Pilot study of new focus-shift accommodating intraocular lens

Cleary, Georgia; Spalton, David J.; Marshall, John

doi:10.1016/j.jcrs.2009.11.025

Cited by 16 publications

(17 citation statements)

References 35 publications

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“…28 Mean pilocarpine-stimulated forward IOL shifts of approximately 0.3 mm have been reported for the Tetraflex IOL and another investigational accommodating IOL. 29,30 In both cases, the authors speculate that pseudoaccommodative factors, rather than the clinically insignificant IOL shifts, were responsible for the subjective improvement in near vision they reported.…”

Section: Discussionmentioning

confidence: 91%

Comparison of visual results with accommodating intraocular lenses versus mini-monovision with a monofocal intraocular lens

Beiko

2013

Journal of Cataract and Refractive Surgery

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Section: Discussionmentioning

confidence: 91%

Comparison of visual results with accommodating intraocular lenses versus mini-monovision with a monofocal intraocular lens

Beiko

2013

Journal of Cataract and Refractive Surgery

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“…A relative criterion for depth-of-focus analysis defines the VA cutoff relative to the best-attained level of VA; relative criteria have not been used in multifocal studies but have been used with the assessment of accommodating IOLs. 3 An absolute criterion identifies the limits of VA independent to the best-attained VA; the limit of 0.3 LogMAR is the most common criterion used with multifocal IOL studies and matches the level of VA defined as the driving standard in Europe 14 and in all but three states in the United States. 15 The defocus curve of a MIOL can pass through the depth of focus criterion line several times; it is unclear how studies have resolved this previously as this possibility has not been addressed.…”

mentioning

confidence: 99%

Multifocal Intraocular Lens Differentiation Using Defocus Curves

Buckhurst

Wolffsohn

Naroo

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To determine the most appropriate analysis technique for the differentiation of multifocal intraocular lens (MIOL) designs by using defocus curve assessment of visual capability.METHODS. Four groups of 15 subjects were implanted bilaterally with either monofocal intraocular lenses, refractive MIOLs, diffractive MIOLs, or a combination of refractive and diffractive MIOLs. Defocus curves between À5.0 D and þ1.5 D were evaluated by using an absolute and relative depth-of-focus method, the direct comparison method, and a new ''area-offocus'' metric. The results were correlated with a subjective perception of near and intermediate vision. RESULTS.Neither depth-of-focus method of analysis was sensitive enough to differentiate between MIOL groups (P > 0.05). The direct comparison method indicated that the refractive MIOL group performed better at þ1.00 diopter (D), À1.00 D, and À1.50 D and worse at À3.00 D, À3.50 D, À4.00 D, and À5.00 D than did the diffractive MIOL group (P < 0.05). The area-of-focus intermediate zone was greater with the refractive than with the diffractive MIOL group (P ¼ 0.005) and the near zone was better with the diffractive (P ¼ 0.020) and ''mix and match'' (P ¼ 0.039) groups than with the refractive MIOL group. The subjective perception of intermediate and near vision agreed best with the area-of-focus metric for the intermediate (r s ¼ 0.408, P ¼ 0.010) and near zone (r s ¼ 0.484, P < 0.001).CONCLUSIONS. Conventional depth-of-focus metrics provide a single value to quantify the useful range of vision; however, they fail to provide sufficient detail to differentiate between MIOL designs. The direct comparison method provides a large amount of information, although the results can be complex to interpret. The proposed area-of-focus metric provides a simple, but differentiating method of evaluating MIOL defocus curves. (Invest Ophthalmol Vis Sci. 2012;53:3920-3926 Previous in vivo MIOL studies have examined the visual range of MIOLs by using measurements of visual acuity (VA) either at varying distances 4-6 or through different levels of spectacle lens defocus.7-9 However, the more physical method of measuring VA at varying distances is often impractical owing to the need to control angular image size and luminance.Measuring VA through a range of spectacle lenses creates a defocus curve profile. A previous study has suggested that VA measured with this method provides an underestimation of the true VA at the corresponding distance owing to the magnification effects of lenses in the spectacle plane (although this can be compensated for mathematically 10 ) and the disrupted natural associated convergence and pupil response. 11The two focal points created by the conventional bifocal MIOL result in a distinctive defocus curve profile with two peaks of optimum acuity: one at the distance focal point and the other at the near focus. 6 Hence, defocus curves demonstrate the strength of the near addition (the separation in diopters between the distance and near peak) as well as the quality of vis...

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“…Such capabilities of automated ocular biometry are necessary for real-time data analysis of accommodative changes. Previous work was based on manual or semiautomated measurements of OCT images, 8,10,18 which is not feasible to conduct in large-scale studies. Additionally, the fully automatic method will make the measurements more objective compared with manual ones, and this will improve the precision of the measurements.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 However, the ongoing challenge with these lenses is to increase their efficacy by improving the dioptric power available for near vision. [8][9][10] In addition, accurate positioning of IOLs during accommodation is important for visual quality at different distances after surgery, especially for AIOLs. Abnormal IOL positioning is identified by the lens tilt and decentration.…”

mentioning

confidence: 99%

Fully Automated Biometry of In Situ Intraocular Lenses Using Long Scan Depth Spectral-Domain Optical Coherence Tomography

Chen

Leng

Zhu

et al. 2014

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Pilot study of new focus-shift accommodating intraocular lens

Abstract: Objective accommodation and forward axial shift were clinically insignificant with the accommodating IOL. The near visual performance was attributed to depth of focus rather than to true pseudophakic accommodation.

Cited by 16 publications

References 35 publications

Comparison of visual results with accommodating intraocular lenses versus mini-monovision with a monofocal intraocular lens

Comparison of visual results with accommodating intraocular lenses versus mini-monovision with a monofocal intraocular lens

Multifocal Intraocular Lens Differentiation Using Defocus Curves

Fully Automated Biometry of In Situ Intraocular Lenses Using Long Scan Depth Spectral-Domain Optical Coherence Tomography

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