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PURPOSE To compare the visual outcomes in both eyes of patients who undergo phacoemulsification and trifocal intraocular lens (IOL) implantation and have asteroid hyalosis (AH) or synchysis scintillans (SS) in only 1 eye. METHODS This retrospective comparative cases series study evaluated uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), predictability, safety, efficacy, and satisfaction after implantation of the same model of trifocal IOL in both eyes (PhysIOL FineVision Pod-F and Micro-F and Rayner RayOne Trifocal). RESULTS A total of 164 eyes from 82 patients (41 females, 50%) met the inclusion criteria. There were no statistically significant differences in sphere, cylinder, spherical equivalent, UDVA, UIVA, and UNVA between the groups. Postoperative CDVA was slightly better in the control group (logMAR 0.03) than in the AH/SS group (logMAR 0.04) (p: 0.014). There were no statistically significant differences in predictability, safety index, and efficacy index between the groups. Overall subjective satisfaction was good (98.2%). CONCLUSIONS Visual outcomes and satisfaction are good after implantation of trifocal IOLs in eyes with AH or SS. Therefore, trifocal IOLs should not be ruled out in these patients when no other vitreoretinal disorder is present.

Purpose: To observe the distribution characteristics of corneal higher-order aberrations (HOAs) in cataract patients, and analyze the relationship of HOAs with patients' age and ocular biometric parameters. Methods: This cross-sectional study review the patients undergoing cataract surgery in Wuhan Aier Eye Department from January to August 2022. Root mean square (RMS) of the total corneal HOA, spherical aberration (SA), coma and trefoil aberration for a corneal central region of 4mm and 6mm were measured by the Wavefront Aberrometer (OPD-Scan III; Nidek Inc, Tokyo, Japan). The biometric parameters were measured by swept source coherence laser interferometry (OA-2000; TOMEY Corp, Aichi, Japan). Subgroup analyses and multiple linear regression analyses were used to determine whether HOAs were associated with age and ocular biometric parameters. Results: A total of 976 patients (976 eyes) were included, averagely aged 65 years. The mean RMS of total corneal HOA at central 4mm and 6mm optic zone were respectively 0.20μm and 0.65μm, the RMS of SA were 0.06μm and 0.30μm. Total HOA decreased with age until 60 years and then started to increase afterwards. Total HOA, coma and trefoil aberration increased with corneal astigmatism. Total HOA, SA, and coma aberration differ among different AL groups, and emmetropes had the smallest aberration. Conclusions: With increasing age, the value of total HOA decrease first and started increasing at 60 years. The trends of corneal HOAs are consistent with corneal low-order aberrations. The values of total HOA, SA and coma aberration were the smallest in emmetropic eyes.

Purpose To evaluate the tolerance of refractive errors and visual outcomes of extended depth of focus intraocular lens (EDOF IOLs) in patients with previous corneal refractive surgery for myopia. Methods Patients from Wuhan Aier Eye Hospital with previous myopia excimer laser correction underwent cataract surgery and implantation of an EDOF IOL. The follow-up period was three months. The uncorrected distance, intermediate, and near visual acuities (UDVA, UIVA, UNVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), defocus curve, optical quality, including modulation transfer functions (MTF) and Strehl ratio (SR), National Eye Institute Visual Functioning Questionnaire-14 for Chinese people (VF-14-CN), spectacle independence, and dysphotopsia were assessed. Results At the final visit, UDVA, CDVA, UIVA, and UNVA (logMAR) were 0.07 ± 0.09, 0.01 ± 0.04, 0.10 ± 0.08, 0.20 ± 0.11, respectively. The mean spherical equivalent (SE) was ± 0.75 ± 0.49D, where 42% (21 eyes) were within ± 0.50D, 70% (35 eyes) were within ± 1.00D, and 98% (49 eyes) were within ± 1.50D. The defocus curve showed that visual acuity could reach 0.1 in the refractive range of 0 ~ -1.5D. SR and MTF values of 10, 15, 20, 35, and 30 c/d spatial frequency were measured with a 3 mm pupil diameter after removing the influence of low-order aberrations, which were all higher than the values before the operation. The mean VF-14-CN questionnaire score was 51.02 ± 2.95 out of 56. Conclusion The EDOF IOLs have a certain tolerance for refractive errors, and they are recommended for patients with prior myopia excimer laser surgery to achieve satisfactory visual performance.

Purpose: To evaluate the effect on visual outcomes of a diffractive trifocal intraocular lens (IOL) in pars plana vitrectomy (PPV) for removal of epiretinal membrane (ERM) in pseudophakic eyes. Methods: This is retrospective case-series study on 20 eyes with a single model of trifocal IOL that underwent PPV for removal of ERM between January 2015 and September 2018 in our clinics. Follow up was at least 1 year. Primary outcome measure was mean change in visual acuity. Other outcome measures were mean change in central macular thickness (CMT), recovery of the external retinal layers, and change in spherical equivalent (SE). Results: Mean corrected distance visual acuity (CDVA) was 0.03±0.03 logMAR after phacoemulsification; this worsened to 0.23±0.10 logMAR with ERM, improving to 0.10±0.04 log MAR 12 months after PPV (p=0.001). Mean uncorrected near visual acuity (UNVA) was Jaeger 2.62±0.51 after lensectomy. This worsened to Jaeger 5.46±1.67 with ERM and improved to the initial Jaeger 2.69±0.84 after PPV (p=0.005). CMT decreased significantly, from 380.15 ±60.50 µm with the ERM to 313.70 ±36.98 µm after PPV. Mean SE after lensectomy was -0.18 ±0.38 D, which minimally changed to – 0.18±0.47 D after PPV (p=0.99). The only complication recorded after PPV was a case of cystoid macular edema. No difficulties in visualization due to IOL design were reported during PPV. Conclusion: PPV for ERM in eyes with this trifocal IOL is safe and effective, and allows recovery of the loss of UNVA.