Search

Purpose: Intraocular lens designs are constantly evolving, trying to obtain more spectacle independence after cataract surgery. This advantage can be linked to some disadvantages, such as optical quality decrease. For that reason, it is important to assess, not only the amount of vision provided but also the quality of vision once they are implanted. The purpose of the present work was to compare the visual performance between two monofocal intraocular models: a standard model and a monofocal with enhanced intermediate vision lens., Methods: Prospective, randomized, comparative study. Sixty adult subjects scheduled to undergo bilateral cataract surgery and IOL implantation were randomized to receive one of the two IOLs in both eyes at Miranza IOA, Madrid, Spain (group A: monofocal with enhanced intermediate vision lens and group B: standard monofocal lens). Monocular outcomes (right eyes) determined 1 and 3 months postoperatively were photopic corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), perceived halo, corrected intermediate-distance contrast sensitivity, and higher-order aberrations. The impact of the new IOL in the postoperative management with autorefraction devices was also evaluated., Results: No differences were found in CDVA between the two groups. Significant differences were detected between the two lenses evaluated in both total HOA (p = 0.028) and internal HOA (p = 0.037). Contrast sensitivity and halometry results obtained at 1 month were similar across the two IOL groups., Conclusion: In patients undergoing cataract surgery, monofocal with enhanced intermediate vision IOL offered similar distance performance and contrast sensitivity along with perceived HOA and halos compared with the standard monofocal IOLs tested., (© 2022. The Author(s).)

Purpose: To evaluate changes in angle κ after the implantation of a trifocal intraocular lens (IOL) and to assess the postoperative outcomes of patients with different angle κ values., Setting: IOA Madrid Innova Ocular, Madrid, Spain., Design: Prospective trial., Methods: Sixty-three eyes from 63 patients who had bilateral implantation of a diffractive trifocal IOL (POD F, PhysIOL) were included. Pupil offset was used as the best estimate of angle κ and was measured using Pentacam (Oculus) preoperatively and at 3 months postoperatively. Postoperative refractive outcomes (sphere, cylinder, and manifest refraction spherical equivalent) 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 a significant decrease in pupil offset values postoperatively (mean: 0.197 ± 0.12 mm) compared with those preoperatively (mean: 0.239 ± 0.12 mm), with a mean decrease of -0.042 mm (P = .0002). The same significant decrease was found for both right and left eyes, when analyzed 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 of 16) complaining of significant halos had eyes with small pupil offset., Conclusions: 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 would be useful to confirm such hypothesis.

Purpose: To study the agreement between manifest refraction and objective refraction measured with two autorefractor models and an aberrometer in eyes implanted with a trifocal diffractive intraocular lens (IOL)., Setting: IOA Madrid Innova Ocular, Madrid, Spain., Design: Prospective comparative cohort study., Methods: An autorefractor keratometer (KR-8800), based on a Scheiner double pinhole, and a 3-dimension wavefront topography aberrometer system (OPD-Scan III), based on the scanning-slit retinoscopy principle, were used to obtain objective refraction readings. In addition, lower-order Zernike coefficients (Z) were used to calculate objective refraction. A set of 7 different results was obtained in power vector notation (spherical equivalent [SE], Jackson cross-cylinder, axes at 180 degrees and 90 degrees [J0] and Jackson cross-cylinder, axes at 45 degrees and 135 degrees [J45]) for 7 different methods: manifest refraction, autorefraction obtained with the autorefractor keratometer, WF-P (Z-based objective refraction for the photopic pupil), WF-M (Z-based objective refraction for the mesopic pupil), WF-4 (Z-based objective refraction for a 4.0 mm pupil), OPD-C (autorefraction measured with the 3-dimension wavefront topography aberrometer system under photopic conditions), and OPD-M (autorefraction measured with the 3-dimension wavefront topography aberrometer system under mesopic conditions)., Results: The study comprised 102 eyes from 51 cataract patients who underwent binocular implantation of a diffractive trifocal IOL (FineVision POD F). All 6 objective methods yielded more negative SE values than manifest refraction (P < .001). As for the astigmatism components (J0 and J45), only autorefraction (P = .003) and OPD-M (P < .001) differed significantly from manifest refraction. The best and worst correlation for the SE component were intraclass correlation coefficient (ICC) = 0.70 (for WF-M) and ICC = 0.48 (for WF-4)., Conclusion: Objective methods tend to yield more negative sphere values than manifest refraction., (Copyright © 2019 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)