Functional outcomes after bilateral refractive lens exchange with a continuous-range-of-vision intraocular lens

Abstract

Purpose: Clinical evaluation of a diffractive continuous-range-of-vision IOL that combines bifocal and extended depth of focus technologies in refractive lens exchange patients. Setting: University Eye Clinic Design: Prospective interventional clinical study. Methods: Bilateral implantation of the TECNIS Synergy IOL (Johnson & Johnson Surgical Vision, Irvine, CA, USA) was performed during a refractive lens exchange procedure in 28 patients. At 3 months postoperatively, uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance corrected intermediate (DCIVA) visual acuity at 80 cm, uncorrected (UNVA) and distance corrected (DCNVA) near visual acuity at 40 cm were assessed. Defocus curve testing and contrast sensitivity testing were also performed. Results: Binocular UDVA and CDVA of 56 eyes (28 patients) were -0.06 ± 0.07 and -0.13 ± 0.05 logMAR. UIVA and DCIVA were -0.06 ± 0.05 and -0.08 ± 0.06 logMAR, UNVA and DCNVA were -0.01 ± 0.07 and -0.04 ± 0.07 logMAR. The defocus curve revealed a visual acuity of 0.10 logMAR or better from +0.50 to -3.00 diopters. Photopic contrast sensitivity at spatial frequencies 3.0, 6.0, 12.0 and 18.0 was 1.68 ± 0.20, 1.77 ± 0.19, 1.45 ± 0.18 and 1.02 ± 0.19 log units. Mesopic contrast sensitivity at the same frequencies was 1.56 ± 0.20, 1.44 ± 0.25, 0.92 ± 0.38 and 0.44 ± 0.37. Conclusions: The Synergy IOL provided very good distance, intermediate and near visual outcomes. A visual acuity of 0.10 logMAR or better was achieved from +0.50 to -3.0 diopters. Contrast sensitivity was within the normal range.

Comparative Evaluation of Visual Performance and Patient Satisfaction following Cataract Surgery: A Retrospective Analysis of an Extended Depth-of-Focus Intraocular Lens and a Diffractive Multifocal Lens with Extended Depth of Focus

“…In this study, we compared both and showed that Symfony ® and Synergy ® had similar values, with a higher value at each point in Symfony ® without any significance. Khoramnia et al [32] reported exact mesopic CS values for Symfony ® , which were 1.56 ± 0.20, 1.44 ± 0.25, 0.92 ± 0.38, and 0.44 ± 0.37 at illumination levels of 3.0, 6.0, 12.0, and 18.0, respectively, and were similar to our results. iTrace measures the objective optical quality of an IOL using a retinal image obtained from a ray-tracing aberrometer system [33].…”

Clinical outcomes of a toric continuous range of vision presbyopia-correcting intraocular lens

“…4–6 Several studies have confirmed the capability of this type of implant to provide an effective restoration of the visual function at different distances, with optimal visual quality at even closer than 40 cm. 7–15 Indeed, a trend to obtain a wider range of functional focus with this hybrid IOL was observed in a comparative study of this IOL with other 2 trifocal IOLs. 16 However, to this date, there is no report showing if these results are also achieved with the toric version of this hybrid IOL, Tecnis Synergy Toric II, which is implanted in eyes with preexisting corneal astigmatism.…”

“…6 By contrast, Khoramnia et al found in another sample of 28 patients implanted with the same IOL a mean postoperative monocular DCIVA measured at 80 cm, UNVA measured at 40 cm, and DCNVA measured at 40 cm of −0.03 ± 0.09 logMAR, 0.03 ± 0.09 logMAR, and −0.01 ± 0.06 logMAR, respectively. 9 Despite these differences among studies that may be attributed to different procedural aspects, the visual outcomes were always within acceptable values. Indeed, in our series, a total of 100%, 81.8%, and 90.9% achieved postoperative CDVA, DCIVA measured at 80 cm, and DCNVA measured at 40 cm of 20/30 or better, respectively.…”

“…As happened with uncorrected visual acuities, some variability was found between previous studies evaluating the nontoric version of the Tecnis Synergy IOL. 6–15 Ribeiro et al found in a sample of 27 patients implanted with Tecnis Synergy IOL that mean 3-month postoperative monocular DCIVA measured at 66 cm, UNVA measured at 40 cm, and DCNVA measured at 40 cm were 0.03 ± 0.11 logMAR, 0.05 ± 0.13 logMAR, and 0.00 ± 0.08 logMAR, respectively. 6 By contrast, Khoramnia et al found in another sample of 28 patients implanted with the same IOL a mean postoperative monocular DCIVA measured at 80 cm, UNVA measured at 40 cm, and DCNVA measured at 40 cm of −0.03 ± 0.09 logMAR, 0.03 ± 0.09 logMAR, and −0.01 ± 0.06 logMAR, respectively.…”

“…6,13,15 However, other authors have reported somewhat better visual outcomes compared with this study when evaluating the clinical performance of Tecnis Synergy. 4,7,9,10,12 Several factors may have accounted for this variability in the visual outcomes of this IOL between studies (maximum difference around 1.5 logMAR line), such as the different procedure used for measuring the visual acuity (optotype used, distance, monocular or binocular, etc. ), differences in terms of lightning illumination conditions, or the range of age of the patients included.…”