This prospective, randomized study on the nondiffractive intraocular lens (IOL) DFT015 demonstrated superior intermediate and near vision, noninferior distance vision, and comparable visual disturbances to that of a monofocal IOL.

We received approval from the U.S. implant Food and Drug Administration and the University's Institutional Review Board to the Artisan lens (Ophtec BV) in both eyes of a patient who was aphakic and had megalocornea. No other intraocular lens would easily solve this patient's need because of the large anterior segment. The patient was having increasing difficulty with aphakic contact lenses because of his work environment. We present almost 5 years of follow-up data of this patient.

Purpose To assess the visual outcomes and quality of vision of patients receiving the AcrySof ® IQ Vivity™ non-diffractive extended vision intraocular lens (NDEV IOL) after uneventful cataract surgery when the non-dominant eye is targeted for slight myopia. Design Single site, prospective, single-arm study. Methods Eligible subjects interested in reducing their dependence on spectacles over a range of working distances were enrolled and followed for 3 months after the second eye surgery. Subjects were bilaterally implanted with this NDEV IOL, with a target of emmetropia in the dominant eye and a myopic refraction of −0.75D in the non-dominant eye. At 3 months postoperative, the uncorrected and distance-corrected (with monovision) visual acuity at 40 cm, 66 cm and 4 m were recorded, along with the manifest refraction. Questionnaires related to spectacle independence, patient satisfaction and quality of vision were also administered. Results Data from 33 subjects were analyzed. The mean difference between eyes by subject was 0.80 ± 0.37 D. Twenty-nine of 33 (88%) subjects had a binocular uncorrected near VA of 0.2 logMAR or better. Twenty-five of 33 eyes (76%) had a binocular distance-corrected (−0.75 D in the non-dominant eye) VA of 0.2 logMAR or better at all three test distances. Satisfaction with vision at all distances was high. The reported level of spectacle independence was higher than for the same lens without monovision. Visual disturbances were higher than has been previously reported for this lens but were not correlated to the level of monovision. Conclusion A target of −0.75 D of myopia in the non-dominant eye of patients bilaterally implanted with this NDEV IOL improved near vision, increasing the rate of spectacle independence in patients relative to those targeted for bilateral emmetropia, with no correlated increases in visual disturbances.

We report the first case of indocyanine green (ICG) being used in an eye with an anterior capsule that was not completely intact. We found that ICG seems to have a selective affinity for the anterior capsule over cortical lens material. The patient had a corneal perforation with a wire and developed endophthalmitis requiring pars plana vitrectomy with intravitreal antibiotics. He subsequently developed a white traumatic cataract with an anterior capsule tear. Five months after the injury, he had cataract extraction. Indocyanine green was used to better visualize the anterior capsule before capsulotomy. The anterior capsule stained green, but the cortical material exposed to ICG did not stain.

The refractive outcome after cataract surgery depends on several factors. According to Norrby, 1 the sources of error in the refractive outcome after cataract surgery include postoperative anterior chamber depth (ACD), 35.47%; postoperative refraction, 26.98%; axial length of the eye, 17.03%; corneal curvatures, asphericity, thickness, and refractive index, 10.19%; pupil size, 8.11%; refractive index of the intraocular lens (IOL), 1.19%; vitreous refractive indices, 0.54%; aqueous refractive index, 0.36%; retinal thickness, 0.14%; and eye chart distance, 0.01%.Per the above, the postoperative refraction, second to only postoperative ACD, is crucial in determining the error from the preoperative intended refractive target. 1,2 Since the corrected distance visual acuity (CDVA) is the endpoint of manifest refraction, we investigated whether the CDVA after cataract surgery affects the assessment of refractive outcome.Two hundred ninety-five patients had uneventful phacoemulsification with implantation of a posterior chamber IOL. The same surgeon (S.L.) performed all procedures through a 2.4 mm temporal limbal incision and implanted a 3-piece IOL with an acrylic optic and poly(methyl methacrylate) haptics (iSert, Hoya Corp.) in all cases.Preoperatively, the biometry was obtained with optical low coherence reflectometry (Lenstar 900, Haag-Streit AG). The IOL power was calculated with the Holladay 2 formula. 3 Eyes with corneal pathology or previous corneal surgery were excluded. Postoperatively, the CDVA was obtained with manifest refraction 3 weeks after surgery or later. There were no postoperative complications. Eyes with a CDVA worse than 20/40 were excluded.One eye from each patient was included in the study. The eyes were divided into 2 groups, 1 with a postoperative CDVA of 20/20 or better and the other, of 20/25 to 20/40. For each group, the mean error and the mean absolute error (MAE) from the intended refractive target were calculated. The statistical comparison was performed with the Student t test. Significant difference was defined as a P value less than 0.05. cause manifest refraction can be refined more easily in eyes with better visual acuity potential. More refined manifest refraction should lead to more accurate assessment of the error from the intended refractive target.With modern IOL power formulas, the mean error and the MAE are used for adjusting the lens constant of the IOL in calculating the IOL power. 2 By continually adjusting the lens constant, the surgeon can improve the refractive accuracy in future cases. The present study indicates that one should be able to obtain more accurate assessment of the refractive outcome by using the postoperative manifest refraction from eyes with a CDVA of 20/20 or better. REFERENCES1. Norrby S. Sources of error in intraocular lens power calculation.