To evaluate visual performance and patient-reported outcomes after bilateral implantation of a new nondiffractive wavefrontshaping extended depth-of-focus (EDoF) intraocular lens (IOL).

PURPOSE: To evaluate the visual performance after bilateral implantation of a toric diffractive aspheric multifocal intraocular lens (IOL) with a +2.17 diopters (D) (60 cm) intermediate and a +3.25 D (40 cm) addition (add) power. METHODS: This prospective single-arm study was conducted at the Department of Ophthalmology, Goethe University, Frankfurt, Germany. Twenty-five patients (50 eyes) received bilateral implantation of the toric PanOptix IOL (AcrySof IQ PanOptix; Alcon Research LLC) before enrollment. Exclusion criteria were previous ocular surgeries excluding lens surgery and ocular pathologies or corneal abnormalities. Examination at 3 months postoperatively included manifest refraction; monocular and binocular uncorrected distance (UDVA) and distance-corrected (DCVA) visual acuity at 4 m and 80, 60, and 40 cm; and slit-lamp examination. At 3 months postoperatively, monocular and binocular defocus, binocular contrast sensitivity under photopic and mesopic conditions, and optical phenomena, and spectacle independence were evaluated. RESULTS: Mean refractive spherical equivalent was 0.12 ± 0.380 D and mean refractive cylinder was −0.21 ± 0.237 D at 3 months postoperatively. A significant decrease in refractive cylinder was observed postoperatively ( P < .05), with 98% showing a postoperative astigmatism below 0.75 D. Monocular UDVA was better than 0.14 logMAR in all distances. Binocular defocus curve showed peaks at 0.00 D (−0.09 logMAR) and −1.50 and −2.00 D (−0.02 and 0.00 logMAR). The worst values between far (4 m) and near (40 cm) distance were 0.04 logMAR at −1.00 D. Despite some optical phenomena, 92% of patients would choose the same IOL again and recommend it to others. CONCLUSIONS: The visual performance of the toric PanOptix IOL showed good visual acuity at all distances; more than 90% achieved a decrease of refractive cylinder below 0.75 D, high patient satisfaction despite some optical phenomena, and high spectacle independence 3 months postoperatively. [ J Refract Surg . 2020;36(10):638–644.]

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Background: To evaluate IOL calculation formulas provided by an online calculation tool from the ASCRS for an extended depth-of-focus (EDOF) IOL after previous myopic laser in situ keratomileusis (LASIK). Setting: Department of Ophthalmology, Goethe University, Frankfurt, Germany. Design: Retrospective consecutive case series. Methods: Patients who underwent cataract surgery or refractive lens exchange with implantation of a diffractive EDOF IOL and who had a history of myopic LASIK were included. Biometry, refractive data regarding the LASIK procedure, target refraction, and postoperative refraction were collected. Mean prediction error, mean absolute error (MAE), and the number of eyes within ±0.5 diopters (D), ±1.0 D, ±1.5 D, and ±2.0 D were calculated with the following formulas from the ASCRS calculator: Shammas, Haigis-L, Barrett True-K, Barrett No History, Masket, modified Masket, and the average of all formulas (average). Results: Twenty-five eyes matched the inclusion criteria. Mean spherical equivalent (SE) was −0.81 ± 0.69 D; the mean pre-LASIK SE was −6.4 ± 3.63 D. The formulas ranked by MAE were Shammas (0.7 ± 0.75 D), Haigis-L (0.72 ± 0.57 D), average (0.79 ± 0.8 D), Barrett True-K (1.14 ± 0.89 D), modified Masket (1.4 ± 1.15 D), Barrett No History (1.45 ± 0.7D ), and Masket (1.64 ± 1.27 D). The formulas with the most eyes within ±0.5 D were average (52%), Shammas (48%), and Haigis-L (44%) formulas. Conclusions: Calculation of IOLs in eyes with a history of refractive surgery remains a challenge. In this study, the Shammas and Haigis-L formulas performed best regarding MAE and percentage of eyes within ±0.5 D; however, the average of all formulas delivered reasonable results.

To evaluate factors that influence postoperative satisfaction in patients with diffractive extended depth-of-focus (EDoF) and multifocal intraocular lenses (mIOLs).

PURPOSE: To evaluate a ray-tracing formula for intraocular lens (IOL) calculation of diffractive extended depth of focus IOLs after myopic laser in situ keratomileusis (LASIK) compared to formulas from an established online calculator. METHODS: This retrospective, consecutive case series included patients after cataract surgery with implantation of an extended depth of focus (EDOF) IOL (AT LARA, Carl Zeiss Meditec; Symfony, Johnson & Johnson) and a history of myopic LASIK. Preoperative assessments included biometry (IOLMaster; Carl Zeiss Meditec) and corneal tomography, including true net power (TNP) (Pentacam; Oculus Optikgeräte GmbH). To evaluate the measurements, the simulated keratometry values (SimK) were compared to the TNP. Regarding IOL calculation, the mean prediction error, mean and median absolute prediction error (MAE and MedAE), and number of eyes within ±0.50, ±1.00, and ±2.00 diopters (D) from the Haigis-L, Shammas, and Barrett True K No History formulas to the Potvin-Hill and Haigis with TNP (Pentacam) formulas were compared. RESULTS: Thirty-six eyes matched the inclusion criteria with a mean spherical equivalent of −6.26 ± 3.25 diopters (D) preoperatively and −0.79 ± 0.75 D postoperatively. The mean difference from SimK and TNP was significantly different from zero ( P < .001; −1.24 ± 0.81 D). The best performing formulas by MedAE were the Potvin-Hill and Barrett True K No History (0.39 ± 0.78 and 0.64 ± 1.00 D). The formula with the most eyes within ±0.50 D was the Potvin-Hill (64%), followed by the Barrett True K No History (44%). For MAE and percentage of eyes within ±0.50 D, the Potvin-Hill formula was significantly better than the Haigis-L, Shammas, and Haigis-TNP formulas ( P < .05). CONCLUSIONS: Calculation of IOLs in patients who had LASIK remains less predicable than calculations for virgin eyes. Using ray-tracing to calculate diffractive EDOF IOLs after myopic LASIK, the Potvin-Hill formula outperformed established formulas in terms of the percentage within target refraction and the MAE. [ J Refract Surg. 2021;37(4):231–239.]

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The LASSO sizing formulas are easy to implement into clinical practice and can significantly improve the predictability of postoperative vault after ICL implantation.