Purpose: To investigate the impact of residual astigmatism on visual acuity (VA) after the implantation of a novel extended range of vision (ERV) intraocular lens (IOL) based on the correction of spherical and chromat...Purpose: To investigate the impact of residual astigmatism on visual acuity (VA) after the implantation of a novel extended range of vision (ERV) intraocular lens (IOL) based on the correction of spherical and chromatic aberration. Method: The study enrolled 411 patients bilaterally implanted with the ERV IOL Tecnis Symfony. Visual acuity and subjective refraction were analyzed during the 4- to 6-month follow-up. The sample of eyes was stratified for four groups according to the magnitude of postoperative refractive astigmatism and postoperative spherical equivalent. Results: The astigmatism analysis included 386 eyes of 193 patients with both eyes of each patient within the same cylinder range. Uncorrected VAs for distance, intermediate and near were better in the group of eyes with lower level of postoperative astigmatism, but even in eyes with residual cylinders up to 0.75 D, the loss of VA lines was clinically not relevant. The orientation of astigmatism did not seem to have an impact on the tolerance to the residual cylinder. The SE evaluation included 810 eyes of 405 patients, with both eyes of each patient in the same SE range. Uncorrected VAs for distance, intermediate and near, were very similar in all SE groups. Conclusion: Residual cylinders up to 0.75 D after the implantation of the Tecnis Symfony IOL have a very mild impact on monocular and binocular VA. The Tecnis Symfony IOL shows a good tolerance to unexpected refractive surprises and thus a better “sweet spot”.展开更多
Purpose: To compare the impact of induced astigmatism with four different types of multifocal intraocular lenses (MIOLs). Method: Prospective, comparative, interventional, mono-centered study, including 80 eyes of pat...Purpose: To compare the impact of induced astigmatism with four different types of multifocal intraocular lenses (MIOLs). Method: Prospective, comparative, interventional, mono-centered study, including 80 eyes of patients with implantation of four different MIOLs: AcrySof ReSTOR +2.5 D (20 eyes), AcrySof ReSTOR +3.0 D (20 eyes), AcrySof Panoptix (20 eyes) (Alcon Laboratories, Inc., Fort Worth, TX, USA), and Tecnis Symfony ZRX00 (Abbott Medical Optics, Santa Ana, USA) (20 eyes). Patients were followed up for 3 months after surgery. Major parameters were uncorrected (UDVA) and corrected (CDVA) distance visual acuity, subjective refraction and patient satisfaction. Results: Differences between IOLs with regard to the impact of the cylinder sign and axis on visual acuity and patient satisfaction were not significant. With mild added negative cylinder, AcrySof ReSTOR +2.5 D and Tecnis Symfony IOLs maintained the baseline visual acuity, while it was mildly reduced with AcrySof ReSTOR +3.0 D and Panoptix IOLs. With moderate induced cylinder, the Tecnis Symfony IOL maintained good visual acuity and patient associated satisfaction. Panoptix IOL was the IOL most affected by the induced astigmatism with regard to dissatisfaction and visual acuity. The highest tolerance to the astigmatic distortion and blurriness induced with a -1.50 D cylinder was obtained with the Tecnis Symfony IOL. Tecnis Symfony IOL showed less dissatisfaction and less reduction of visual acuity than the other MIOLs. Conclusion: Simulated residual cylinders after the implantation of the Tecnis Symfony IOL up to 1.0 D have a very mild and not clinically relevant impact on visual acuity or patient satisfaction. The ERV IOL showed a better tolerance to unexpected postoperative residual errors than diffractive bifocal and trifocal IOLs.展开更多
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 implantati...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.展开更多
文摘Purpose: To investigate the impact of residual astigmatism on visual acuity (VA) after the implantation of a novel extended range of vision (ERV) intraocular lens (IOL) based on the correction of spherical and chromatic aberration. Method: The study enrolled 411 patients bilaterally implanted with the ERV IOL Tecnis Symfony. Visual acuity and subjective refraction were analyzed during the 4- to 6-month follow-up. The sample of eyes was stratified for four groups according to the magnitude of postoperative refractive astigmatism and postoperative spherical equivalent. Results: The astigmatism analysis included 386 eyes of 193 patients with both eyes of each patient within the same cylinder range. Uncorrected VAs for distance, intermediate and near were better in the group of eyes with lower level of postoperative astigmatism, but even in eyes with residual cylinders up to 0.75 D, the loss of VA lines was clinically not relevant. The orientation of astigmatism did not seem to have an impact on the tolerance to the residual cylinder. The SE evaluation included 810 eyes of 405 patients, with both eyes of each patient in the same SE range. Uncorrected VAs for distance, intermediate and near, were very similar in all SE groups. Conclusion: Residual cylinders up to 0.75 D after the implantation of the Tecnis Symfony IOL have a very mild impact on monocular and binocular VA. The Tecnis Symfony IOL shows a good tolerance to unexpected refractive surprises and thus a better “sweet spot”.
文摘Purpose: To compare the impact of induced astigmatism with four different types of multifocal intraocular lenses (MIOLs). Method: Prospective, comparative, interventional, mono-centered study, including 80 eyes of patients with implantation of four different MIOLs: AcrySof ReSTOR +2.5 D (20 eyes), AcrySof ReSTOR +3.0 D (20 eyes), AcrySof Panoptix (20 eyes) (Alcon Laboratories, Inc., Fort Worth, TX, USA), and Tecnis Symfony ZRX00 (Abbott Medical Optics, Santa Ana, USA) (20 eyes). Patients were followed up for 3 months after surgery. Major parameters were uncorrected (UDVA) and corrected (CDVA) distance visual acuity, subjective refraction and patient satisfaction. Results: Differences between IOLs with regard to the impact of the cylinder sign and axis on visual acuity and patient satisfaction were not significant. With mild added negative cylinder, AcrySof ReSTOR +2.5 D and Tecnis Symfony IOLs maintained the baseline visual acuity, while it was mildly reduced with AcrySof ReSTOR +3.0 D and Panoptix IOLs. With moderate induced cylinder, the Tecnis Symfony IOL maintained good visual acuity and patient associated satisfaction. Panoptix IOL was the IOL most affected by the induced astigmatism with regard to dissatisfaction and visual acuity. The highest tolerance to the astigmatic distortion and blurriness induced with a -1.50 D cylinder was obtained with the Tecnis Symfony IOL. Tecnis Symfony IOL showed less dissatisfaction and less reduction of visual acuity than the other MIOLs. Conclusion: Simulated residual cylinders after the implantation of the Tecnis Symfony IOL up to 1.0 D have a very mild and not clinically relevant impact on visual acuity or patient satisfaction. The ERV IOL showed a better tolerance to unexpected postoperative residual errors than diffractive bifocal and trifocal IOLs.
文摘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.
