Cataract extraction with multifocal intraocular lens implantation: Clinical, functional, and quality-of-life outcomes

Javitt, Jonathan C.; Brauweiler, H. P.; Jacobi, K. W.; Klemen, U. M.; Kohnen, Stephan; Quentin, C. D.; Teping, C.; Pham, Thoai; Knorz, Michael C.; Pöetzsch, Detleff

doi:10.1016/s0886-3350(00)00636-2

Cited by 208 publications

(259 citation statements)

References 7 publications

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“…[15][16][17][18][19][20] In this study, we compared the presenting visual functions between two groups of patients who had either monofocal or multifocal IOLs and presented with PCO and needed Nd:YAG capsulotomy with view to relating that to a possible effect on Nd:YAG capsulotomy rate. We showed that while near BCVA, Pelli-Robson CS and CCI were not significantly different at presentation in the two groups, high-and low-contrast acuity values were significantly greater in the multifocal group.…”

Section: Discussionmentioning

confidence: 99%

Effect of posterior capsular opacification on visual function in patients with monofocal and multifocal intraocular lenses

Elgohary

Beckingsale

2006

Eye

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Purpose To compare the effect of posterior capsular opacification (PCO) on visual function in patients with monofocal and multifocal intraocular lenses (IOLs). Methods Thirty-three consecutive patients with clinically significant PCO, 24 with monofocal, and nine with multifocal IOLs, were recruited. Patients with concurrent cause of visual loss or pupillary distortion were excluded. LogMAR high-and low-contrast (10%) distance visual acuity (VA), logMAR near VA, Pelli-Robson contrast sensitivity (CS), colour confusion index (CCI), and the presenting symptoms were compared between the two groups. Results There was no significant difference between the proportions of patient with different PCO grade in the two groups. At presentation, high-and low-contrast distance VA were significantly greater in the multifocal group (0.40 vs 0.20; P ¼ 0.04 and 0.34 vs 0.98; P ¼ 0.006), whereas near VA, CS, and CCI were not significantly different between the two groups. After capsulotomy, the above visual functions were not significantly different between the two groups. Blurred distance and near vision were the most common presenting symptoms (95.8 and 100% in the monofocal group and 88.9 and 66.7% in the multifocal group). A greater proportion of patients in the monofocal group had blurred near vision (100 vs 66.7%) and, whereas the symptoms in the majority of patients in the monofocal group were moderate to severe, they were mild to moderate in the multifocal group. ConclusionThe effect of PCO on visual function in the two groups seems to be comparable, although patients in the multifocal group appear to present with earlier loss of visual function.

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Section: Discussionmentioning

confidence: 99%

Effect of posterior capsular opacification on visual function in patients with monofocal and multifocal intraocular lenses

Elgohary

Beckingsale

2006

Eye

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“…It also showed the presence of blur and glare/halo symptoms more commonly in these patients (12.5% and 18.8%) and their absence in the monofocal group, which concur with findings of previous studies. 3,4,16 In a prospective case series, Dick et al, 17 found the latter symptoms not to be significantly different in the two groups, and other factors such as the patients' age and corneal surface irregularities were found to have a significant role in causing similar photic phenomena. The subjective appreciation of difficulty with outdoor bright light in the multifocal group further highlights the importance of patient selection.…”

Section: Discussionmentioning

confidence: 95%

“…[1][2][3][4][5] However, they are known to reduce contrast sensitivity (CS) under low-contrast 6,7 and mesopic conditions, 8 and to induce photic phenomena such as glare and halo with bright light. 5,6,9 In daily life, exposure to different levels of illumination is unavoidable and, although visual acuity is known to improve with increasing illumination, 10 it has not been reported before if, in patients with multifocal IOLs, visual acuity and CS are affected by changing the level of illumination.…”

Section: Introductionmentioning

confidence: 99%

Effect of illumination on visual function after monofocal and multifocal intraocular lens implantation

Elgohary

Beckingsale

2005

Eye

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Purpose To compare best-corrected visual acuity (BCVA) and contrast sensitivity (CS) under different levels of illumination in patients who had monofocal and multifocal intraocular lenses (IOLs) and to establish the effect of different lighting conditions on vision in the two groups of patients. Methods We retrospectively reviewed 27 patients who underwent phacoemulsification for age-related cataract and IOL implantation of either monofocal (SI30NB; n ¼ 10, 37%) or multifocal (SA40N; n ¼ 17, 63%) IOLs. Binocular distance and near BCVA and CS were tested using logMAR and Pelli-Robson charts that were externally illuminated with 20, 200, 400 and 1600 lux, and were compared using repeated-measures analysis of variance. A questionnaire was administered to establish the lighting preference in the two groups and the effect of lighting conditions on their vision. Results Binocular distance and near BCVA and CS significantly increased with increasing illumination from 20 to 200 lux in the monofocal (mean ¼ 0.04 vs -0.07, P ¼ 0.006; 0.37 vs 0.26, P ¼ 0.002 and 1.47 vs 1.60, P ¼ 0.01) as well as in the multifocal group (mean ¼ 0.03 vs À0.12, Po0.001; 0.38 vs 0.23, Po0.001 and 1.47 vs 1.61, P ¼ 0.002). No significant difference in BCVA or CS was found between the two groups at any of the four illumination levels. Both groups had similar lighting preference, but 43.8% of patients in the multifocal group experienced subjective worsening of their vision in bright outdoor lights. Conclusions Distance and near BCVA and CS improve with increasing illumination in patients with monofocal and multifocal IOLs, but remain comparable in the two groups under common levels of indoor illumination. Patients with multifocal IOLs may experience worsening of their vision in bright outdoor lights.

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“…The modified TyPE questionnaire (Appendix 1) was developed specifically to assess quality of life after cataract surgery. It assesses 10 functional status items using 18 questions (17,18) .A significance level of 5% was adopted, using comparison tests such as the Tukey, Kruskal-Wallis, Mann-Whitney, and Chisquare (two-tailed) tests and adjusting the significance level when needed. …”

mentioning

confidence: 99%

“…We applied the TyPE questionnaire, a satisfaction questionnaire developed to assess quality of life after multifocal IOL implantation, not available in this study. This is an important method to assess and compare the satisfaction of subjects included in the four groups (17,18) . It is also in agreement with the idea that hyperopic patients would have milder symptoms than myopic patients, although this comparison was not done in this study (19) .…”

mentioning

confidence: 99%

Elaboração e validação do questionário de satisfação dos pacientes pseudofácicos em português

Hida¹,

Nakano²,

Yamane³

et al. 2013

Rev. bras.oftalmol.

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Purpose: Development and validation of quality of life questionnaire in pseudophakic patients in Portuguese. Methods: The modified Cataract TyPESpecification questionnaire was specifically developed to assess quality of life after cataract surgery, functional status evaluated with 10 items and contains 18 questions. All questions were applied by a single examiner, with the goal of graduating visual satisfaction from 0 to 10 (0 means very dissatisfied, 5 neutral, 10 very satisfied).This prospective comparative study included 142 eyes of 71 patients in Sao Paulo University. The ophthalmologic evaluation performed included near, intermediate and distance corrected and uncorrected visual acuity and quality of life questionaire. The minimum follow-up was 6 months. Results: The mean age of patients was 60.7± 6.6 years in theTecnis ® MF, 63.1 ±4.4 years in-groupRestor ® 63.7±4.2 years in-group SN60AT/SN60WF. Uncorrected and distance-corrected near visual acuity were statistically higher in theRestor ® and Tecnis ® groups compared to the SN60AT/SN60WF group (p<0.001). There were no statistical differences between groups comparing uncorrected and best-corrected distance visual acuity (p=0.56). Satisfaction questionnaire showed high glasses independence fortheTecnis ® MF (9.3 /10) and Restor ® (8.7 /10) INTRODUCTIONP hacoemulsification and IOL implantation using increasingly smaller incisions have allowed rapid visual recovery with low rates of complications in the hands of experienced surgeons, as well as good quality of vision in the postoperative period. Assessment of the quality of vision can be done through various tests, such as those assessing contrast sensitivity, which is the ability to distinguish the details of images and depends on ambient brightness (1)(2)(3)(4) .In order to provide additional benefits to the visual quality of pseudophakic patients, intraocular lenses (IOLs) have been refined using an aspherical lens design to correct positive spherical aberrations of the cornea (5)(6)(7)(8) . One such aspherical lens is the SN60WF lens, developed from the SN60AT lens, both produced by Alcon Laboratories (Fort Worth, Texas, USA). The former provides greater reduction in spherical aberrations with better vision in low light conditions and increased contrast sensitivity in the postoperative period compared to the latter (5,6,9) .Monofocal IOLs are traditionally used for intraocular implants in cataract surgery. Do to their lack of optical correction, they do not provide a satisfactory depth of focus at varying distances. Despite the potential benefits of multifocal IOLs, their indications are still limited (10,11) .More advanced multifocal IOLs aim to provide contrast sensitivity similar that accepted for monofocal IOLs and to induce minimal optical aberrations. However, the scientific literature reports a loss of contrast sensitivity and functional vision associated with photic phenomena that affect patient satisfaction (12,13) .The aim of this study was to develop and evaluate a quality of life qu...

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Cataract extraction with multifocal intraocular lens implantation: Clinical, functional, and quality-of-life outcomes

Abstract: Those who had bilateral implantation of the Array multifocal IOL obtained better uncorrected and distance-corrected near visual acuities and reported better overall vision, less limitation in visual function, and less spectacle dependency than patients with bilateral monofocal IOLs.

Cited by 208 publications

References 7 publications

Effect of posterior capsular opacification on visual function in patients with monofocal and multifocal intraocular lenses

Effect of posterior capsular opacification on visual function in patients with monofocal and multifocal intraocular lenses

Effect of illumination on visual function after monofocal and multifocal intraocular lens implantation

Elaboração e validação do questionário de satisfação dos pacientes pseudofácicos em português

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