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Pseudophakic negative dysphotopsia and intraocular lens orientation: a prospective doublea??masked randomized controlled trial
摘要： Purpose: To determine whether horizontal orientation of the intraocular lens optic-haptic junctions has an effect on the incidence of pseudophakic negative dysphotopsia. Methods: Single-centre prospective double-masked randomized controlled trial. 220 eyes of 201 participants undergoing routine cataract surgery were randomized to receive their intraocular lens either orientated with the optic-haptic junctions at 180° (‘horizontal’) or without manipulation following implantation (control). Patients were excluded according to age (<19 and > 99 years), coexisting eye disease affecting visual function and insufficient cognitive function to complete the study. In the fourth postoperative week, a telephone interview was conducted to determine rates of negative dysphotopsia. The data were analysed to provide the relative risk of negative dysphotopsia with horizontal orientation of the intraocular lens (IOL) optic-haptic junctions compared with standard treatment. Results: Orientating the IOL optic-haptic junctions horizontally halved the incidence of pseudophakic negative dysphotopsia in the fourth postoperative week (9/110 in the intervention group; 18/110 in the control group; RR: 0.50, 95% confidence interval: 0.235–1.064, p = 0.072). The overall incidence of negative dysphotopsia was 12.2% (27/220 participating eyes). No intraoperative adverse effects of intraocular lens rotation were reported. Conclusion: The simple intraoperative manoeuvre of rotating the intraocular lens to orientate the optic-haptic junctions at 180° may be a safe and effective measure to reduce the risk of developing postoperative pseudophakic negative dysphotopsia in the first postoperative month. This is the first report that demonstrates the benefit of horizontal optic-haptic junction positioning to be sustained beyond the first postoperative day.
关键词： negative,intraocular lens,haptic,orientation,pseudophakic,dysphotopsia
更新于2025-09-19 17:13:59
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Patient-reported vision-related quality of life after laser in situ keratomileusis, surface ablation, and phakic intraocular lens
摘要： To evaluate the long-term efficacy of refractive surgery of all cases in a single center via the use of a patient-reported outcome (PRO) refractive status questionnaire using descriptive statistics. This study was prospective, single-center, cohort study that involved 1422 patients who underwent refractive surgery (laser in situ keratomileusis, surface ablation, and phakic intraocular lens) at Baptist Eye Institute, Kyoto, Japan. The patients were asked to answer the Refractive Status and Vision Profile (RSVP) questionnaire before the surgery after 6 months (n = 1133 patients) and after 5.5 years (n = 232 patients). During the same period, examination by slit-lamp biomicroscopy and visual acuity tests were performed. Moreover, the patients were asked to rate their satisfaction with the surgery 6 months and 5.5 years after it. We examined overall RSVP scale (S), 8 RSVP subscales, rate of satisfaction with surgical outcome, slit-lamp biomicroscopy findings, and refractive error. The mean preoperative S was 36, yet that score significantly improved to 19 at 6 postoperative months postoperatively (P < .01), and basically remained the same (i.e., 20) throughout the 5.5-year postoperative period. During the 5-year follow-up period, mean refractive error became slightly myopic (0.3 D). No change in the rate of satisfaction was observed at both 6 months and 5.5 years postoperative period. The findings of this study help to clarify long-term PRO quality of vision (QOV) postrefractive surgery in a single center, and show that minor change in refractive error during 5 years postoperative period had no influence on the mean RSVP scores among outpatients. Nearly all patients reported short-term improvement of QOV, which continued throughout the long-term follow-up period.
关键词： patient-reported outcome,phakic intraocular lens,refractive surgery,laser in situ keratomileusis,surface ablation
更新于2025-09-19 17:13:59
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Diode laser transscleral cyclophotocoagulation for uveitis-glaucoma-hyphema syndrome
摘要： Rationale: To report a case of diode laser transscleral cyclophotocoagulation (DLTSC) for uveitis-glaucoma-hyphema syndrome (UGH). Patient concerns: The patient developed UGH on the right eye (OD) after vitrectomy and intraocular lens (IOL) implantation. Diagnoses: Best corrected visual acuity (BCVA) was HM/50 cm, intraocular pressure (IOP) was 51.3 mm Hg on the OD. He was found to have 3+ anterior chamber cells. A B-scan ultrasound showed vitreous opacity. Ultrasound biomicroscopy (UBM) showed the chafing between the IOL and the posterior surface of the iris. Thus, he was diagnosed as UGH on the OD. Interventions: The patient was worried about the complications for removal of the IOL, a DLTSC approach was performed. Outcomes: BCVA was 20/40 on the OD, IOP was 12 mm Hg on the OD. There were no anterior chamber inflammation and no vitreous opacity. UBM showed there was no contact between IOL and the posterior surface of the iris, the fundus of the eye was clearly visible. Lessons: UGH syndrome is a severe complication of cataract extraction. IOL extraction has been the traditional approach to treatment. DLTSC can be an option when the IOL is slightly tilted.
关键词： acrylic single-piece intraocular lens,uveitis-glaucoma-hyphema (UGH) syndrome,diode laser transscleral cyclophotocoagulation,case report
更新于2025-09-19 17:13:59
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Presbyopic refractive lens exchange with trifocal intraocular lens implantation after corneal laser vision correction: Refractive results and biometry analysis
摘要： To evaluate the refractive and biometry results of presbyopic refractive lens exchange (RLE) with trifocal intraocular lens (IOL) implantation in eyes with previous myopic or hyperopic corneal laser vision correction (LVC).
关键词： refractive results,trifocal intraocular lens,corneal laser vision correction,Presbyopic refractive lens exchange,biometry analysis
更新于2025-09-16 10:30:52
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Validation of the SToP formula for calculating intraocular lens power in eyes with previous myopic excimer laser surgery
摘要： To validate the accuracy of the SToP formula for calculating the intraocular lens (IOL) power from measurements obtained with a rotating Scheimpflug camera (Pentacam) in eyes with previous myopic excimer laser surgery.
关键词： myopic excimer laser surgery,Scheimpflug camera,Pentacam,intraocular lens power,SToP formula
更新于2025-09-12 10:27:22
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Intraocular lens tilt and decentration after?Nd:YAG laser posterior capsulotomy: Femtosecond laser capsulorhexis versus manual capsulorhexis
摘要： To compare intraocular lens (IOL) tilt and decentration after Nd:YAG laser posterior capsulotomy in eyes that had femtosecond laser–assisted capsulotomy versus manual capsulorhexis. Setting: Ekol Eye Hospital, Izmir, Turkey. Design: Retrospective case series. Methods: Intraocular lens decentration and angle of tilt were measured using a Scheimpflug camera before and 1 month after Nd:YAG capsulotomy. Results: Eighteen eyes had a femtosecond laser–assisted capsulotomy and 25 eyes a manual capsulorhexis. The mean age was 58.2 years G 10.2 (SD) (range 44 to 69 years) and 60.6 G 8.3 years (range 45 to 70 years), respectively. Before capsulotomy, tilt and decentration at both meridians did not differ significantly between the 2 groups (P > .05). After capsulotomy, the angle of tilt was significantly decreased in both groups (femtosecond: vertical 1.5 degrees and horizontal 1.2 degrees; manual: vertical 1.1 degrees and horizontal) and decentration was significantly increased (femtosecond: vertical 0.085 mm and horizontal 0.096 mm; manual: vertical 0.2 mm and horizontal 0.2 mm) at both meridians (P < .05). After capsulotomy, all tilt and decentration parameters were significantly different between the 2 groups (P < .05) except decentration on the horizontal meridian (P Z .669). Conclusions: Nd:YAG posterior capsulotomy performed after femtosecond laser–assisted capsulotomy resulted in better mechanical stability of the IOL. This suggests that a femtosecond laser–created capsulotomy better maintains a proper IOL position. Although the differences were statistically significant, the tilt and decentration values were small and might not be clinically significant.
关键词： tilt,Nd:YAG laser,manual capsulorhexis,intraocular lens,femtosecond laser,decentration,posterior capsulotomy
更新于2025-09-12 10:27:22
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PSS1 POOLED RESULTS OF THE TECNIS SYMFONY EXTENDED DEPTH OF FOCUS INTRAOCULAR LENS
摘要： Several prospective studies have indicated that the TECNIS Symfony, an extended depth of focus (EDOF) intraocular lens (IOL), achieves excellent visual outcomes at all distances after cataract surgery. The purpose of this study was to combine the visual outcomes from multiple recent studies of the TECNIS Symfony ZXR00. We performed a systematic literature review and subsequent data pooling of studies looking at corrected visual outcomes for patients within 6 months (range: 3-6 months) of receiving bilateral implantation of TECNIS Symfony IOLs following cataract surgery. The primary visual quality outcome of interest was accommodation measured by defocus curves. Data from monocular and binocular defocus curves were extracted and then pooled using a weighted average approach. Separate pooled curves were estimated for monocular and binocular data. We identified 25 articles of potential interest in the database review; 7 of these included TECNIS Symfony defocus curves. Of these, 3 provided monocular defocus curves (total eyes = 130), and 6 provided binocular defocus curves (total eyes = 310). The pooled defocus curves showed best corrected visual acuity generally remained high (LogMar # 0.2) from 1.0 diopters (D) to -2.0 D in patients who received TECNIS Symfony IOLs. For the pooled monocular defocus curve, the corrected distance visual acuity (0 D) was LogMar-0.04, the corrected intermediate visual acuity (66cm; -1.5 D) was LogMar0.13, and the corrected near visual acuity (40cm; -2.5 D) was LogMar0.40. For the pooled binocular defocus curve, the corrected distance visual acuity was LogMar-0.02, the corrected intermediate visual acuity was LogMar0.11, and the corrected near visual acuity was LogMar0.34. The TECNIS Symfony EDOF IOL provides successful visual restoration across all distances after cataract surgery, with a minimal level of disturbing photic phenomena and high levels of patient satisfaction.
关键词： intraocular lens,TECNIS Symfony,cataract surgery,visual outcomes,extended depth of focus
更新于2025-09-11 14:15:04
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Short-Term Comparison of Surgical Results between One-Haptic and Two-Haptics Transscleral Fixation of Intraocular Lens
摘要： Purpose: To compare the short-term clinical outcomes of transscleral fixation intraocular lens (IOL) with two haptics or one haptic. Methods: We retrospectively reviewed the medical records of 26 patients with transscleral fixation of IOL (11 with one-haptic fixation, 15 with two-haptic fixation) except in patients whose visual acuity is not expected to improve due to retinal problems or ocular trauma. We analyzed the manifest refraction, visual acuity, refractive error preoperatively and postoperatively, preoperative IOL decentration, operating time, and postoperative complications. Results: When comparing the two groups preoperatively, the mean lens decentration in the one-haptic group was 2.73 ± 2.88 mm and 4.59 ± 2.18 mm in the two-haptics group. The decentration in the two-haptic group was greater than in the one-haptic group, but not significantly. Visual acuity and refractive power were not significantly different between the groups. The mean operation time (minutes) was 65.00 ± 22.69 and 93.66 ± 29.54 in the one-haptic and two-haptic groups, respectively. The operation time in the one-haptic group was significantly shorter than in the two-haptic group (p = 0.020). When comparing visual acuity preoperatively and postoperatively, both groups showed significant improvement (p < 0.01). However, refractive error and postoperative IOL decentration were similar between the groups. Conclusions: The short-term surgical results of transscleral fixation using the two surgical techniques were not different; one-haptic transscleral fixation was preferred due to shorter operation time and lower patient discomfort.
关键词： Two-haptic fixation of intraocular lens,One-haptic fixation of intraocular lens,Dislocated intraocular lens,Transscleral fixation
更新于2025-09-10 09:29:36
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Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands
摘要： To evaluate the cost-effectiveness of toric versus monofocal intraocular lens (IOL) implantation in cataract patients with bilateral corneal astigmatism. Setting: Two ophthalmology clinics in the Netherlands. Design: Prospective cost-effectiveness analysis. Methods: Resource-use data were collected over a 6-month postoperative period. Consecutive patients with bilateral age-related cataract and 1.25 diopters or more of corneal astigmatism were included in the economic evaluation. Patients were randomized to phacoemulsification with bilateral toric or monofocal IOL implantation. All relevant resources were included in the cost analysis. The base-case analysis was performed from a societal perspective based on quality-adjusted life years (QALYs). The main outcome was the incremental cost-effectiveness ratio. Results: The analysis comprised 77 consecutive patients (33 toric IOL; 44 monofocal IOL). Societal costs were higher in the toric IOL group (V3203 [$3864]) than in the monofocal IOL group (V2796 [US$3373]). QALYs were slightly lower in the toric IOL group (0.30 versus 0.31; P Z .75). Toric IOLs were therefore inferior to monofocal IOLs from a cost-effectiveness perspective. The cost-effectiveness probability ranged from 1% to 15%, assuming a ceiling ratio for the incremental cost-effectiveness ratio of V2500 to V20 000 per QALY. Conclusions: From a societal perspective, bilateral toric IOL implantation in cataract patients with corneal astigmatism was not cost-effective compared with monofocal IOL implantation. Copayment by patients should therefore be considered.
关键词： monofocal intraocular lens,corneal astigmatism,cost-effectiveness,toric intraocular lens,cataract
更新于2025-09-10 09:29:36
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Characterization of optical performance with defocusing curve: Analysis of two refractive intraocular lens models with high and medium addition
摘要： Purpose: To characterize the optical performance of two models of refractive bifocal intraocular lenses, with medium and high addition, using defocus curves. Methods: 20 eyes from 20 subjects were included in this study. 10 eyes underwent cataract surgery with an implant of a medium addition refractive bifocal intraocular lens (IOL) (Lentis LS-313 MF20) and the other 10 eyes underwent cataract surgery with an implant of a high addition refractive bifocal IOL (Lentis LS-313 MF30). Six weeks after surgery, subjective refraction and defocus curve were made. Results: Mean final residual refraction in spherical equivalent was +0.10 ± 0.07 D in the LS-313MF30 group and +0.12 ± 0.10 D in the LS-313MF20 group. Defocus curve showed a different optical performance in intermediate/near distance depending on the IOL model. The medium addition IOL provided good visual acuity (VA) at far and intermediate distance up to 50 cms, and the high addition IOL provided better VA in near distance up to 25 cms. Conclusions: The high addition intraocular lens provides better visual acuity in the spatial range from infinity to the point close to 25 cm. The medium addition intraocular lens provides excellent visual acuity in far and intermediate vision. The defocus curve seems to be a valid and reproducible tool for evaluating the optical behavior of multifocal sector refractive lenses.
关键词： High addition,Intraocular lens,Defocus curve,Bifocal,Medium addition
更新于2025-09-10 09:29:36