Objective and subjective evaluation of photic phenomena after monofocal and multifocal intraocular lens implantation11The authors have no commercial or financial interest in any aspect of this study.

Dick, H. Burkhard; Krummenauer, Frank; Schwenn, Oliver; Krist, R.; Pfeiffer, Norbert

doi:10.1016/s0161-6420(99)90396-2

Cited by 157 publications

(98 citation statements)

References 20 publications

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“…Anyway, this effect would be eliminated when measuring near vision with correction for far vision. Another important point is the fact that no patients had a refractive outcome greater than 1 D, which could lead to increased frequency and severity of photic phenomena (20) .Our results for uncorrected visual acuity and visual acuity corrected for far vision among patients who received the Tecnis™ MF and Restor™ lenses are in agreement with the literature. In a European multicentre study, Kohnen et al (21) found that all patients who received Restor™ lenses achieved an uncorrected far visual acuity of 20/40 or better, and 97.5% of patients achieved an uncorrected near vision of 20/40 or better.…”

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confidence: 88%

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Elaboração e validação do questionário de satisfação dos pacientes pseudofácicos em português

Hida¹,

Nakano²,

Yamane³

et al. 2013

Rev. bras.oftalmol.

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Purpose: Development and validation of quality of life questionnaire in pseudophakic patients in Portuguese. Methods: The modified Cataract TyPESpecification questionnaire was specifically developed to assess quality of life after cataract surgery, functional status evaluated with 10 items and contains 18 questions. All questions were applied by a single examiner, with the goal of graduating visual satisfaction from 0 to 10 (0 means very dissatisfied, 5 neutral, 10 very satisfied).This prospective comparative study included 142 eyes of 71 patients in Sao Paulo University. The ophthalmologic evaluation performed included near, intermediate and distance corrected and uncorrected visual acuity and quality of life questionaire. The minimum follow-up was 6 months. Results: The mean age of patients was 60.7± 6.6 years in theTecnis ® MF, 63.1 ±4.4 years in-groupRestor ® 63.7±4.2 years in-group SN60AT/SN60WF. Uncorrected and distance-corrected near visual acuity were statistically higher in theRestor ® and Tecnis ® groups compared to the SN60AT/SN60WF group (p<0.001). There were no statistical differences between groups comparing uncorrected and best-corrected distance visual acuity (p=0.56). Satisfaction questionnaire showed high glasses independence fortheTecnis ® MF (9.3 /10) and Restor ® (8.7 /10) INTRODUCTIONP hacoemulsification and IOL implantation using increasingly smaller incisions have allowed rapid visual recovery with low rates of complications in the hands of experienced surgeons, as well as good quality of vision in the postoperative period. Assessment of the quality of vision can be done through various tests, such as those assessing contrast sensitivity, which is the ability to distinguish the details of images and depends on ambient brightness (1)(2)(3)(4) .In order to provide additional benefits to the visual quality of pseudophakic patients, intraocular lenses (IOLs) have been refined using an aspherical lens design to correct positive spherical aberrations of the cornea (5)(6)(7)(8) . One such aspherical lens is the SN60WF lens, developed from the SN60AT lens, both produced by Alcon Laboratories (Fort Worth, Texas, USA). The former provides greater reduction in spherical aberrations with better vision in low light conditions and increased contrast sensitivity in the postoperative period compared to the latter (5,6,9) .Monofocal IOLs are traditionally used for intraocular implants in cataract surgery. Do to their lack of optical correction, they do not provide a satisfactory depth of focus at varying distances. Despite the potential benefits of multifocal IOLs, their indications are still limited (10,11) .More advanced multifocal IOLs aim to provide contrast sensitivity similar that accepted for monofocal IOLs and to induce minimal optical aberrations. However, the scientific literature reports a loss of contrast sensitivity and functional vision associated with photic phenomena that affect patient satisfaction (12,13) .The aim of this study was to develop and evaluate a quality of life qu...

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confidence: 88%

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confidence: 99%

Elaboração e validação do questionário de satisfação dos pacientes pseudofácicos em português

Hida¹,

Nakano²,

Yamane³

et al. 2013

Rev. bras.oftalmol.

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“…Researchers have noted these factors, and some studies have analyzed the governing factors for patient satisfaction after implantation of multifocal IOLs. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Causes associated with photic phenomena noted in previous studies have included IOL decentration, retained lens fragment, posterior capsular opacification, dry-eye syndrome, uncorrected visual acuity (UCVA), use of spectacles for distance purposes, postoperative astigmatism, and postoperative spherical equivalent. 9,21 However, none of the studies in published literature have evaluated the role of misalignment between the visual axis and the pupillary axis, or the angle kappa, as a specific predictor for patient symptoms.…”

Section: Introductionmentioning

confidence: 99%

Predictive factor and kappa angle analysis for visual satisfactions in patients with multifocal IOL implantation

Prakash

Agarwal

et al. 2011

Eye

104

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Purpose To evaluate the visual acuity and quality-related satisfaction of patients implanted with a refractive design multifocal intraocular lens (IOL), and evaluate the factors predicting it including angle kappa. Setting Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai. Methods In this prospective trial, 50 eyes of 44 consecutive patients were included. All patients underwent phacoemulsification with multifocal IOL implantation (Rezoom IOL, Abbott Medical Optics). The preoperative and postoperative assessment included slit lamp biomicroscopy, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA) and kappa angle assessment. At 1 year, 37 patients (43 eyes), who finished follow-up, were asked to rate their symptoms on a graded questionnaire (0-5 for five queries). Results The decimal scores for UCVA and BCVA were 0.38 ± 0.21 and 0.47 ± 0.17 (preoperative), and 0.75 ± 0.22 and 0.99 ± 0.11 (postoperative), respectively. Symptom scores were haloes 0.98 ± 1.7, glare 0.69 ± 1.48, blurred distance 1.0 ± 1.7, intermediate 1.34 ± 1.6, near 1.06±1.8. On regression analysis haloes depended on angle kappa and distance UCVA (R 2 ¼ 0.26, P ¼ 0.029), and glare on angle kappa (R 2 ¼ 0.26, P ¼ 0.033). Poor satisfactions with distance, intermediate, and near vision were linked with distance UCVA (R 2 ¼ 0.17, P ¼ 2.3 Â 10 À4 ), distance UCVA (R 2 ¼ 0.1, P ¼ 0.04), and near UCVA (R 2 ¼ 0.12, P ¼ 0.03), respectively. The strongest predictor, however, for overall visual discomfort was distance UCVA (R 2 ¼ 0.1, P ¼ 0.04).Conclusions Our study suggests that there may be a role of misalignment between the visual and pupillary axis (angle kappa) in the occurrence of photic phenomenon after refractive multifocal IOL implantation.

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“…It also showed the presence of blur and glare/halo symptoms more commonly in these patients (12.5% and 18.8%) and their absence in the monofocal group, which concur with findings of previous studies. 3,4,16 In a prospective case series, Dick et al, 17 found the latter symptoms not to be significantly different in the two groups, and other factors such as the patients' age and corneal surface irregularities were found to have a significant role in causing similar photic phenomena. The subjective appreciation of difficulty with outdoor bright light in the multifocal group further highlights the importance of patient selection.…”

Section: Discussionmentioning

confidence: 93%

Effect of illumination on visual function after monofocal and multifocal intraocular lens implantation

Elgohary

Beckingsale

2005

Eye

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Purpose To compare best-corrected visual acuity (BCVA) and contrast sensitivity (CS) under different levels of illumination in patients who had monofocal and multifocal intraocular lenses (IOLs) and to establish the effect of different lighting conditions on vision in the two groups of patients. Methods We retrospectively reviewed 27 patients who underwent phacoemulsification for age-related cataract and IOL implantation of either monofocal (SI30NB; n ¼ 10, 37%) or multifocal (SA40N; n ¼ 17, 63%) IOLs. Binocular distance and near BCVA and CS were tested using logMAR and Pelli-Robson charts that were externally illuminated with 20, 200, 400 and 1600 lux, and were compared using repeated-measures analysis of variance. A questionnaire was administered to establish the lighting preference in the two groups and the effect of lighting conditions on their vision. Results Binocular distance and near BCVA and CS significantly increased with increasing illumination from 20 to 200 lux in the monofocal (mean ¼ 0.04 vs -0.07, P ¼ 0.006; 0.37 vs 0.26, P ¼ 0.002 and 1.47 vs 1.60, P ¼ 0.01) as well as in the multifocal group (mean ¼ 0.03 vs À0.12, Po0.001; 0.38 vs 0.23, Po0.001 and 1.47 vs 1.61, P ¼ 0.002). No significant difference in BCVA or CS was found between the two groups at any of the four illumination levels. Both groups had similar lighting preference, but 43.8% of patients in the multifocal group experienced subjective worsening of their vision in bright outdoor lights. Conclusions Distance and near BCVA and CS improve with increasing illumination in patients with monofocal and multifocal IOLs, but remain comparable in the two groups under common levels of indoor illumination. Patients with multifocal IOLs may experience worsening of their vision in bright outdoor lights.

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Objective and subjective evaluation of photic phenomena after monofocal and multifocal intraocular lens implantation11The authors have no commercial or financial interest in any aspect of this study.

Cited by 157 publications

References 20 publications

Elaboração e validação do questionário de satisfação dos pacientes pseudofácicos em português

Elaboração e validação do questionário de satisfação dos pacientes pseudofácicos em português

Predictive factor and kappa angle analysis for visual satisfactions in patients with multifocal IOL implantation

Effect of illumination on visual function after monofocal and multifocal intraocular lens implantation

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