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Submitted: July 31, 2023 | Final revision submitted: February 1, 2024 | Accepted: February 5, 2024, Purpose: To evaluate visual and refractive outcomes, as well as patient satisfaction after bilateral implantation of an enhanced monofocal intraocular lens (IOL) with emmetropia as a target refraction. Setting: San Carlos Hospital, Madrid, Spain. Design: Prospective, monocentric, non-comparative study. Methods: Adults 21 years or older suitable for cataract surgery and with corneal astigmatism < 1.50D were bilaterally implanted with the RayOne EMV IOL and followed up for 3-months. Outcomes measures included refraction, monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance corrected intermediate visual acuity (DCIVA), and defocus curve, aberrometry, and satisfaction. Visual symptoms were assessed using the CatQuest-9SF questionnaire. Results: 50 eyes of 25 patients were included. At Month-3, the mean manifest spherical equivalent was -0.39 ± 0.28 D, with all eyes within 1.00 D. Binocularly, uncorrected, at distance, 68% of patients could read ≤ 0.0 logMAR and 95% ≤ 0.2 logMAR; at intermediate 59% of patients could read ≤0.1 and 100% ≤ 0.2 logMAR. Mean monocular CDVA was -0.03 ± 0.06 logMAR and mean monocular DCIVA was 0.28 ± 0.07 logMAR. Binocular defocus curve demonstrated a visual acuity ≤ 0.2 logMAR over a 2 D range from +1.00 D to -1.25 D. Satisfaction was good in 96% of patients. Conclusion: Bilateral implantation of an enhanced monofocal IOL with emmetropia as a target provided excellent binocular CDVA and good DCIVA, with a high level of satisfaction., Depto. de Optometría y Visión, Depto. de Inmunología, Oftalmología y ORL, Fac. de Óptica y Optometría, Fac. de Medicina, TRUE, pub, Pagado por el autor

Submitted: November 19, 2019 | Final revision submitted: January 26, 2020 | Accepted: February 17, 2020, Purpose: To develop a new method that makes it easy to detect accuracy deficiencies of any intraocular lens power calculation formulae and to test it on 9 different formulae. Setting: IOA, Madrid, Spain Design: Retrospective observational case series. Methods: This study’s first stage included 3519 eyes from 3519 candidates to cataract surgery for which frequency distributions for the following biometric eye parameters were computed: axial length (AXL), anterior-chamber depth (ACD), lens thickness (LT), white-to-white (WTW) and mean corneal radius (Rm). The resulting data for each parameter were 5th, 25th, 75th and 95th percentile, which allowed us to define the corresponding normality range. In a second stage, the new graphic-representation method was tested for 9 different formulae in a sample of 70 eyes undergoing cataract surgery with multifocal intraocular lens (MIOL) implantation. Results: Normality ranges (defined as the 25th-to-75th-percentile interval) were 22.84 to 24.42 mm for AXL, 2.86 to 3.39 mm for ACD, 4.36 to 4.88 mm for LT, 11.64 to 12.19 mm for WTW and 7.52 to 7.87 mm for Rm, with lower sizes in women. No significant differences were found along the 9 formulae for percentage of eyes in ±0.50D (p=0.82) or ±1.00D (p=0.97). The new graphical method showed less accuracy in ±0.50 D for ACDs from 2.46 to 2.85 mm (5th to 25th percentile) for several formulae (p<0.05). Conclusions: 9 formulae showed non-significant differences in the general predictability for a sample of eyes candidates to MIOL implantation. Predictability in this sample decreased for short ACDs., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Received April 05, 2019; revised form November 27, 2019; Accepted February 08, 2020, Purpose: To evaluate changes in angle kappa following the implantation of a trifocal intraocular lens (IOL), and to assess the postoperative outcomes of patients with different angle kappa values. Setting: IOA Madrid Innova Ocular, Madrid, Spain Design: Prospective trial Methods: Sixty-three patients due to have bilateral implantation of the diffractive trifocal IOL (POD F, PhysIOL, Belgium) were included. Pupil offset was used as the best estimate of angle kappa and was measured using Pentacam (Oculus, Wetzlar, Germany) preoperatively and at 3-months after surgery. Postoperative refractive outcomes (sphere, cylinder, and MRSE) and visual outcomes at far, intermediate and near distance were assessed and compared between eyes with small pupil offset and eyes with large pupil offset. Quality of vision was assessed using a subjective questionnaire. Results: There was significant decrease in pupil offset post-operatively (mean: 0.197 ± 0.12 mm) compared to preoperatively (mean: 0.239 ± 0.12 mm), with a mean decrease of -0.042 mm (P = 0.0002). The same significant decrease was found for both the right eyes and left eyes, when analysed separately. No statistically significant difference was found in any of the refractive and visual acuity outcomes between eyes with small pupil offset and eyes with large pupil offset. The majority of patients (14 out of 16) complaining of significant halos had eyes with small pupil offset. Conclusion: Large pupil offset did not negatively affect visual and refractive outcomes. The tolerance to larger pupil offset might be due to the IOL optical design, with the first diffractive ring being larger than other commonly used multifocal IOLs. More studies comparing various diffractive IOL models will be useful to confirm such hypothesis., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub