Selektion von Intraokularlinsen bei Patienten mit Makulopathien

Kaymak, Hakan; Graff, Birte; Nienhaus, Svenja; Neller, Kai; Seitz, Berthold; Langenbucher, Achim; Schwahn, Hartmut

doi:10.1055/a-1160-5917

Cited by 6 publications

(6 citation statements)

References 24 publications

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“…U, Barcelona, Spain) allows the patient's defocusing curve for IOLs to be obtained. 21 , 23 , 25 However, some caution should be exercised when evaluating the results given that in VirtIOL experiments, the monofocal IOL achieved relatively good results at distances, 21 which does not correspond to clinical experience. Additionally, as this device is immobile, it is impossible to see the real world, and the patient can only see a simple target.…”

Section: Discussionmentioning

confidence: 99%

A Novel Intraocular Lens Simulator that Allows Patients to Experience the World Through Multifocal Intraocular Lenses Before Surgeries

Kim

Nam

et al. 2022

Trans. Vis. Sci. Tech.

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Purpose The purpose of this study was to investigate whether the intraocular lens (IOL) simulator can simulate how the world appears to patients with multifocal IOLs by allowing the patients to see far and near objects through the IOL simulator. Methods Twenty eyes from 20 patients (age = 50–70 years old) were included in the study. The IOL simulator we developed consists of a trial lens frame adapter, a lens tube, a concave lens, a spacer, a wet cell, and an IOL. We used two IOLs: Tecnis monofocal and Tecnis bifocal IOL (add +3.25 diopter [D]). Patients wore a trial lens frame with an IOL simulator on distant corrected trial lenses and underwent the following tests: defocus curve, satisfaction with distance and near vision, halo around the light, and near point accommodation (NPA). To check how the world appears to the patients through this simulator, a machine vision lens and a scientific camera were attached to the simulator, and far and near objects were photographed. Results In the defocus curve of multifocal IOL, the visual acuity showed the second peak at –4 D. Compared to monofocal IOL, satisfaction with distant vision was slightly worse, more halos were felt, satisfaction with near vision was higher, and the NPA was shorter in multifocal IOL. In the scientific camera test, through the multifocal IOL, the waiting room was blurry, the halo around the ceiling light was prominent, and the characteristics on the near visual acuity chart were clear. Conclusion Subjects could experience the functions of multifocal IOLs with our newly developed IOL simulator. Translational Relevance This IOL simulator using geometric optics allows patients to experience the function of multifocal IOLs before cataract surgery.

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Section: Discussionmentioning

confidence: 99%

A Novel Intraocular Lens Simulator that Allows Patients to Experience the World Through Multifocal Intraocular Lenses Before Surgeries

Kim

Nam

et al. 2022

Trans. Vis. Sci. Tech.

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“…Other conditions such as patients operated on with a monofocal IOL in the fellow eye, previous corneal refractive surgery with excimer laser, age over 75 years, or amblyopia have been also suggested to be relative contraindications to multifocality as the implantation of a multifocal IOL can compromise the patient's visual quality due to more di culty in the neuroadaptation ability or a baseline already compromised visual function [31]. Alternatives such as monovision or EDOF IOLs [20][21][22] have been described for this typology of patients. It should be considered that EDOF IOLs were designed with the aim of reducing dysphotopsia, with less reduction in contrast sensitivity [2][3][4][5][6][7][8][9][10][11][12] and higher tolerance to residual refractive errors than multifocal IOLs [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

“…To this date, very few studies have been conducted to evaluate the potential of EDOF IOLs for providing a successful visual restoration in those cases which the indication of multifocal IOLs is risky and not fully accepted [20][21][22]. The aim of the current study was to evaluate the visual and patient-reported outcomes of patients undergoing cataract surgery with implantation of an EDOF IOL who were not good candidates for multifocal IOL implantation due to one of the following conditions (common exclusion criteria of studies evaluating the outcomes of trifocal diffractive IOLs): patients operated on with a monofocal IOL in the fellow eye, previous corneal refractive surgery with excimer laser, mild and non-progressive maculopathy, mild and non-progressive glaucoma, age over 75 years, amblyopia, or previous vitrectomy.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Visual and Patient-Reported Outcomes After Implantation of Extended Depth of Focus Intraocular Lenses in Patients Not Suitable for Multifocal Lenses

Álvarez-García

Fuente-García

Muñoz-Puyol

et al. 2022

Preprint

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Purpose To evaluate the visual and patient-reported outcomes of patients undergoing cataract surgery with implantation of an extended depth of focus (EDOF) intraocular lens (IOL) who were not good candidates for multifocal IOL implantation Methods Retrospective analysis of data from 30 eyes (23 patients) undergoing cataract surgery with implantation of one of two EDOF IOLs (follow-up: 37.9 ± 16.2 months), and prospective observational study including 106 eyes (78 patients) implanted with one of 6 different EDOF models (follow-up: 8.0 ± 7.7 months). Patients recruited had one of the following conditions: monofocal IOL implanted in the fellow eye, previous corneal refractive surgery, mild and non-progressive maculopathy or glaucoma, age > 75 years, amblyopia, or previous vitrectomy. Results In the retrospective phase, significant improvements were found in uncorrected distance (UDVA), corrected distance (CDVA) and corrected near visual acuity (CNVA) (p ≤ 0.013), with a non-significant trend to improvement in uncorrected near visual acuity (UNVA). A total of 90% of patients were completely to moderately satisfied with the outcome achieved. In the prospective phase, significant improvements were found in UDVA, CDVA, UNVA and CNVA (p ≤ 0.032), with a total of 85.5% of patients being completely to moderately satisfied (dissatisfaction 3.3%). In both phases, extreme difficulties were only reported by a limited percentage of patients for performing some near vision activities. Conclusions EDOF IOLs should be considered as a new therapeutic option in this type of patients, being a viable alternative to monofocal IOLs.

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“…Although traditional thinking would typically exclude patients with macular pathology from multifocal technology, some studies have suggested that these patients can still benefit. 1,2…”

Section: Iqbal Ike K Ahmed MD Frcscmentioning

confidence: 99%

Bilaterally subluxed diffractive intraocular lenses: big expectations and even bigger comorbidities

Fram,

Assia,

Venkateswaran

et al. 2024

J Cataract Refract Surg

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A 78-year-old woman with an ocular history of cataract surgery with a diffractive intraocular lens (IOL) in each eye has developed fluctuating vision, greater in the right eye than the left eye, after 4 years. She has a history of inactive central serous retinopathy and a vision potential of 20/25 + 2 in the right eye and 20/25 in the left eye. She has well-controlled diabetes, hypertension, and hypercholesterolemia. She has enjoyed her spectacle independence for some time and wishes to have her vision restored. On examination, her uncorrected distance visual acuity (UDVA) was 20/50 in the right eye and 20/25 in the left eye and her uncorrected near visual acuity (UNVA) was J3 in the right eye and J1 in the left eye. Intraocular pressures (IOPs) measured 22 mm Hg in the right eye and 18 mm Hg in the left eye. Pupils had limited reactivity with irregularity in the right eye but no obvious relative afferent pupillary defect. Motility and confrontation visual fields were unremarkable in both eyes. Retinal acuity meter was 20/20 in both eyes, and manifest refraction was plano −1.25 × 105 20/40, J3 in the right eye and +0.50 × 20/25, J1 in the left eye. Pertinent findings on slitlamp examination included temporal iris atrophy and transillumination defects greater in the right eye than the left eye, peripupillary pseudoexfoliative changes in both eyes, significant inferior subluxation of a diffractive 3-piece posterior chamber IOL in the capsular bag with lens-pitting peripherally and few central, moderate pseudophacodonesis, and an open posterior capsule in the right eye. In the left eye, she had mild inferior subluxation of a single-piece acrylic diffractive IOL in the capsular bag with moderate pseudophacodonesis and an open posterior capsule (Figure 1 JOURNAL/jcrs/04.03/02158034-202403000-00019/figure1/v/2024-02-20T193212Z/r/image-tiff ). All other anterior segment findings were unremarkable. On dilated posterior examination, she had a cup-to-disc ratio of 0.50 in the right eye and 0.65 in the left eye without edema hemorrhage or pallor. There were attenuated vessels in both eyes, posterior vitreous detachment in both eyes, and a few small drusen peripherally in both eyes. There was retinal pigment epithelium irregularity and dropout parafoveal in the right eye and subfoveal in the left eye (Figure 2). There was no evidence of macular edema, subretinal fluid, choroidal thickening, or neovascular membranes. The periphery was unremarkable in both eyes. JOURNAL/jcrs/04.03/02158034-202403000-00019/figure2/v/2024-02-20T193212Z/r/image-tiff What testing would you obtain preoperatively to help guide your decision-making? How would you counsel the patient regarding comorbid conditions and expectations?

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Selektion von Intraokularlinsen bei Patienten mit Makulopathien

Cited by 6 publications

References 24 publications

A Novel Intraocular Lens Simulator that Allows Patients to Experience the World Through Multifocal Intraocular Lenses Before Surgeries

A Novel Intraocular Lens Simulator that Allows Patients to Experience the World Through Multifocal Intraocular Lenses Before Surgeries

Evaluation of Visual and Patient-Reported Outcomes After Implantation of Extended Depth of Focus Intraocular Lenses in Patients Not Suitable for Multifocal Lenses

Bilaterally subluxed diffractive intraocular lenses: big expectations and even bigger comorbidities

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