Toric and toric multifocal IOLs in meridional amblyopia

【正】Dear Sir,M eridional amblyopia is sometimes put forward as a reason for not implanting Toric intraocular lenses(IOLs).It has been noted that patients with high levels of childhood astigmatism(】3 DC)can develop persistent orientation-dependent visual deficits despite optical correction.Studies by Mitchell et al[1]demonstrated that meridional visual deprivation during the critical period of visual development results in permanently reduced response to stimuli in those orientations.This phenomenon was termed

Retinal image quality with multifocal, EDoF, and accommodative intraocular lenses as studied by pyramidal aberrometry

BackgroundTo study and compare the clinical optical image quality following implantation with different premium IOLs by analysing the point spread function (PSF) Strehl ratio using a pyramidal wavefront sensor (PWS)-based aberrometer.MethodsThis study included 194 eyes implanted with: (a) 19 AcrySof SA60AT (control group);(b) 19 Miniwell;(c) 24 LENTIS Mplus LS-313 MF30;(d) 33 LENTIS Mplus LS-313 MF15;(e) 17 AkkoLens Lumina;(f) 31 AT LISA Tri 839MP;(g) 20 Precizon Presbyopic;(h) 20 AcrySof IQ PanOptix;(i) 11 Tecnis Eyhance. Main outcome measures were PSF Strehl ratio, PSF Strehl ratio excluding second-order aberrations (PSFw2), total root mean square (RMS), low-order aberration (LOA) and high-order aberration (HOA) RMS measured by PWS aberrometer.ResultsAT LISA Tri had the highest PSFw2 Strehl ratio at both 3.0- and 4.0-mm pupil size (0.52 ± 0.14 and 0.31 ± 0.10;P < 0.05), followed by SA60AT (0.41 ± 0.11 and 0.28 ± 0.07) and PanOptix (0.4 ± 0.07 and 0.26 ± 0.04). AT LISA Tri was found to provide a significantly better retinal image quality than PanOptix at both 3.0 mm (P < 0.0001) and 4.0 mm (P = 0.004). Mplus MF15 was found to be significantly better than Mplus MF30 at both 3.0 mm (P < 0.0001) and 4.0 mm (P = 0.002). Total RMS, LOA RMS, HOA RMS, PSF Strehl ratio and PSFw2 varied significantly between the studied groups (P < 0.001).ConclusionsFar distance clinical image quality parameters measured by PWS aberrometer differed significantly according to the technology of the implanted lens. AT LISA Tri, SA60AT and PanOptix showed the highest values of far distance retinal image quality, while the lowest PSFw2 Strehl ratios were displayed by Miniwell, Mplus MF30 and Precizon Presbyopic.

Retinal image quality with multifocal,EDoF,and accommodative intraocular lenses as studied by pyramidal aberrometry

Background:To study and compare the clinical optical image quality following implantation with different premium IOLs by analysing the point spread function(PSF)Strehl ratio using a pyramidal wavefront sensor(PWS)-based aberrometer.Methods:This study included 194 eyes implanted with:(a)19 AcrySof SA60AT(control group);(b)19 Miniwell;(c)24 LENTIS Mplus LS-313 MF30;(d)33 LENTIS Mplus LS-313 MF15;(e)17 AkkoLens Lumina;(f)31 AT LISA Tri 839MP;(g)20 Precizon Presbyopic;(h)20 AcrySof IQ PanOptix;(i)11 Tecnis Eyhance.Main outcome measures were PSF Strehl ratio,PSF Strehl ratio excluding second-order aberrations(PSFw2),total root mean square(RMS),low-order aberration(LOA)and high-order aberration(HOA)RMS measured by PWS aberrometer.Results:AT LISA Tri had the highest PSFw2 Strehl ratio at both 3.0-and 4.0-mm pupil size(0.52±0.14 and 0.31±0.10;P<0.05),followed by SA60AT(0.41±0.11 and 0.28±0.07)and PanOptix(0.4±0.07 and 0.26±0.04).AT LISA Tri was found to provide a significantly better retinal image quality than PanOptix at both 3.0 mm(P<0.0001)and 4.0 mm(P=0.004).Mplus MF15 was found to be significantly better than Mplus MF30 at both 3.0 mm(P<0.0001)and 4.0 mm(P=0.002).Total RMS,LOA RMS,HOA RMS,PSF Strehl ratio and PSFw2 varied significantly between the studied groups(P<0.001).Conclusions:Far distance clinical image quality parameters measured by PWS aberrometer differed significantly according to the technology of the implanted lens.AT LISA Tri,SA60AT and PanOptix showed the highest values of far distance retinal image quality,while the lowest PSFw2 Strehl ratios were displayed by Miniwell,Mplus MF30 and Precizon Presbyopic.

The relationship between patient satisfaction and visual and optical outcome after bilateral implantation of an extended depth of focus multifocal intraocular lens

Purpose:To evaluate patient satisfaction after implantation of the Tecnis Symfony multifocal intraocular lens(MIOL).Methods:120 eyes of 60 subjects with senile cataract were bilaterally implanted with the Tecnis Symfony IOL.Follow-up examination was performed 6 months postoperatively.Main outcome measures included uncorrected and corrected distance and near visual acuity,manifest refraction,and visual quality metrics.According to their subjective symptoms patient were divided in two groups:satisfied and unsatisfied.Results:Uncorrected intermediate(0.15±0.11 vs 0.18±0.01,P=0.04)and near(0.26±0.12 vs 0.31±0.11,P=0.04)(UIVA,UNVA)log MAR visual acuity was significantly better,cylindrical error less(0.31±0.36 vs 0.67±0.29,P=0.05),axial length(AL)smaller(23.68±1.3 vs 24.22±1.6,P=0.05),Strehl ratio higher(0.08±0.08 vs 0.05±0.04,P=0.03)and mesopic pupil larger(4.3±1.1 vs 3.7±1.05,P=0.01)among satisfied patients.Residual cylinder,Strehl ratio,halos,mesopic pupil diameter and UNVA were significant predictors of patient satisfaction.Uncorrected distance visual acuity,higher order Strehl ratio and pupil diameter were significant predictors of halos.Near visual acuity significantly correlated(P=0.018,R=0.22)with axial length.Conclusions:Uncorrected cylindrical error,poor reading quality,larger pupil and halos seem to be the most disturbing factors for patients implanted with the Tecnis Symfony IOL.