Above-average defocus curves in photopic and mesopic vision with multifocal intraocular lenses after laser assisted in situ keratomileusis

I am Dr. David P Pifiero from the Department of Optics, Pharmacology and Anatomy of the University of Alicante and from the Department of Ophthalmology of Vithas Medimar （Oftalmar） and Vithas Virgen del Carmen （Qvision） hospitals in Spain.

Comparison of dynamic defocus curve Checkfor updates on cataract patients implanting extended depth of focus and monofocal intraocular

Background:The aim of the study was to compare the dynamic defocus curve on patients post-implantation of the extended depth-of-focus(EDOF)and monofocal intraocular lens(IOL).Methods:A total of 62 age-related cataract patients receiving phacoemulsification with implantation of TECNIS Symfony(ZXRoO)or monofocal IOLs were enrolled.The binocular static and dynamic defocus curves with corrected distance visual acuity were evaluated at one month postoperatively.Results:The ZXR00 group achieved signifcantly better intermediate(P=0.044)and near(P=0.017)visual acuity(VA)than the monofocal group.Two groups had similar uncorrected and corrected distance VA(P>0.05,respectively).The dynamic defocus curve revealed a smoother decline from 0.0 D to-2.0 D in the ZXRo0 group.Defocused dynamic VA in the ZXR00 group was significantly better(P<0.05)except at 0.0 D(P=0.724)and-0.5 D(P=0.176).The area under the curve(P=0.002)and corrected dynamic vision accommodation(P=0.001)derived from the dynamic defocus curves were better in the ZxRoo group.A positive correlation was observed between defocused dynamic and static VA in both groups(P<0.001).Multiple linear regression analysis indicated that defocused static VA and cor-rected dynamic vision accommodation were significant influential factors for the defocused dynamic VA from-1.0 D to-3.0 D(P<0.05).Conclusions:The EDOF IOL provided similar distant vision,better intermediate and near vision,and a better overall dynamic defocus curve than the monofocal IOL.The dynamic defocus curve may be comprehensively applied to evaluate the all-distance dynamic visual performance post-cataract surgery.

Postoperative visual performance with a bifocal and trifocal diffractive intraocular lens during a 1-year follow-up

AIM：To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens（IOL）during a 12-month follow-up.METHODS：Prospective comparative study including75 eyes of 38 patients（44-70y）undergoing uneventful cataract surgery.Each patient was randomly assigned to one type of IOL,bifocal（35 eyes）or trifocal（40 eyes）.Visual,refractive,and contrast sensitivity changes were evaluated in a 12-month follow-up.The binocular defocus curve was also measured at 12mo postoperatively.RESULTS：No statistically significant differences between groups were found in postoperative uncorrected and corrected distance visual acuities（P≥0.276）.Postoperative corrected near visual acuity（33 cm）was significantly better in the trifocal group during all follow-up（P≤0.004）as well as 6-month uncorrected near（P=0.008）and distancecorrected near visual acuities（P=0.016）（33/40 cm）.Significantly better uncorrected intermediate and distance corrected-intermediate visual acuity were found during all follow-up in the trifocal group（P〈0.001）,which was consistent with differences among groups in binocular defocus curve.Differences among groups in contrast sensitivity were minimal,being only significant at 6 months for some low to medium spatial frequencies（P≤0.006）.CONCLUSION：Bifocal and trifocal diffractive IOLs are able to provide an effective visual restoration which is maintained during a 12-month follow-up,with a clear benefit of the trifocal IOL for the intermediate vision.

A More Natural Way of Seeing: Visual Performance of Three Presbyopia Correcting Intraocular Lenses

Purpose: To compare the visual and refractive outcomes, patient satisfaction and spectacle independence between three novel designs of diffractive IOLs. Method: Prospective study including 150 patients with implantation of three IOLs: trifocal diffractive IOL AT LISA tri 839 MP (ATLISA, n = 50), trifocal diffractive IOL PhysIOL FineVision (FineVision, n = 50) and the extended range of vision IOL Tecnis Symfony ZRX00 (Symfony, n = 50). Patients were followed up for 6 months after surgery. Major parameters were monocular and binocular uncorrected (UDVA) and corrected (CDVA) distance, uncorrected (UIVA) and distance corrected (DCIVA) intermediate (80 cm), and uncorrected (UNVA) and distance corrected (DCNVA) near (40 cm) visual acuities (UNVA), contrast sensitivity (CS), defocus curve as well as patient satisfaction and spectacle use. Results: Mean postoperative decimal UDVA was 1.01 for Symfony, 0.96 for ATLISA and 0.95 for the FineVision IOL. Postoperative UIVA was 0.95 with Symfony, 0.72 with ATLISA and 0.85 with the FineVision IOL. Postoperative UNVA was 0.96 with the FineVision, 0.72 with the ATLISA and 0.63 with the Symfony IOL. The Symfony defocus curve showed the smoothest profile. Mean mesopic CS was 0.84 log units with the Symfony, 0.83 with the ATLISA (0.83) and 0.65 with the FineVision IOL. Mean photopic CS with the Symfony, ATLISA and FineVision was 1.05, 0.85 and 0.69 log units, respectively. Twenty percent of the patients with the ATLISA and FineVision IOLs and 5.6% of the Symfony patients reported halos and glare as troublesome or disabling. Reading glasses were frequently used by 5.6% of the Symfony patients. All patients with the trifocal IOLs reported to be spectacle-free for any distance. Conclusion: All 3 IOLs produce excellent results with high levels of spectacle independence. The Symfony produces better levels of distance and intermediate visual acuity, whereas the trifocal IOLs produced better near vision. Higher frequency of dysphotopsia was seen with the trifocal IOLs.