The results demonstrated that the trifocal FineVision IOL is able to restore near, intermediate, and distance visual function.
PurposeTo evaluate the subjective and objective visual results after the implantation of a new trifocal diffractive intraocular lens.MethodsA new trifocal diffractive intraocular lens was designed combining two superimposed diffractive profiles: one with +1.75 diopters (D) addition for intermediate vision and the other with +3.50 D addition for near vision. Fifty eyes of 25 patients that were operated on by one surgeon are included in this study. The uncorrected and best distance-corrected monocular and binocular, near, intermediate, and distance visual acuities, contrast sensitivity, and defocus curves were measured 6 months postoperatively. In addition to the standard clinical follow-up, a questionnaire evaluating individual satisfaction and quality of life was submitted to the patients.ResultsThe mean age of patients at the time of surgery was 70 ± 10 years. The mean uncorrected and corrected monocular distance visual acuity (VA) were LogMAR 0.06 ± 0.10 and LogMAR 0.00 ± 0.08, respectively. The outcomes for the binocular uncorrected distance visual acuity were almost the same (LogMAR −0.04 ± 0.09). LogMAR −010 ± 0.15 and 0.02 ± 0.06 were measured for the binocular uncorrected intermediate and near VA, respectively. The distance-corrected visual acuity was maintained in mesopic conditions. The contrast sensitivity was similar to that obtained after implantation of a bifocal intraocular lens and did not decrease in mesopic conditions. The binocular defocus curve confirms good VA even in the intermediate distance range, with a moderate decrease of less than LogMAR 0.2 at −1.5 D, with respect to the best distance VA at 0 D defocus. Patient satisfaction was high. No discrepancy between the objective and subjective outcomes was evidenced.ConclusionThe introduction of a third focus in diffractive multifocal intraocular lenses improves the intermediate vision with minimal visual discomfort for the patient.
We report four cases of keratitis and corneal scarring from a total of 117 eyes treated with CXL. The location of the scarring determined the amount of loss of visual acuity: in two eyes, there was a persistent decrease in best spectacle-corrected visual acuity.
Overall, the flap dimensions and refractive results were predictable and the complication rate was acceptable after LASIK using the new femtosecond laser for flap creation.
The results of this study suggest that this simple macular function test has a positive predictive value of 94.2% in predicting a visual outcome of 20/25 or better after cataract surgery. The sensitivity was 94.2% and the specificity, 32.4%. The negative predictive value was 32.4% and the positive predictive value for a BCVA of 20/30 or better, 99.2%.
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Objective: To evaluate clinical results of a high-frequency, low-energy, small spot femtosecond laser for the creation of thin corneal flaps in laser in situ keratomileusis (LASIK) used in a comparative case series at a private practice in Brussels, Belgium. Methods: A series of 75 patients selected for LASIK refractive surgery were enrolled for treatment with the Ziemer FEMTO LDV femtosecond laser and received a corneal flap of either 90 µm (59 patients, 103 eyes) or 80 µm (16 patients, 27 eyes) nominal thickness. Prospective evaluation included flap dimensions, intra-and post-operative complications and visual outcomes. 1-5 A thin flap may thus be desirable: it enables the treatment of higher corrections, permits larger ablation zones, induces fewer aberrations, has a lower enhancement rate and better functional results than a conventional >100 µm flap. Moreover, thin flaps help to maximise the RSB -staying further away from the critical 250 µm barrier -and preserve the biomechanical stability of the cornea, hence reducing the risk of ectasia.A critical prerequisite for thin flaps to be a practical alternative is to use a flap-making modality that creates flaps of uniform and predictable thickness. Femtosecond lasers have been shown to meet this condition better than mechanical microkeratomes. The practical limits of femtosecond lasers are determined by the mechanical stability and precision of the docking mechanism that applanates the cornea, by the pulse energy, by the capability of the laser optics to focus the laser beam in the cutting plane and finally by the quality of the achieved dissection.A thinner than conventional flap blends the advantages of lamellar and surface approaches: to preserve as much tissue as possible and at the same time retain an intact flap for fast recovery and protection. 1,6,7 Sub-Bowman keratomileusis (SBK) is a laser procedure that involves the use of a customised corneal flap between 90 and 110 µm with a diameter that is closely matched to the ablation zone of the excimer laser being used, typically ± 8.5 mm. 8One of the principal concerns in thin-flap LASIK is that very thin flaps induce the risk of intraoperative complications (pseudo-buttonhole): the thinner the flap, the closer you get to Bowman's layer. Ultra thin flaps are more difficult to handle and more easily displaced enhancing the risk of flap striae and irregular astigmatism. [9][10][11] Remaining tissue bridges can cause force to be required for separating the flap, which may cause a very thin flap to tear or to over-stretch.
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