We find that tilt and decentration of intraocular lens (IOL) commonly cause visualquality deterioration after cataract surgery. Multiple factors affect IOL tilt anddecentration in the pre-, mid-, and post-operation ph...We find that tilt and decentration of intraocular lens (IOL) commonly cause visualquality deterioration after cataract surgery. Multiple factors affect IOL tilt anddecentration in the pre-, mid-, and post-operation phases. Moreover, the tilt anddecentration of 1-piece IOL are less correlated with internal ocular HOAs thanthose of 3-piece IOL. Aspherical IOLs are more sensitive to decentration or tiltthan spherical IOLs. Furthermore, the optical performance of toric IOLs with anaccurate axis remains stable irrespective of tilt and decentration. The opticalquality of asymmetric multifocal IOLs varies significantly after decentration andtilt in different directions. The image quality enhances or deteriorates in thedirection of the decentered IOL. An extended depth of focus IOL can achievegood visual acuity in the distant, intermediate, and near range. Additionally, itstilt and decentration have less impact on the vision than bifocal and trifocal IOL.This is the first review that compares the effect of IOL tilt and decentration onimage quality for various IOL designs. The result indicates that a deeperunderstanding of tilt and decentration of various IOLs can help achieve a bettervisual effect to visually improve refractive cataract surgery.展开更多
Background:To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses(MfIOLs)in myopic eyes.Methods:Myopic(axial length[AXL]>24.5 mm)and non-myopic(21.0 mm<AXL≤24.5 mm)cataract eyes ...Background:To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses(MfIOLs)in myopic eyes.Methods:Myopic(axial length[AXL]>24.5 mm)and non-myopic(21.0 mm<AXL≤24.5 mm)cataract eyes were enrolled in this prospective study and randomly assigned to receive implantation of Zeiss AT LISA tri 839MP lenses(Group A)or Tecnis ZMB00 lenses(Group B).In total,122 eyes of 122 patients were available for analysis.Decentration and tilt of MfIOLs,high-order aberrations(HOAs),and modulation transfer functions(MTFs)were evaluated using the OPD-Scan III aberrometer 3 months postoperatively.Subjective symptoms were assessed with a Quality of Vision questionnaire.Results:Near and distance visual acuities,tilt and horizontal decentration did not differ between the two groups,postoperatively.However,myopic eyes of Group B showed greater vertical decentration than those of Group A(−0.17±0.14 mm vs.-0.03±0.09 mm,respectively),particularly when the MfIOLs were placed horizontally or obliquely.Overall decentration of myopic eyes was greater in Group B than in Group A(0.41±0.15 mm vs.0.16±0.10 mm,respectively).In Group B,AXL was negatively correlated with vertical decentration and positively correlated with overall decentration.No such correlations were found in Group A.Intraocular total HOAs,coma,trefoil and spherical aberrations were lower in Group A than in Group B for a 6.0 mm pupil among myopic eyes.Generally,Group A had better MTFs and fewer subjective symptoms than Group B among myopic eyes.Conclusions:Plate-haptic design of MfIOLs may be a suggested option for myopic cataract eyes due to the less inferior decentration and better visual quality postoperatively.展开更多
AIM:To investigate the effect of Cionni-modified capsular tension ring(CTR)implantation in patients with severely traumatic subluxated cataracts.METHODS:All patients who totally had traumatic cataracts and lost zonule...AIM:To investigate the effect of Cionni-modified capsular tension ring(CTR)implantation in patients with severely traumatic subluxated cataracts.METHODS:All patients who totally had traumatic cataracts and lost zonule support and underwent cataract surgery were retrospectively analyzed.Corrected distance visual acuity(CDVA),extent of zonulysis,intraocular lens(IOL)position,intraoperative presentation,and complications were assessed.The primary outcomes included IOL centration stability and other postoperative complications.RESULTS:Twenty patients(20 eyes)were included in this study.The mean age in this study was 58.0±11.3y,and the average follow-up time was 17.3±12.8mo.Capsule bags were saved by Cionni-modified CTR.Nine eyes(45%)underwent simultaneously anterior vitrectomy due to the presence of vitreous in the anterior chamber.The preoperative mean CDVA was 0.83±0.24 log MAR,and the postoperative average CDVA was 0.23±0.30 log MAR(P<0.05).The horizontal and vertical IOL decentration after surgery was 0.27±0.12 mm and 0.41±0.19 mm,respectively;the vertical and horizontal IOL tilt after surgery was 5.5°±2.5°and 6.1°±2.2°,respectively.None of the eyes had obvious IOL decentration during the follow-up time.Eight eyes(40%)had posterior capsule opacification(PCO)that was severe enough to cause poor vision.Neodymium:YAG laser capsulotomy were performed on these eyes when the CTR was stabilized.CONCLUSION:With the help of Cionni-modified CTR,capsular bag preservation and better IOL concentration can be achieved without major complications in patients with severely traumatic subluxated cataracts.展开更多
人工晶状体(intraocular lens,IOL)在眼内常有不同程度的倾斜、偏心或旋转,是影响白内障患者术后视觉质量的重要因素。以往常用视力来评价视觉质量,近年来引入像差、调制传递函数(modulation transfer function,MTF)、主观视觉评价等新...人工晶状体(intraocular lens,IOL)在眼内常有不同程度的倾斜、偏心或旋转,是影响白内障患者术后视觉质量的重要因素。以往常用视力来评价视觉质量,近年来引入像差、调制传递函数(modulation transfer function,MTF)、主观视觉评价等新指标,表明IOL偏斜将引起视力下降、像差增加、MTF下降、屈光不正等。因此,更好地评价IOL偏斜对视觉质量的影响,将对IOL选择、定位和白内障个体化治疗具有指导意义。展开更多
Purpose:To evaluate the influence of corneal ablation patterns on the prediction error after cataract surgery in postmyopic-LASIK eyes.Methods:Eighty-three post-myopic-LASIK eyes of 83 patients that underwent uneventf...Purpose:To evaluate the influence of corneal ablation patterns on the prediction error after cataract surgery in postmyopic-LASIK eyes.Methods:Eighty-three post-myopic-LASIK eyes of 83 patients that underwent uneventful cataract surgery were retrospectively included.Predicted postoperative spherical equivalence(SE)was calculated for the implanted lens using the Haigis-L and Barrett True-K formula.Prediction error at one month postsurgery was calculated as actual SE minus predicted SE.For each eye,area and decentration of the ablation zone was measured using the tangential curvature map.The associations between prediction errors and corneal ablation patterns were investigated.Results:The mean prediction error was-0.83±1.00 D with the Haigis-L formula and-1.00±0.99 D with the Barrett True-K formula.Prediction error was positively correlated with keratometry(K)value and negatively correlated with ablation zone area using either formula,and negatively correlated with decentration of the ablation zone using the Barrett True-K formula(all P<0.05).In the K<37.08 D group,prediction error was negatively correlated with decentration of the ablation zone with both formulas(all P<0.05).Multivariate analysis showed that with the Haigis-L formula,prediction error was associated with axial length(AL),K value and decentration,and with the Barrett True-K formula,prediction error was associated with AL and decentration(all P<0.05).Conclusion:A flatter cornea,larger corneal ablation zone and greater decentration will lead to more myopic prediction error after cataract surgery in post-myopic-LASIK eyes.展开更多
目的：通过检测Nd∶YAG激光后囊膜切开术前与术后前房深度、人工晶状体（IOL）倾斜度和偏心量的变化，评估其对IOL稳定性的影响。方法前瞻性研究。纳入2013年3月至2014年9月在温州医科大学附属眼视光医院行Nd∶YAG激光后囊切开术的符合...目的：通过检测Nd∶YAG激光后囊膜切开术前与术后前房深度、人工晶状体（IOL）倾斜度和偏心量的变化，评估其对IOL稳定性的影响。方法前瞻性研究。纳入2013年3月至2014年9月在温州医科大学附属眼视光医院行Nd∶YAG激光后囊切开术的符合入选标准的后发性白内障患者29例（35眼）。术前及术后1个月予以常规眼科检查[包括裸眼视力（UCVA）、最佳矫正视力（BCVA）、眼压（IOP）、眼前段及眼底检查]，并利用眼前节扫频光源相干断层扫描结合Matlab图像分析软件对眼前节进行三维重建，测量前房深度及IOL在x轴（水平方向）和y轴（垂直方向）的倾斜度和偏心量。应用配对样本t检验和符号秩和检验对BCVA、IOP、前房深度及IOL倾斜度和偏心量做相应的统计学分析。结果 BCVA从术前的0.57±0.34（logMAR）提高到术后1个月的0.15±0.15（logMAR），差异有统计学意义（t=7.753，P〈0.01）。术前、术后IOP的差异无统计学意义。术前前房深度为（4.15±0.37）mm，术后1个月为（4.16±0.39）mm，差异无统计学意义。术前、术后1个月IOL在x轴的倾斜度分别为-0.099°（-0.840°-0.057°）和-0.125°（-0.757°-0.067°），在 y 轴的倾斜度分别为-0.015°（-0.564°-0.113°）和-0.014°（-0.210°-0.155°），在x轴的偏心量分别为0.051（-0.066-0.192）mm和0.049（-0.038-0.127）mm，在y轴的偏心量分别为0.111（0.009-0.204）mm和0.106（0.013-0.194）mm，差异均无统计学意义。结论Nd：YAG激光后囊膜切开术是治疗后发性白内障安全有效的方法，术后视力显著提高，IOL稳定，前房深度、IOL的倾斜度和偏心量均无明显改变。展开更多
基金Supported by Haidian District Innovation and Transformation Fund of China,No. HDCXZHK2021212
文摘We find that tilt and decentration of intraocular lens (IOL) commonly cause visualquality deterioration after cataract surgery. Multiple factors affect IOL tilt anddecentration in the pre-, mid-, and post-operation phases. Moreover, the tilt anddecentration of 1-piece IOL are less correlated with internal ocular HOAs thanthose of 3-piece IOL. Aspherical IOLs are more sensitive to decentration or tiltthan spherical IOLs. Furthermore, the optical performance of toric IOLs with anaccurate axis remains stable irrespective of tilt and decentration. The opticalquality of asymmetric multifocal IOLs varies significantly after decentration andtilt in different directions. The image quality enhances or deteriorates in thedirection of the decentered IOL. An extended depth of focus IOL can achievegood visual acuity in the distant, intermediate, and near range. Additionally, itstilt and decentration have less impact on the vision than bifocal and trifocal IOL.This is the first review that compares the effect of IOL tilt and decentration onimage quality for various IOL designs. The result indicates that a deeperunderstanding of tilt and decentration of various IOLs can help achieve a bettervisual effect to visually improve refractive cataract surgery.
基金Publication of this article was supported by research grants from the National Natural Science Foundation of the People’s Republic of China(grant nos.81870642,81670835 and 81470613)the Shanghai High Myopia Study Group,the International Science and Technology Cooperation Foundation of Shanghai(grant no.14430721100)the Outstanding Youth Medical Talents Program of Shanghai Health and Family Planning Commission(grant no.2017YQ011).
文摘Background:To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses(MfIOLs)in myopic eyes.Methods:Myopic(axial length[AXL]>24.5 mm)and non-myopic(21.0 mm<AXL≤24.5 mm)cataract eyes were enrolled in this prospective study and randomly assigned to receive implantation of Zeiss AT LISA tri 839MP lenses(Group A)or Tecnis ZMB00 lenses(Group B).In total,122 eyes of 122 patients were available for analysis.Decentration and tilt of MfIOLs,high-order aberrations(HOAs),and modulation transfer functions(MTFs)were evaluated using the OPD-Scan III aberrometer 3 months postoperatively.Subjective symptoms were assessed with a Quality of Vision questionnaire.Results:Near and distance visual acuities,tilt and horizontal decentration did not differ between the two groups,postoperatively.However,myopic eyes of Group B showed greater vertical decentration than those of Group A(−0.17±0.14 mm vs.-0.03±0.09 mm,respectively),particularly when the MfIOLs were placed horizontally or obliquely.Overall decentration of myopic eyes was greater in Group B than in Group A(0.41±0.15 mm vs.0.16±0.10 mm,respectively).In Group B,AXL was negatively correlated with vertical decentration and positively correlated with overall decentration.No such correlations were found in Group A.Intraocular total HOAs,coma,trefoil and spherical aberrations were lower in Group A than in Group B for a 6.0 mm pupil among myopic eyes.Generally,Group A had better MTFs and fewer subjective symptoms than Group B among myopic eyes.Conclusions:Plate-haptic design of MfIOLs may be a suggested option for myopic cataract eyes due to the less inferior decentration and better visual quality postoperatively.
基金Supported by the National Natural Science Foundation of China(No.82070968)China Postdoctoral Science Foundation(No.2022M712386)+4 种基金Tianjin Health Research Project(No.TJWJ2022MS040,No.ZC20166)Nankai University Eye Institute(No.NKYKK202203,No.NKYKK202206)Tianjin Eye Hospital Research Project(No.YKYB1902)Natural Science Foundation of Tianjin(No.20JCQNJC01860)Tianjin Key Medical Discipine(Specialty)Construction Project(No.TJYXZDXK-016A)。
文摘AIM:To investigate the effect of Cionni-modified capsular tension ring(CTR)implantation in patients with severely traumatic subluxated cataracts.METHODS:All patients who totally had traumatic cataracts and lost zonule support and underwent cataract surgery were retrospectively analyzed.Corrected distance visual acuity(CDVA),extent of zonulysis,intraocular lens(IOL)position,intraoperative presentation,and complications were assessed.The primary outcomes included IOL centration stability and other postoperative complications.RESULTS:Twenty patients(20 eyes)were included in this study.The mean age in this study was 58.0±11.3y,and the average follow-up time was 17.3±12.8mo.Capsule bags were saved by Cionni-modified CTR.Nine eyes(45%)underwent simultaneously anterior vitrectomy due to the presence of vitreous in the anterior chamber.The preoperative mean CDVA was 0.83±0.24 log MAR,and the postoperative average CDVA was 0.23±0.30 log MAR(P<0.05).The horizontal and vertical IOL decentration after surgery was 0.27±0.12 mm and 0.41±0.19 mm,respectively;the vertical and horizontal IOL tilt after surgery was 5.5°±2.5°and 6.1°±2.2°,respectively.None of the eyes had obvious IOL decentration during the follow-up time.Eight eyes(40%)had posterior capsule opacification(PCO)that was severe enough to cause poor vision.Neodymium:YAG laser capsulotomy were performed on these eyes when the CTR was stabilized.CONCLUSION:With the help of Cionni-modified CTR,capsular bag preservation and better IOL concentration can be achieved without major complications in patients with severely traumatic subluxated cataracts.
文摘人工晶状体(intraocular lens,IOL)在眼内常有不同程度的倾斜、偏心或旋转,是影响白内障患者术后视觉质量的重要因素。以往常用视力来评价视觉质量,近年来引入像差、调制传递函数(modulation transfer function,MTF)、主观视觉评价等新指标,表明IOL偏斜将引起视力下降、像差增加、MTF下降、屈光不正等。因此,更好地评价IOL偏斜对视觉质量的影响,将对IOL选择、定位和白内障个体化治疗具有指导意义。
基金This work was supported by research grants from the National Natural Science Foundation of the People's Republic of China(Grant Nos.82122017,81870642,81970780 and 81670835)Shanghai High Myopia Study,Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission(Grant Nos.19441900700 and 21S31904900)+6 种基金National Key R&D Program of China(Grant No.2018YFC0116800)the Outstanding Youth Medical Talents Program of Shanghai Health and Family Planning Commission(Grant No.2017YQ011)the Shanghai Talent Development Fund(Grant No.201604)Clinical Research Plan of Shanghai Shenkang Hospital Development Center(Grant Nos.SHDC12019X08 and SHDC2020CR4078)Double-E Plan of Eye&ENT Hospital(SYA202006)the WIT120 Research Project of Shanghai(Grant No.2018ZHYL0220)the Shanghai Municipal Key Clinical Specialty Program(Grant No.shslczdzko1901).
文摘Purpose:To evaluate the influence of corneal ablation patterns on the prediction error after cataract surgery in postmyopic-LASIK eyes.Methods:Eighty-three post-myopic-LASIK eyes of 83 patients that underwent uneventful cataract surgery were retrospectively included.Predicted postoperative spherical equivalence(SE)was calculated for the implanted lens using the Haigis-L and Barrett True-K formula.Prediction error at one month postsurgery was calculated as actual SE minus predicted SE.For each eye,area and decentration of the ablation zone was measured using the tangential curvature map.The associations between prediction errors and corneal ablation patterns were investigated.Results:The mean prediction error was-0.83±1.00 D with the Haigis-L formula and-1.00±0.99 D with the Barrett True-K formula.Prediction error was positively correlated with keratometry(K)value and negatively correlated with ablation zone area using either formula,and negatively correlated with decentration of the ablation zone using the Barrett True-K formula(all P<0.05).In the K<37.08 D group,prediction error was negatively correlated with decentration of the ablation zone with both formulas(all P<0.05).Multivariate analysis showed that with the Haigis-L formula,prediction error was associated with axial length(AL),K value and decentration,and with the Barrett True-K formula,prediction error was associated with AL and decentration(all P<0.05).Conclusion:A flatter cornea,larger corneal ablation zone and greater decentration will lead to more myopic prediction error after cataract surgery in post-myopic-LASIK eyes.
文摘目的：通过检测Nd∶YAG激光后囊膜切开术前与术后前房深度、人工晶状体（IOL）倾斜度和偏心量的变化，评估其对IOL稳定性的影响。方法前瞻性研究。纳入2013年3月至2014年9月在温州医科大学附属眼视光医院行Nd∶YAG激光后囊切开术的符合入选标准的后发性白内障患者29例（35眼）。术前及术后1个月予以常规眼科检查[包括裸眼视力（UCVA）、最佳矫正视力（BCVA）、眼压（IOP）、眼前段及眼底检查]，并利用眼前节扫频光源相干断层扫描结合Matlab图像分析软件对眼前节进行三维重建，测量前房深度及IOL在x轴（水平方向）和y轴（垂直方向）的倾斜度和偏心量。应用配对样本t检验和符号秩和检验对BCVA、IOP、前房深度及IOL倾斜度和偏心量做相应的统计学分析。结果 BCVA从术前的0.57±0.34（logMAR）提高到术后1个月的0.15±0.15（logMAR），差异有统计学意义（t=7.753，P〈0.01）。术前、术后IOP的差异无统计学意义。术前前房深度为（4.15±0.37）mm，术后1个月为（4.16±0.39）mm，差异无统计学意义。术前、术后1个月IOL在x轴的倾斜度分别为-0.099°（-0.840°-0.057°）和-0.125°（-0.757°-0.067°），在 y 轴的倾斜度分别为-0.015°（-0.564°-0.113°）和-0.014°（-0.210°-0.155°），在x轴的偏心量分别为0.051（-0.066-0.192）mm和0.049（-0.038-0.127）mm，在y轴的偏心量分别为0.111（0.009-0.204）mm和0.106（0.013-0.194）mm，差异均无统计学意义。结论Nd：YAG激光后囊膜切开术是治疗后发性白内障安全有效的方法，术后视力显著提高，IOL稳定，前房深度、IOL的倾斜度和偏心量均无明显改变。
