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PURPOSE: Evaluate the clinical outcomes of the secondary piggyback add-on IOL implantation in the ciliary sulcus for pseudophakic patients previously implanted with a monofocal IOL, who pursue a spectacle-free option after IOL surgery. METHODS: A prospective case series including seven pseudophakic patients who underwent an in-the-bag monofocal IOL implantation. All eyes underwent a piggyback IOL implantation of the new sulcus designed A4 AddOn IOL in the ciliary sulcus as a secondary procedure for pseudophakic patients pursuing a spectacle-free option for near and intermediate distance after IOL surgery. RESULTS: Seven eyes from six patients were included in this study, from which 4 (71.43%) were female, with a mean age of 58.33 ± 3.5 years (range 54-63; 95% CI 54.66, 62.01). The postoperative spherical equivalent at the 3-month visit was -0.10 m ± 0.82. Also, the UDVA was 0.11 ± 0.08 logMAR, the UIVA 0.01 ± 0.03, and the UNVA 0.01 ± 0.03 3 months after their surgical procedure. CONCLUSIONS: The A4 AddOn multifocal IOL's secondary piggyback implant is an efficient alternative for monofocal pseudophakic patients seeking presbyopia solutions. This sulcus-designed IOL provides an optimal visual outcome for near and distance vision.
Assuntos
Lentes Intraoculares , Lentes Intraoculares Multifocais , Facoemulsificação , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Implante de Lente Intraocular/métodos , Acuidade Visual , Desenho de PróteseRESUMO
The aim of our investigation was to examine the possible correlations between optical aberrations, angle kappa, angle alpha, and visual outcomes following cataract surgery. In total, 56 eyes of 28 patients were implanted with the Liberty 677MY trifocal intraocular lens (IOL). Pre- and postoperative higher-order aberrations, coma, astigmatism, angle alpha, and angle kappa were registered, along with uncorrected and corrected visual acuities at multiple distances. Visual acuity and contrast sensitivity defocus curves were plotted, and the areas under the curve were calculated 1 and 3 months postoperatively. Excellent visual outcomes were found at all distances. Patients reported low levels of dysphotopsia, and 96.4% of patients achieved complete spectacle independence. While angle kappa significantly decreased during cataract surgery (p = 0.0007), angle alpha remained unchanged (p = 0.5158). Angle alpha correlated with postoperative HOAs and had a negative impact on near vision (p = 0.0543). Preoperative corneal HOA and coma had a strong adverse effect on future intermediate and near vision. Residual astigmatism significantly affected postoperative intermediate vision (p = 0.0091). Our results suggest that angle kappa is not an optimal predictive factor for future visual outcomes, while angle alpha and the preoperative screening of optical aberrations might help patient selection prior to multifocal IOL implantation.
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PURPOSE: To analyze the association between angle α and ocular biometry in the general population at a third-level ophthalmology hospital. SETTING: Anterior Segment Surgery Department, Asociación para Evitar la Ceguera en México I.A.P., Mexico City, Mexico. DESIGN: Prospective, cross-sectional study. METHODS: Healthy subjects who attended the hospital for a comprehensive ophthalmological evaluation were examined, and general data were collected. A complete ophthalmological assessment and biomicroscopy evaluation were performed and biometry and clinical data were obtained, including visual acuity, axial length (AL), keratometry (K), white-to-white (WTW) measurement. An OPD-Scan III analyzer was used to assess both the angle α distance and biometry parameters. RESULTS: 74 eyes from the same number of patients were included; 43 (58.10%) were women. A statistically significant inverse correlation was found between the angle α and the AL (r = -0.585; P < .0001) and between the WTW distance and the mean K (r = 0.557; P < .0001). A significant correlation was found between the mean K and the angle α (r = 0.271; P = .019). A significant inverse correlation was observed regarding the WTW distance and angle α (r = -0.359; P = .001). By contrast, a direct correlation was evidenced between the WTW and the AL (r = 0.385; P = .0007). CONCLUSIONS: There was a significant inverse correlation between the AL and the angle α magnitude. Hyperopic patients demonstrated significantly higher angle α values when compared with those of myopic patients. In addition, hyperopic eyes with steeper mean K and lesser WTW distance were associated with an increased angle α.
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Comprimento Axial do Olho , Biometria , Córnea , Estudos Transversais , Feminino , Humanos , Estudos ProspectivosRESUMO
Prospective, randomized, comparative, and controlled study to estimate the association between angle κ distance and higher-order aberrations (HOAs) with postoperative visual acuity after presbyopia-correcting IOL implantation. Forty-three eyes from 43 patients were included and randomly assigned in two groups for either AT LISA tri 839MP or Acrysof IQ PanOptix IOL implantation. The OPD-Scan III analyzer was utilized to assess the angle κ distance and higher-order aberration (HOAs). Twenty-three eyes were in the Acrysof IQ PanOptix group and 20 patients in the AT LISA tri 839MP group. The uncorrected distance visual acuity (UDVA) for the PanOptix group was 0.092 ± 0.10, whereas for AT LISA tri was 0.050 ± 0.06 (P=0.229). The uncorrected intermediate visual acuity (UIVA) for the PanOptix group was 0.173 ± 0.18, whereas for AT LISA tri, it was 0.182 ± 0.11 (P=0.669). Uncorrected near visual acuity (UNVA) was 0.068 ± 0.04 and 0.085 ± 0.07, respectively (P=0.221). Also, correlation coefficient between HOAs and the Strehl ratio for each group were -0.768 (P < 0.0001) and -0.863 (P=0.0001). Patients implanted with both trifocal IOLs showed excellent postoperative visual performance at all distances at the six-month follow-up visit. No association was found between angle κ distance and postoperative visual acuity regardless of the angle κ magnitude or the two trifocal IOLs inner optical diameter. Also, internal aberrations demonstrated a significant inverse correlation with the Strehl ratio for both trifocal IOLs.
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PURPOSE: To compare the biometric measurements obtained from the Verion Image-Guided System to those obtained by auto-refracto-keratometer in normal eyes. METHODS: This is a prospective, observational, comparative study conducted at the Asociación para Evitar la Ceguera en México I.A.P., Mexico. Three sets of keratometry measurements were obtained using the image-guided system to assess the coefficient of variation, the within-subject standard deviation and intraclass correlation coefficient (ICC). A paired Student t test was used to assess statistical significance between the Verion and the auto-refracto-keratometer. A Pearson's correlation coefficient (r) was obtained for all measurements, and the level of agreement was verified using Bland-Altman plots. RESULTS: The right eyes of 73 patients were evaluated by each platform. The Verion coefficient of variation was 0.3% for the flat and steep keratometry, with the ICC being greater than 0.9 for all parameters measured. Paired t test showed statistically significant differences between groups (P = 0.0001). A good correlation was evidenced for keratometry values between platforms (r = 0.903, P = 0.0001 for K1, and r = 0.890, P = 0.0001). Bland-Altman plots showed a wide data spread for all variables. CONCLUSION: The image-guided system provided highly repeatable corneal power and keratometry measurements. However, significant differences were evidenced between the two platforms, and although values were highly correlated, they showed a wide data spread for all analysed variables; therefore, their interchangeable use for biometry assessment is not advisable.
Assuntos
Afacia Pós-Catarata/diagnóstico , Biometria/métodos , Extração de Catarata , Córnea/patologia , Topografia da Córnea/métodos , Lentes Intraoculares , Adolescente , Adulto , Afacia Pós-Catarata/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Desenho de Prótese , Reprodutibilidade dos Testes , Adulto JovemRESUMO
PURPOSE: To examine the stability and efficacy of high-cylinder power AcrySof toric intraocular lenses (IOLs), models SN60T6, SN60T7, SN60T8, and SN60T9 (Alcon Laboratories Inc). METHODS: Eligible eyes had cataract and symmetric corneal astigmatism > 2.25 diopters (D). Outcomes included monocular uncorrected distance visual acuity (UDVA), manifest refraction, and assessment of IOL axis. RESULTS: Nineteen eyes from 14 patients had preoperative corneal astigmatism of 4.00 ± 1.10 D. Postoperatively, residual refractive cylinder was 0.55 ± 0.60 D at 3 months. Uncorrected distance visual acuity was 1.3 ± 0.5 logMAR preoperatively and improved to 0.11 ± 0.09 logMAR 3 months postoperatively (P<.0001). All IOLs were stable within 5°. CONCLUSIONS: The IOLs were stable and effective in correcting high amounts of preexisting astigmatism at the time of cataract surgery.