocular lens calculator in eyes implanted with a bitoric intraocular lens. PATIENTS AND METHODS: Retrospective observational comparative study in patients that underwent cataract surgery with implantation of the bitoric intraocular lens AT TORBI 709M (Carl Zeiss Meditec AG, Jena, Germany). Visual and refractive outcomes were evaluated at 1 month after surgery. The selection of the toric intraocular lens power was performed with the software Z CALC 2.0 (Carl Zeiss Meditec AG). The absolute refractive prediction errors for the spherical equivalent and cylinder were calculated and compared with the values that would have been obtained using version 1.5 of the same software. RESULTS: A total of 393 eyes of 276 patients were evaluated. Mean postoperative sphere and cylinder were +0.03 ± 0.54 and -0.19 ± 0.30 D, respectively. A total of 95.67%, 98.22%, and 95.17% of eyes had a postoperative sphere, cylinder, and spherical equivalent within ±1.00 D, respectively. Mean absolute refractive prediction error for spherical equivalent was 0.34 ± 0.27 D with the two versions of the Z CALC software. In contrast, a significantly higher absolute refractive prediction error value for the cylinder was found with Z CALC 1.5 compared to version 2.0 (0.35 ± 0.32 vs 0.28 ± 0.30 D, p < 0.001). The absolute refractive prediction error for cylinder was ⩽0.25 D in 62.3% and 47.5% when using the versions 2.0 and 1.5, respectively. CONCLUSION: The use of an optimized software for toric intraocular lens power calculation, considering the contribution of posterior corneal astigmatism, improved the astigmatic outcome with a bitoric intraocular lens.

Visual and refractive outcomes after implantation of a fully diffractive trifocal lens.

BACKGROUND: The purpose of this study was to record the visual outcomes of patients treated by six surgeons after implantation of a trifocal lens. METHODS: The setting for this study comprised six ophthalmology units and eye clinics in Belgium and France, with a coordinating center in France, and data management and statistical analysis in France and Belgium. Ninety-four eyes from 47 patients were implanted with a trifocal FineVision(®) intraocular lens by six surgeons. Monocular and binocular, uncorrected and best distance-corrected, and photopic and mesopic visual acuity was measured, as well as the defocus curve between +4 D and -4 D with best distance correction. RESULTS: Near and far monocular visual acuities were similar to the data published after bifocal intraocular lens implantation. Intermediate vision was improved, and was demonstrated by scores of near visual acuity as well as far visual acuity with defocus -1.5 D-add lens. Far vision is maintained in mesopic conditions. CONCLUSION: The trifocal intraocular lens provides good far, intermediate, and near visual acuity.