AIM: To evaluate contrast visual acuity(CVA) after implantation of an aspheric apodized diffractive intraocular lens(IOL) or a spherical apodized diffractive IOL in cataract surgery. ·METHODS: This prospective ra...AIM: To evaluate contrast visual acuity(CVA) after implantation of an aspheric apodized diffractive intraocular lens(IOL) or a spherical apodized diffractive IOL in cataract surgery. ·METHODS: This prospective randomized controlled study with a 12-month follow-up compared the results of cataract surgery with implantation of an aspheric AcrySof ReSTOR SN6AD3 IOL(30 eyes) and a spherical AcrySof ReSTOR SN60D3 IOL(30 eyes). CVA with best distance correction was measured at 4 contrast levels(100%,25%,10% and 5%) under 3 levels of chart luminance [250,85 and 25 candelas per square meter(cd/m2)] using a multi-functional visual acuity tester(MFVA-100). ·RESULTS: At 12 months after surgery,there were no statistically significant differences in 100% CVA and 25% CVA under 250cd/m2(P100% =0.875 and P25% =0.057) and 85cd/m2(P100% =0.198 and P25% =0.193) between the aspheric group and the spherical group. However,the 10% CVA and 5% CVA were significant better in aspheric group than spherical group under 250cd/m2(P10% =0.042 and P5% = 0.007) and 85cd/m2(P10% =0.002 and P5%=0.039). Under the luminance level of 25cd/m 2,no significant differences was found in the 100% CVA between the 2 group(P100% = 0.245),while aspheric group had better visual acuity in the remaining 3 contracts(P25% =0.023,P10% =0.026 and P5% = 0.002,respectively). ·CONCULSION: The aspheric AcrySof ReSTOR SN6AD3 IOL provided patients with better low-contrast visual acuity than the spherical AcrySof ReSTOR SN60D3 IOL.展开更多
AIM: To investigate the effects of intraocular lens(IOL) implantation on visual field(VF) in patients with glaucoma and comorbid cataracts(G&C) with different disease severities.METHODS: Totally 56 eyes of 50 pati...AIM: To investigate the effects of intraocular lens(IOL) implantation on visual field(VF) in patients with glaucoma and comorbid cataracts(G&C) with different disease severities.METHODS: Totally 56 eyes of 50 patients with primary G&C were included. All patients were divided into three groups based on the severity of the VF defect: the mild, moderate, and severe stage. Phacoemulsification was performed for cataract removal combined with IOL implantation. Visual acuity(VA) and VF tests were performed for all enrolled patients, up to 3 mo after surgery. Changes in VF threshold and global VF index in various groups were also recorded before and after surgery. The mean light sensitivity(MS) values and the changes following surgery(DMS) were compared between the three groups. Advanced Glaucoma Intervention Study(AGIS) scoring was analyzed on all VF results for analysis of changes in VF before and after surgery.RESULTS: Following surgery, the MS values of the three groups of G&C increased significantly, while the AGIS scores decreased statistically in all groups. The DMS values for the three zones in moderate and severe stage but not mild stage were statistically different between zones. The DMS value was significantly higher in zone I than those in zone II and III(zone I>zone II>zone III;P<0.05). The DMS was significantly higher in zone I than that in zone III in moderate stage patients(zone I>zone II>zone III;P<0.01), while the DMS values in the severe stage patients was significantly higher in zone I than those in zone II and III(zone I>zone II>zone III;P<0.01). CONCLUSION: The mean VF sensitivity of glaucoma patients increased significantly after cataract removal and IOL implantation. Variations in the severity and distribution of characteristics of VF defects result in differences in postoperative VF improvements after cataract surgery. The magnitude of increase in VF sensitivity is associated with VF defect characteristic in glaucoma.展开更多
·AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ...·AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ·METHODS: Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively: monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire. ·RESULTS:Threemonthspostoperatively,themonocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups. ·CONCLUSION: Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractive power than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo. ·展开更多
AIM: To compare the clinical outcomes of a variety of multifocal intraocular lenses(MIOLs) in patients diagnosed with presbyopia or cataracts. METHODS: This clinical trial study included 141 patients(282 eyes) with di...AIM: To compare the clinical outcomes of a variety of multifocal intraocular lenses(MIOLs) in patients diagnosed with presbyopia or cataracts. METHODS: This clinical trial study included 141 patients(282 eyes) with different MIOLs implantation. The Symfony(60 eyes), the Re STOR(100 eyes), the AT LISAtri(60 eyes), and the Pan Optix(62 eyes) intraocular lenses were evaluated in this prospective interventional study. The near, intermediate, and distant visual acuities, contrast sensitivity, and defocus curve were measured as valid criteria. To statistically analyze the results, we used the Statistical Package for Social Science software, the non-parametric Wilcoxon signed-rank t, the one-way analysis of variance and the Tukey’s post-hoc test in our analysis. Moreover, we conducted a detailed literature search on the Pub Med database in English about MIOLs, in total 59 studies were included in this review article.RESULTS: The four approaches did not show any significant difference in the best-corrected distance visual acuity(P>0.05). The defocus curves at the contrast of 100% showed that trifocal IOLs had better intermediate performance than the bifocal IOL(P<0.05). There were no statistically significant differences between AT LISAtri and Pan Optix lenses for visual acuity at all distances. The eyes with Pan Optix, Symfony, and AT LISAtri IOL showed better contrast sensitivity than those Re STOR at spatial frequencies of 1, 3, and 6 cpd in photopic and mesopic conditions(P<0.001). CONCLUSION: All four groups of the multifocal lenses were satisfying in terms of distance and near vision. Also, the group of trifocal lenses led to satisfactory outcomes in intermediate vision, without degradation in quality of vision.展开更多
AIM:To compare the visual performance of pseudophakic eyes implanted with Al-UV and SN60WF aspheric intraocular lens(IOL),and to investigate the correlations between visual quality parameters and pupil size.METHODS:Th...AIM:To compare the visual performance of pseudophakic eyes implanted with Al-UV and SN60WF aspheric intraocular lens(IOL),and to investigate the correlations between visual quality parameters and pupil size.METHODS:This prospective comparative study included 105 eyes of 90 patients with age-related cataract who underwent uneventful phacoemulsification.The subjects were divided into two groups according to the implanted IOL type.Three months postoperatively,visual acuity and contrast sensitivity were measured,wave-front aberrations were assessed using a KR-IW aberrometer(Topcon),and objective optical quality parameters were performed using an optical quality analysis system-OQAS Il(Visiometrics).Independent sample Mest and Spearman correlation analysis were used for data analysis.RESULTS:There were no significant differences found in visual acuity,contrast sensitivity and visual quality parameters between the two groups(P>0.05).The measured intraocular spherical aberration(SA)in Al-UV IOL eyes of-0.19±0.05 pm was close to the designed SA value of-0.20 pm.The modulation transfer function cutoff,Strehl ratio and OQAS values were negatively correlated with pupil size in both groups(P<0.01).CONCLUSION:The subjective and objective visual quality in pseudophakic eyes with A1-UV and SN60WF IOLs are comparable.For aspheric IOL eyes,visual quality decreases with increasing pupil size.展开更多
Purpose: To assess the visual outcome after implantation of the new Hydrophylic IOL type 41 B/G accommodating intraocular lens (AIOL). Methods: The presented lens was implanted during cataract surgery. All patients we...Purpose: To assess the visual outcome after implantation of the new Hydrophylic IOL type 41 B/G accommodating intraocular lens (AIOL). Methods: The presented lens was implanted during cataract surgery. All patients were offered follow-ups, allowing two postoperative measurements to be performed at 3 months and between 2020 and 2021. The mean time between lens implantation and last follow-up was 5.3 years (min. 1 year, max. 10 years). Excluded were patients with age-related macular degeneration or amblyopia. Patients with a foreign lens implanted into the second eye were included in a separate control group. Corrected distance (CDVA) and uncorrected distance visual acuity (UDVA) at 5 m, and corrected near (CNVA) and uncorrected near visual acuity (UNVA) at 40 cm were assessed. Furthermore, the postoperative spherical equivalent (SE), the dependence on spectacles and the occurrence of optical phenomena were evaluated. Results: The final study cohort consists of 65 patients with 119 implanted AIOLs. Significantly better visual results were obtained in both postoperative follow-ups compared with the preoperative results. The mean values of the last follow-up for the UNVA, CNVA, UDVA, and CDVA were 0.107 ± 0.10;0.039 ± 0.08;0.097 ± 0.11;and 0.040 ± 0.09 logMAR, respectively. Visual outcomes remained on a high level for up to 10 years and showed significantly better results compared to the control group. Postoperative SE was significantly improved. Nearly 70% of patients were no longer dependent on glasses. Furthermore, the occurrence of disturbing optical phenomena was denied by all patients. Conclusion: The results of this AIOL are particularly promising, especially since gratifying visual results could still be measured 10 years after implantation.展开更多
AIM: To evaluate the effect of different lens constant optimization methods on the accuracy of intraocular lens(IOL) power calculation formulas for highly myopic eyes.METHODS: This study comprised 108 eyes of 94 conse...AIM: To evaluate the effect of different lens constant optimization methods on the accuracy of intraocular lens(IOL) power calculation formulas for highly myopic eyes.METHODS: This study comprised 108 eyes of 94 consecutive patients with axial length(AL) over 26 mm undergoing phacoemulsification and implantation of a Rayner(Hove, UK) 920H IOL. Formulas were evaluated using the following lens constants: manufacturer’s lens constant, User Group for Laser Interference Biometry(ULIB) constant, and optimized constant for long eyes. Results were compared with Barrett Universal II formula, original Wang-Koch AL adjustment method, and modified Wang-Koch AL adjustment method. The outcomes assessed were mean absolute error(MAE) and percentage of eyes with IOL prediction errors within ±0.25, ±0.50, and ±1.0 diopter(D). The nonparametric method, Friedman test, was used to compare MAE performance among constants.RESULTS: Optimized constants could significantly reduce the MAE of SRK/T, Hoffer Q, and Holladay 1 formulas compared with manufacturer’s lens constant, whereas the percentage of eyes with IOL prediction errors within ±0.25, ±0.50, and ±1.0 D had no statistically significant differences. Optimized lens constant for long eyes alone showed non-significant refractive advantages over the ULIB constant. Barrett Universal II formula and formulas with AL adjustment showed significantly higher accuracy in highly myopic eyes(P<0.001). CONCLUSION: Lens constant optimization for the subset of long eyes reduces the refractive error only to a limited extent for highly myopic eyes.展开更多
AIM:To evaluate the surgical treatment and visual outcomes of eyes with cataract and persistent hyperplastic primary vitreous(PHPV).METHODS:This retrospective study included patients with cataract and PHPV treated...AIM:To evaluate the surgical treatment and visual outcomes of eyes with cataract and persistent hyperplastic primary vitreous(PHPV).METHODS:This retrospective study included patients with cataract and PHPV treated with various strategies.Anterior PHPV was treated using phacoemulsification with underwater electric coagulation on posterior capsule neovascularization,posterior capsulotomy,anterior vitrectomy,and intraocular lens(IOL)implantation. Posterior PHPV was treated with lensectomy,posterior vitrectomy,retinal photocoagulation,and IOL implantation or silicone oil tamponade. Visual acuity(VA),pattern visual evoked potential(P-VEP),anatomic recovery,postoperative complications,and amblyopia outcome were examined.Subjects were followed-up for 3-48 mo after surgery.RESULTS:Of the 30 patients(33 eyes)with congenital cataract and PHPV included(average age,39.30±35.47mo),9 eyes had anterior PHPV and 24 had posterior PHPV. Thirty-two eyes were surgically treated. Eyes with anterior PHPV received an IOL during one-stage(6 eyes)and twostage(3 eyes)implantation. Postoperative complications included retinal detachment(1 eye)and recurrent anterior chamber hemorrhage(1 eye). In eyes with posterior PHPV,6 and 11 eyes received IOLs in one-and two-stage procedures,respectively. Silicone oil was retained in 2 eyes,and IOLs were not implanted in 4 eyes. VA significantly improved in 25 eyes following operations and 3-48 mo of amblyopia treatment. P-VEP P_(100) was improved following surgery in both PHPV types.CONCLUSION:Our surgical strategies are appropriate and effective for anterior and posterior PHPV. Early surgical intervention and amblyopia therapy result in positive treatment outcomes.展开更多
BACKGROUND Phakic intraocular lens(pIOL)implantation has been commonly prescribed and is considered as a safe and effective option for correcting high myopia.However,it is associated with multiple complications.CASE S...BACKGROUND Phakic intraocular lens(pIOL)implantation has been commonly prescribed and is considered as a safe and effective option for correcting high myopia.However,it is associated with multiple complications.CASE SUMMARY This report describes a case of full-thickness macular hole(MH)in a patient with a history of bilateral pIOL implantation for the correction of myopia of–12.00 diopters in both eyes 7 mo ago.The MH closed after pars plana vitrectomy with internal limiting membrane removal and the best-corrected visual acuity improved to 20/40 in the left eye.CONCLUSION In rare cases,MH can occur following pIOL.In this present case report,we analyzed the formation process of MH following the surgery and emphasized that it is important to inform highly myopic patients about the risk of MH occurrence while being aware of the symptoms of this complication.展开更多
BACKGROUND Asymmetric multifocal intraocular lenses(IOLs)are now widely used in the modern cataract surgery,providing a good level of visual performance over a range of distances and high postoperative patient satisfa...BACKGROUND Asymmetric multifocal intraocular lenses(IOLs)are now widely used in the modern cataract surgery,providing a good level of visual performance over a range of distances and high postoperative patient satisfaction.We report a case of improved visual quality after shifting the near segment of an asymmetrical multifocal IOL to the superotemporal placement in the dominant eye of a glaucoma patient.CASE SUMMARY A 72-year-old woman with bilateral glaucoma underwent phacoemulsification in the dominant eye(left eye)with implantation of an asymmetrical multifocal IOL.Postoperative uncorrected distance visual acuity(UDVA)was 0.0 logMAR(20/20 Snellen)and uncorrected near visual acuity(UNVA)was 0.1 logMAR(20/25 Snellen).Two weeks later,the patient presented to our clinic with decreased vision due to migration of lens epithelial cells to IOL anterior surface and edema of corneal endothelial cells.Anterior capsule polishing and superotemporal placement of near segment[+3.00 diopter(D)addition(add)]of IOL were performed.As a result,UDVA at the first week and first year after reposition was 0.0 logMAR(20/20 Snellen),and compared with 0.3 logMAR(20/40 Snellen)in the first week,the UNVA was improved to 0.0 logMAR(20/20 Snellen)one year after surgery.CONCLUSION The postoperative inflammatory reaction and lens epithelial cells proliferation were obvious in this glaucoma patient.Capsule polishing and rotation of the lens were beneficial to the patient,which not only enhanced the patient's vision,but also improved the patient's satisfaction.Therefore,glaucoma patients need to be cautious of implanting multifocal IOLs.Placement of a near segment of an asymmetrical multifocal IOL in the dominant eye should be performed on an individual basis.展开更多
文摘AIM: To evaluate contrast visual acuity(CVA) after implantation of an aspheric apodized diffractive intraocular lens(IOL) or a spherical apodized diffractive IOL in cataract surgery. ·METHODS: This prospective randomized controlled study with a 12-month follow-up compared the results of cataract surgery with implantation of an aspheric AcrySof ReSTOR SN6AD3 IOL(30 eyes) and a spherical AcrySof ReSTOR SN60D3 IOL(30 eyes). CVA with best distance correction was measured at 4 contrast levels(100%,25%,10% and 5%) under 3 levels of chart luminance [250,85 and 25 candelas per square meter(cd/m2)] using a multi-functional visual acuity tester(MFVA-100). ·RESULTS: At 12 months after surgery,there were no statistically significant differences in 100% CVA and 25% CVA under 250cd/m2(P100% =0.875 and P25% =0.057) and 85cd/m2(P100% =0.198 and P25% =0.193) between the aspheric group and the spherical group. However,the 10% CVA and 5% CVA were significant better in aspheric group than spherical group under 250cd/m2(P10% =0.042 and P5% = 0.007) and 85cd/m2(P10% =0.002 and P5%=0.039). Under the luminance level of 25cd/m 2,no significant differences was found in the 100% CVA between the 2 group(P100% = 0.245),while aspheric group had better visual acuity in the remaining 3 contracts(P25% =0.023,P10% =0.026 and P5% = 0.002,respectively). ·CONCULSION: The aspheric AcrySof ReSTOR SN6AD3 IOL provided patients with better low-contrast visual acuity than the spherical AcrySof ReSTOR SN60D3 IOL.
基金Supported by the National Natural Science Foundation of China(No.81760170)the Shandong Provincial Natural Science Foundation(No.ZR2019MH135No.ZR2019PH110)。
文摘AIM: To investigate the effects of intraocular lens(IOL) implantation on visual field(VF) in patients with glaucoma and comorbid cataracts(G&C) with different disease severities.METHODS: Totally 56 eyes of 50 patients with primary G&C were included. All patients were divided into three groups based on the severity of the VF defect: the mild, moderate, and severe stage. Phacoemulsification was performed for cataract removal combined with IOL implantation. Visual acuity(VA) and VF tests were performed for all enrolled patients, up to 3 mo after surgery. Changes in VF threshold and global VF index in various groups were also recorded before and after surgery. The mean light sensitivity(MS) values and the changes following surgery(DMS) were compared between the three groups. Advanced Glaucoma Intervention Study(AGIS) scoring was analyzed on all VF results for analysis of changes in VF before and after surgery.RESULTS: Following surgery, the MS values of the three groups of G&C increased significantly, while the AGIS scores decreased statistically in all groups. The DMS values for the three zones in moderate and severe stage but not mild stage were statistically different between zones. The DMS value was significantly higher in zone I than those in zone II and III(zone I>zone II>zone III;P<0.05). The DMS was significantly higher in zone I than that in zone III in moderate stage patients(zone I>zone II>zone III;P<0.01), while the DMS values in the severe stage patients was significantly higher in zone I than those in zone II and III(zone I>zone II>zone III;P<0.01). CONCLUSION: The mean VF sensitivity of glaucoma patients increased significantly after cataract removal and IOL implantation. Variations in the severity and distribution of characteristics of VF defects result in differences in postoperative VF improvements after cataract surgery. The magnitude of increase in VF sensitivity is associated with VF defect characteristic in glaucoma.
基金Zhejiang Key Innovation Team Project(No. 2009R50039)Doctoral Fund of Ministry of Education of China (No: 20100101120135)Key Lab Fund of Zhejiang Province, China (No. 2011E10006)
文摘·AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ·METHODS: Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively: monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire. ·RESULTS:Threemonthspostoperatively,themonocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups. ·CONCLUSION: Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractive power than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo. ·
文摘AIM: To compare the clinical outcomes of a variety of multifocal intraocular lenses(MIOLs) in patients diagnosed with presbyopia or cataracts. METHODS: This clinical trial study included 141 patients(282 eyes) with different MIOLs implantation. The Symfony(60 eyes), the Re STOR(100 eyes), the AT LISAtri(60 eyes), and the Pan Optix(62 eyes) intraocular lenses were evaluated in this prospective interventional study. The near, intermediate, and distant visual acuities, contrast sensitivity, and defocus curve were measured as valid criteria. To statistically analyze the results, we used the Statistical Package for Social Science software, the non-parametric Wilcoxon signed-rank t, the one-way analysis of variance and the Tukey’s post-hoc test in our analysis. Moreover, we conducted a detailed literature search on the Pub Med database in English about MIOLs, in total 59 studies were included in this review article.RESULTS: The four approaches did not show any significant difference in the best-corrected distance visual acuity(P>0.05). The defocus curves at the contrast of 100% showed that trifocal IOLs had better intermediate performance than the bifocal IOL(P<0.05). There were no statistically significant differences between AT LISAtri and Pan Optix lenses for visual acuity at all distances. The eyes with Pan Optix, Symfony, and AT LISAtri IOL showed better contrast sensitivity than those Re STOR at spatial frequencies of 1, 3, and 6 cpd in photopic and mesopic conditions(P<0.001). CONCLUSION: All four groups of the multifocal lenses were satisfying in terms of distance and near vision. Also, the group of trifocal lenses led to satisfactory outcomes in intermediate vision, without degradation in quality of vision.
基金Supported by Project of Science&Technology Department of Sichuan Province(No.2019YJ0381)Key Project of Sichuan Health and Family Planning Commission(No.18ZD022).
文摘AIM:To compare the visual performance of pseudophakic eyes implanted with Al-UV and SN60WF aspheric intraocular lens(IOL),and to investigate the correlations between visual quality parameters and pupil size.METHODS:This prospective comparative study included 105 eyes of 90 patients with age-related cataract who underwent uneventful phacoemulsification.The subjects were divided into two groups according to the implanted IOL type.Three months postoperatively,visual acuity and contrast sensitivity were measured,wave-front aberrations were assessed using a KR-IW aberrometer(Topcon),and objective optical quality parameters were performed using an optical quality analysis system-OQAS Il(Visiometrics).Independent sample Mest and Spearman correlation analysis were used for data analysis.RESULTS:There were no significant differences found in visual acuity,contrast sensitivity and visual quality parameters between the two groups(P>0.05).The measured intraocular spherical aberration(SA)in Al-UV IOL eyes of-0.19±0.05 pm was close to the designed SA value of-0.20 pm.The modulation transfer function cutoff,Strehl ratio and OQAS values were negatively correlated with pupil size in both groups(P<0.01).CONCLUSION:The subjective and objective visual quality in pseudophakic eyes with A1-UV and SN60WF IOLs are comparable.For aspheric IOL eyes,visual quality decreases with increasing pupil size.
文摘Purpose: To assess the visual outcome after implantation of the new Hydrophylic IOL type 41 B/G accommodating intraocular lens (AIOL). Methods: The presented lens was implanted during cataract surgery. All patients were offered follow-ups, allowing two postoperative measurements to be performed at 3 months and between 2020 and 2021. The mean time between lens implantation and last follow-up was 5.3 years (min. 1 year, max. 10 years). Excluded were patients with age-related macular degeneration or amblyopia. Patients with a foreign lens implanted into the second eye were included in a separate control group. Corrected distance (CDVA) and uncorrected distance visual acuity (UDVA) at 5 m, and corrected near (CNVA) and uncorrected near visual acuity (UNVA) at 40 cm were assessed. Furthermore, the postoperative spherical equivalent (SE), the dependence on spectacles and the occurrence of optical phenomena were evaluated. Results: The final study cohort consists of 65 patients with 119 implanted AIOLs. Significantly better visual results were obtained in both postoperative follow-ups compared with the preoperative results. The mean values of the last follow-up for the UNVA, CNVA, UDVA, and CDVA were 0.107 ± 0.10;0.039 ± 0.08;0.097 ± 0.11;and 0.040 ± 0.09 logMAR, respectively. Visual outcomes remained on a high level for up to 10 years and showed significantly better results compared to the control group. Postoperative SE was significantly improved. Nearly 70% of patients were no longer dependent on glasses. Furthermore, the occurrence of disturbing optical phenomena was denied by all patients. Conclusion: The results of this AIOL are particularly promising, especially since gratifying visual results could still be measured 10 years after implantation.
基金Supported by National Natural Science Foundation of China(No.81770905)
文摘AIM: To evaluate the effect of different lens constant optimization methods on the accuracy of intraocular lens(IOL) power calculation formulas for highly myopic eyes.METHODS: This study comprised 108 eyes of 94 consecutive patients with axial length(AL) over 26 mm undergoing phacoemulsification and implantation of a Rayner(Hove, UK) 920H IOL. Formulas were evaluated using the following lens constants: manufacturer’s lens constant, User Group for Laser Interference Biometry(ULIB) constant, and optimized constant for long eyes. Results were compared with Barrett Universal II formula, original Wang-Koch AL adjustment method, and modified Wang-Koch AL adjustment method. The outcomes assessed were mean absolute error(MAE) and percentage of eyes with IOL prediction errors within ±0.25, ±0.50, and ±1.0 diopter(D). The nonparametric method, Friedman test, was used to compare MAE performance among constants.RESULTS: Optimized constants could significantly reduce the MAE of SRK/T, Hoffer Q, and Holladay 1 formulas compared with manufacturer’s lens constant, whereas the percentage of eyes with IOL prediction errors within ±0.25, ±0.50, and ±1.0 D had no statistically significant differences. Optimized lens constant for long eyes alone showed non-significant refractive advantages over the ULIB constant. Barrett Universal II formula and formulas with AL adjustment showed significantly higher accuracy in highly myopic eyes(P<0.001). CONCLUSION: Lens constant optimization for the subset of long eyes reduces the refractive error only to a limited extent for highly myopic eyes.
基金Supported by the Science and Technology Research Projects of Henan Province,China(No.201202010)
文摘AIM:To evaluate the surgical treatment and visual outcomes of eyes with cataract and persistent hyperplastic primary vitreous(PHPV).METHODS:This retrospective study included patients with cataract and PHPV treated with various strategies.Anterior PHPV was treated using phacoemulsification with underwater electric coagulation on posterior capsule neovascularization,posterior capsulotomy,anterior vitrectomy,and intraocular lens(IOL)implantation. Posterior PHPV was treated with lensectomy,posterior vitrectomy,retinal photocoagulation,and IOL implantation or silicone oil tamponade. Visual acuity(VA),pattern visual evoked potential(P-VEP),anatomic recovery,postoperative complications,and amblyopia outcome were examined.Subjects were followed-up for 3-48 mo after surgery.RESULTS:Of the 30 patients(33 eyes)with congenital cataract and PHPV included(average age,39.30±35.47mo),9 eyes had anterior PHPV and 24 had posterior PHPV. Thirty-two eyes were surgically treated. Eyes with anterior PHPV received an IOL during one-stage(6 eyes)and twostage(3 eyes)implantation. Postoperative complications included retinal detachment(1 eye)and recurrent anterior chamber hemorrhage(1 eye). In eyes with posterior PHPV,6 and 11 eyes received IOLs in one-and two-stage procedures,respectively. Silicone oil was retained in 2 eyes,and IOLs were not implanted in 4 eyes. VA significantly improved in 25 eyes following operations and 3-48 mo of amblyopia treatment. P-VEP P_(100) was improved following surgery in both PHPV types.CONCLUSION:Our surgical strategies are appropriate and effective for anterior and posterior PHPV. Early surgical intervention and amblyopia therapy result in positive treatment outcomes.
文摘BACKGROUND Phakic intraocular lens(pIOL)implantation has been commonly prescribed and is considered as a safe and effective option for correcting high myopia.However,it is associated with multiple complications.CASE SUMMARY This report describes a case of full-thickness macular hole(MH)in a patient with a history of bilateral pIOL implantation for the correction of myopia of–12.00 diopters in both eyes 7 mo ago.The MH closed after pars plana vitrectomy with internal limiting membrane removal and the best-corrected visual acuity improved to 20/40 in the left eye.CONCLUSION In rare cases,MH can occur following pIOL.In this present case report,we analyzed the formation process of MH following the surgery and emphasized that it is important to inform highly myopic patients about the risk of MH occurrence while being aware of the symptoms of this complication.
基金Supported by National Natural Science Foundation of China,No.81974130Natural Science Foundation of Hunan Province,China,No.2020JJ4882.
文摘BACKGROUND Asymmetric multifocal intraocular lenses(IOLs)are now widely used in the modern cataract surgery,providing a good level of visual performance over a range of distances and high postoperative patient satisfaction.We report a case of improved visual quality after shifting the near segment of an asymmetrical multifocal IOL to the superotemporal placement in the dominant eye of a glaucoma patient.CASE SUMMARY A 72-year-old woman with bilateral glaucoma underwent phacoemulsification in the dominant eye(left eye)with implantation of an asymmetrical multifocal IOL.Postoperative uncorrected distance visual acuity(UDVA)was 0.0 logMAR(20/20 Snellen)and uncorrected near visual acuity(UNVA)was 0.1 logMAR(20/25 Snellen).Two weeks later,the patient presented to our clinic with decreased vision due to migration of lens epithelial cells to IOL anterior surface and edema of corneal endothelial cells.Anterior capsule polishing and superotemporal placement of near segment[+3.00 diopter(D)addition(add)]of IOL were performed.As a result,UDVA at the first week and first year after reposition was 0.0 logMAR(20/20 Snellen),and compared with 0.3 logMAR(20/40 Snellen)in the first week,the UNVA was improved to 0.0 logMAR(20/20 Snellen)one year after surgery.CONCLUSION The postoperative inflammatory reaction and lens epithelial cells proliferation were obvious in this glaucoma patient.Capsule polishing and rotation of the lens were beneficial to the patient,which not only enhanced the patient's vision,but also improved the patient's satisfaction.Therefore,glaucoma patients need to be cautious of implanting multifocal IOLs.Placement of a near segment of an asymmetrical multifocal IOL in the dominant eye should be performed on an individual basis.