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Resultados visuales, independencia de gafas e insatisfacción tras implante de una lente intraocular difractiva trifocal
摘要： Purpose: To investigate visual outcomes, spectacle independence, and patient satisfaction after trifocal intraocular lens implantation. Methods: A retrospective study conducted on 5,186 patients who underwent phacoemulsification and were implanted with a diffractive trifocal intraocular lens (FineVision Micro F, PhysIOL SA, Liège, Belgium). Results: The mean pre-operative keratometry was 43.61 ± 1.55 D, and mean keratometric cylinder was -0.86 ± 0.66 D. At 3 months post-operatively, values changed to 43.59 ± 1.56 and -0.71 ± 0.46 D, respectively. Mean sphere varied from 2.04 ± 2.60 to 0.14 ± 0.38 D, and mean spherical equivalent from 1.64 ± 2.61 to -0.05 ± 0.36 D. More than 60% of the patients achieved better corrected distance visual acuity. The majority had a final residual refractive error (predictability) lower than 1 D (99.1%), with 14.3% needing optical adjustment (bioptics). Posterior capsulotomy was performed in 2.2%, and the lens was replaced in 5 patients. A high percentage of patients were satisfied in terms of vision and spectacle independence at all distances. Although 2% referred to worsening of night vision quality, only 2% were not very satisfied and 20 patients were dissatisfied. The causes were: blurred vision (7 cases), spectacle dependence (10), dysphotopsia (7), and dry eye (4). Conclusions: The implantation of this model provided good visual performance in all distances, as well as high levels of spectacle independence and satisfaction.
关键词： Trifocal,Intraocular lens,Multifocal,Dissatisfaction,Satisfaction
更新于2025-09-23 15:23:52
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Fulla??face skin resurfacing using a combination of fractional and full spot ablative 2940??nm erbium laser
摘要： BACKGROUND: Full-field deep ablative laser resurfacing is a popular method for skin rejuvenation due to maximum improvement in a single treatment. However, it is associated with disadvantages such as pain, prolonged erythema, swelling, crusting, infections, pigmentary changes, and scarring. Patients are increasingly seeking less invasive options with comparable effect. AIMS: The aim of this retrospective study was to evaluate the safety and efficacy of full face resurfacing using a combination of full spot and fractional erbium (Er:YAG) laser resurfacing. PATIENTS/METHODS: 109 patients, mostly females over 50 years old, were treated with a two phase protocol: full spot ablation (5 J/cm2, three passes) and fractional ablation (132 J/cm2, 5% coverage, 3 passes). We recorded time to re-epithelization and duration of post-treatment erythema. Any side effects observed at follow-up or reported by the patient were recorded. Patient satisfaction questionnaire and blinded evaluation of pre and post treatment photographs were used to assess efficacy. RESULTS: A single session was performed in 96% of cases. Post-operative re-epithelization lasted on average 6.4±2.9 days. Post-treatment erythema lasted on average 13.8±15.2 days. One patient had hyperpigmentation, one infection, one hypo-pigmentation, and one ulcer. All side effects resolved without complications. According to the blinded assessment of photographs 78% of patients showed improvement. 97% of patients were satisfied with the results of the treatment. CONCLUSIONS: A combination of fractional and full spot ablative Er:YAG laser is a safe and effective option for full face resurfacing.
关键词： patient satisfaction,improvement,fractional,skin resurfacing,laser,erbium
更新于2025-09-23 15:19:57
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Visual, aberrometric, photic phenomena, and patient satisfaction after myopic wavefront-guided LASIK using a high-resolution aberrometer
摘要： The purpose of this study was to evaluate the visual, refractive, and aberrometric outcomes as well as the level of patient satisfaction and photic phenomena after myopic laser in situ keratomileusis (LASIK) surgery using wavefront-guided (WFG) ablations based on measurements obtained with a high-resolution aberrometer. This study was a prospective analysis including 253 eyes of 127 patients (aged between 19 years and 54 years) undergoing WFG LASIK using the STAR S4 IR Excimer Laser System combined with the iDesign System and iFS Femtosecond Laser. Visual, refractive, and aberrometric outcomes during a 2-month follow-up as well as patient satisfaction and photic phenomena were evaluated by means of a questionnaire. A total of 85% (215/253) and 99% (251/253) of eyes achieved a postoperative (Postop) uncorrected distance visual acuity of 20/16 and 20/20, respectively, and all eyes achieved an uncorrected distance visual acuity of 20/25. Postop spherical equivalent values were within ±0.25 D and ±0.50 D in 97% and 100% of eyes, respectively. Likewise, manifest cylinder was <0.25 D in 97% (245/253) of eyes. A statistically significant reduction was found in the total root mean square (P<0.001) and in the level of primary spherical aberration (P=0.001). Postop difficulties related to vision were graded as minimal, with low levels of photic phenomena and high levels of patient satisfaction. The level of difficulty to perform daily activities and the level of glare perceived by patients while driving car were significantly decreased (P<0.001). WFG LASIK surgery using the technology evaluated is predictable and effective for the correction of myopia and leads to high levels of patient satisfaction.
关键词： Wave-front guided LASIK,patient satisfaction,glare,LASIK,high resolution aberrometer,photic phenomena
更新于2025-09-11 14:15:04
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Use of Expectation Disconfirmation Theory to Test Patient Satisfaction with Asynchronous Telemedicine for Diabetic Retinopathy Detection
摘要： Objective. The purpose of the study is to extend research on patient satisfaction with telemedicine services by employing the theoretical framework of Expectation Disconfirmation Theory (EDT) for diabetic retinopathy screenings focusing on rural patients. Method. Adult subjects (n=220) with diabetes were recruited from a single family practice office in rural Iowa. Subjects completed a “pre” survey concerning their forward-looking perceptions of telemedicine prior to using telemedicine for detection of diabetic retinopathy and a “post” survey after they received recommendations from the distant ophthalmologists. Results. All hypotheses of the EDT model were supported. Patient satisfaction is influenced by both patients’ expectations (P<.001) and disconfirmation of expectations (P<.001), and patient satisfaction has a positive impact on patient preference for telemedicine services (P<.001). Overall, patients who received telemedicine services were highly satisfied with telemedicine and developed a favorable disposition towards telemedicine services. Conclusions. The EDT model is a viable framework to study patient satisfaction of telemedicine services. While previous feasibility studies have shown that telemedicine for diabetic retinopathy screenings yields diagnostic efficacy, this study applies a theoretical framework to demonstrate the viability of telemedicine for diabetic retinopathy screenings in rural areas.
关键词： diabetic retinopathy,telemedicine,rural healthcare,patient satisfaction,Expectation Disconfirmation Theory
更新于2025-09-09 09:28:46
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Clinical Outcomes of Patients with Refractive Aspheric Multifocal IOL Implantation
摘要： ??: ??? ??? ??? ?????(Lentis Mplus? LS-313)? ??? ???? ??? ? ??? ????? ????? ???. ??? ??: Lentis Mplus? LS-313? ??? 53? 68?? ???? ? ? 1?, 2?, 1?3?6??? ?? ???????????? ??, ???? ? ? ? 3??? Optical Quality Analysis System Ⅱ (OQAS II)? ??? ??? ??, ????? ?????? ??? ????? ?????. ??: ? ? 6??? ?? ????? ??? 0.06 ± 0.07, ???? 63 cm 0.18 ± 0.14, ???? 100 cm 0.15 ± 0.13, ??? 0.11 ± 0.10 (logMAR)???. OQAS II ??? ?? ??? ????(Objective scatter index, OSI)? 1.20 ± 0.69, ??????(MTF cut off value)? 34.15 ± 9.53 cpd, Strehl ??? 0.17 ± 0.05??? ????? 3.09 ± 0.25D??. ????? 5 mm 0.61 ± 0.14, 6 mm 1.07 ± 0.20???. ? ? 82%?? ????? 71%? ?????? ?????? ??? 24%??. ??: Lentis Mplus? LS-313? ??? ???, ???? ? ??? ??? ??? ?? ???? ??? ???? ??? ?? ??? ? ?? ??? ?????? ????.
关键词： Cataract,Multifocal intraocular lens,Satisfaction,Lentis Mplus
更新于2025-09-09 09:28:46
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Patient-reported outcomes of multifocal and accommodating intraocular lenses: analysis of 117 patients 2–10 years after surgery
摘要： The purpose of this study was to determine the satisfaction levels of patients at least 2 years after cataract surgery implantation with bilateral accommodating or bilateral multifocal intraocular lenses (IOLs) and to determine the relative rate of spectacle independence and adverse symptoms in that same time frame. Design: Patient questionnaire administered in a single-center private practice at least 2 years after cataract surgery with presbyopia-correcting IOL implantation. Methods: Patients who had undergone uncomplicated cataract surgery with an accommodating or multifocal IOL implant were eligible for inclusion. Patients with visually significant non-IOL-related postoperative morbidity were excluded. Patients with astigmatism or residual refractive error were not excluded. The main outcome measure was patient satisfaction at least 2 years after IOL implantation. Results: Sixty-eight patients who received accommodating lenses and 49 patients who received multifocal lenses completed the questionnaire. The mean age of all patients was 75.7 years at the time of survey; the mean number of years since cataract surgery was 5.4 years. Overall, there were no significant differences between the two groups or within each group between the different lenses used. About 90% of patients in each group were “very satisfied” or “somewhat satisfied” with their vision at least 2 years after the initial surgery. Conversely, only one in eleven patients found his vision to be worse than expected. Conclusions: The majority of patients who received either accommodating or multifocal IOLs remain satisfied with their lens of choice more than 5 years after the original surgery. Glare and halos remain more noticeable in patients who received multifocal lenses.
关键词： accommodating IOLs,presbyopia,Tecnis,satisfaction,intraocular lenses,crystalens,ReSTOR,patient-reported satisfaction,multifocal IOLs,glasses
更新于2025-09-04 15:30:14
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A comparison of lighting control strategies for open offices
摘要： Providing environmental control to users in multi-user offices has long being considered not done. One of the reasons is it was believed that personal control in an open office would rather create conflict among office users than bring benefits. However, a number of experimental studies conducted to explore the experience of personal control of lighting in open offices start building empirical evidence that can help more informed decision-making. This paper presents the results of the second field experiment conducted as part of a larger study exploring the experience of personal control in a multi-user open office context. The experiment showed that despite users having diverse lighting preferences, provision of control even in a multi-user office resulted in a higher satisfaction with the lighting environment than in an office with a fixed light level. The study evaluated three personal control strategies. The results did not deliver evidence of benefits of the control strategy “control set-point” in which the user selected light level was treated as a set-point for daylight regulation. The results showed that when the system remembered the last level set by the user it resulted in a smaller amount of user actions executed using personal control and the resulting lighting conditions in the office better reflected individual preferences compared to the “forgetting” strategy in which the system was resetting overnight to its default state. The results were significant only with respect to satisfaction with daylight in favor of the system remembering the user set light level.
关键词： multi-user office,open office,lighting control,satisfaction,Personal control,experimental study
更新于2025-09-04 15:30:14
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Long-term results of a diffractive trifocal intraocular lens: Visual, aberrometric and patient satisfaction results
摘要： Purpose: To evaluate the long-term objective and subjective results of a trifocal intraocular lens. Methods: Prospective observational study enrolling 24 eyes that underwent uneventful microincisional cataract surgery with bilateral implantation of a diffractive trifocal intraocular lens (FineVision Micro F, PhysIOL, Belgium). After a mean follow-up period of 60 ± 2 months, patients answered the 10-item Near Activity Vision Questionnaire (NAVQ-10) and were assessed for uncorrected and corrected distance, intermediate and near visual acuity, defocus curve, light-distortion analysis, and total ocular aberrometry with a pyramidal wavefront sensor (Osiris, CSO, Italy). Results: There was significant improvement of uncorrected visual acuity at all distances in all eyes (p < 0.01). The distorsion index and best-fit circle radius were significantly lower in binocular conditions (p = 0.02). Mean Rasch score at NAVQ-10 was 16.29 ± 11.57. Patients reported to be completely, very, and moderately satisfied with their uncorrected near vision in 67%, 25%, and 8% of cases, respectively. We found no significant correlation between patient satisfaction scores at near vision satisfaction questionnaire and other variables such as light-distortion analysis or wavefront aberrometry parameters. Conclusion: The studied diffractive trifocal intraocular lens provides good and stable long-term results for distance, intermediate, and near vision, with high levels of patient satisfaction at long-term follow-up. The intraocular lens’ light-distortion effect is less disturbing in binocular conditions and may have its perception down-modulated by neuroadaptation over time.
关键词： diffractive trifocal intraocular lens,patient satisfaction,Cataract surgery
更新于2025-09-04 15:30:14
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Clinical Results and Optical Quality of Diffractive Multifocal Intraocular Lens
摘要： Purpose: To compare postoperative clinical outcomes, optical quality, and patient satisfaction between two types of diffractive multifocal intraocular lens (IOL, Acri Lisa 366D and Acrysof ReSTOR +3.00 D). Methods: In a total of 68 eyes, one of two diffractive multifocal IOL (Acri Lisa 366D and Acrysof ReSTOR +3.00 D) was implanted after cataract extraction. Visual acuity was measured postoperatively at one week, 1 month, and 6 months. Contrast sensitivity, wavefront aberration, and visual function were determined via questionnaire at postoperative 1 month. Results: Intermediate visual acuity of Acri Lisa 366D and Acrysof ReSTOR at 6 months were 0.31 ± 0.14, and 0.24 ± 0.11 (log MAR), respectively. At 6 months, near and distant visual acuity results showed no significant differences between the two groups. The photopic contrast sensitivity of Acri Lisa 366D at 6 cycles/degree was 55.36 ± 7.40 and showed significant differences with Acrysof ReSTOR (47.25 ± 9.67). The mesopic contrast sensitivity values of Acri Lisa 366D and Acrysof ReSTOR were 40.26 ± 11.38 and 28.97 ± 10.45, respectively, and the spherical aberration values were 0.037 ± 0.039 μm and 0.105 ± 0.066 μm. The spherical aberration of Acri Lisa 366D was significantly lower than that of Acrysof ReSTOR. Total and high order aberration, coma, and trefoil show no significant differences between the two groups. Conclusions: The Acri Lisa 366D multifocal IOL showed better contrast sensitivity and spherical aberration compared to Acrysof ReSTOR multifocal IOL, which had an effective intermediate visual acuity.
关键词： Contrast sensitivity,Multifocal intraocular lens,Patient satisfaction,Spherical aberration
更新于2025-09-04 15:30:14