Clinical outcomes with a diffractive trifocal intraocular lens

Alió, Jorge L.; Plaza-Puche, Ana B.; Barrio, Jorge L. Alió del; Amat-Peral, Pedro; Ortuño, Vicente; Yébana, Pilar; Al-Shymali, Olena; Vega-Estrada, Alfredo

doi:10.1177/1120672118762231

Cited by 59 publications

(69 citation statements)

References 25 publications

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“…Acuity of 0.3 logMAR or better from distance to near (−3.00D, equivalent to a reading distance of 33 cm) is common. 5,9,11,12 Results appear consistent with these prior results, though perhaps not as good as reported by Gundersen and Potvin, possibly because they used best distance-corrected VA at 6 months to 2 years postop while the current study used uncorrected VA at 1-month postop. 13 We found that 90% of our subjects had a 3.0D range of vision with an acuity of 0.2 logMAR or better.…”

Section: Discussionsupporting

confidence: 90%

“…11 Good contrast sensitivity outcomes have also been demonstrated in several studies with similar VA under different lighting conditions suggesting a level of pupil independence. 8,9,14 Results here appear within the normal range for subjects tested on the device. 15 Contrast sensitivity results in the current study were better than the results reported by Ruiz-Mesa et al, especially at the higher spatial frequencies, despite the previous authors' use of corrected VA for contrast sensitivity testing.…”

Section: Discussionsupporting

confidence: 64%

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Refractive and Visual Outcomes After Bilateral Implantation of a Trifocal Intraocular Lens in a Large Population

Carreño¹,

Carreño²,

Carreño³

et al. 2020

OPTH

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Purpose: To review refractive, visual acuity, defocus curve and contrast sensitivity results after bilateral implantation of a trifocal intraocular lens (IOL) in a large population. Setting: One site in Santiago, Chile. Design: Single arm, non-randomized retrospective chart review. Methods: This was a single-arm retrospective chart review of clinical outcomes after bilateral implantation of a trifocal IOL (Panoptix ®), both toric and non-toric versions. Binocular visual acuity at 4 m, 60 cm and 40 cm was tested. Other tests included refraction, mesopic and photopic contrast sensitivity, and defocus curve measurement. Results: The review included 500 eyes of 250 patients implanted with the trifocal IOL and 200 eyes of 100 patients implanted with the trifocal toric IOL, with no clinically significant differences between groups. Ninety-six percent of all eyes were within 0.50D of the intended spherical equivalent correction. In the toric group, 94% of eyes (187/200) had a residual refractive cylinder ≤0.50D, compared to 81% of eyes (406/500) in the non-toric group. Four out of five patients (80.6%, 282/350) had a binocular uncorrected VA of 0.1 logMAR (20/25) at all test distances. Mean defocus was 0.1 logMAR or better from vergences from 0.00 to −3.00 D (corresponding to vision from distance to about 33 cm). With a cutoff of 0.2 logMAR, 96% of patients had a range of vision 2.5 D or greater. Contrast sensitivity was similar between the toric and non-toric lenses, and similar to age-matched normal results. Conclusion: The non-toric and toric trifocal IOLs provided good distance, intermediate and near vision to patients, with a wide range of vision and good contrast sensitivity.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 64%

Refractive and Visual Outcomes After Bilateral Implantation of a Trifocal Intraocular Lens in a Large Population

Carreño¹,

Carreño²,

Carreño³

et al. 2020

OPTH

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“…Other studies have also shown that postoperative visual acuities at near, intermediate, and far with the PanOptix Trifocal IOL are good. [5][6][7][8][9] Despite the good visual acuity in these trifocal IOLs, visual disturbances can occur due to the light being split to create distinct focal points. Disturbances such as glare and halos are possible, and reduced contrast sensitivity has been reported relative to monofocal IOLs.…”

Section: Introductionmentioning

confidence: 99%

Comparing Visual Acuity, Low Contrast Acuity and Contrast Sensitivity After Trifocal Toric and Extended Depth of Focus Toric Intraocular Lens Implantation

Gundersen¹,

Potvin²

2020

OPTH

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The aim of this study was to compare visual acuity at various distances (far, intermediate and near), low contrast acuity and contrast sensitivity after trifocal toric and extended depth of focus (EDOF) toric intraocular lens (IOL) implantation. Patients and Methods: This was a non-interventional two-arm comparative study of visual outcomes after uncomplicated bilateral cataract or refractive lens exchange surgery with IOL implantation between 6 months and 5 years before a single diagnostic examination visit. There was no masking and no control group. Subjects had to have uncorrected distance visual acuity (UDVA) of 20/40 (0.3 logMAR) or better measured at the time of their study visit. Clinical evaluations included the manifest refraction, visual acuity (VA) at distance, intermediate (60 cm) and near (40 cm), low contrast (10%) VA and contrast sensitivity. Results: A total of 50 bilaterally implanted patients (25 trifocal, 25 EDOF) were examined; the two groups had similar characteristics, including corneal astigmatism. Postoperative refractive outcomes were also similar. There were no statistically significant differences in distance or intermediate VA between groups, but the trifocal group had significantly better near VA both uncorrected (p = 0.009) and distance-corrected (p = 0.014). There were no statistically significant differences in the low contrast acuity measures between IOLs at either distance or 40 cm, with or without glare. Contrast sensitivity in mesopic and photopic conditions was similar. Conclusion: The trifocal and EDOF toric IOLs performed similarly for all measures except near VA, where the trifocal toric provided significantly better acuity. For subjects interested in reducing spectacle independence at near, this may be an important consideration.

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“…These are usually referred to as diffractive lenses because their imaging properties rely on specific optical path length changes between zones and result in constructive interference (images) at focal distances determined by the ring geometry . In these lenses, a half wavelength (pi) phase shift between each zone produces a lens with two powers, a bifocal and other phase step combinations can be used to generate trifocal designs . These diffractive designs can be distinguished from the previously described concentric refractive lenses because every location across the lens contributes to each power, and thus these lenses are often referred to as ‘full aperture’ designs, in which the relative amount of energy in the distance and near images does not necessarily vary with pupil size, as it does with concentric refracting designs .…”

Section: Lens Power Variationsmentioning

confidence: 99%

“…102 In these lenses, a half wavelength (pi) phase shift between each zone produces a lens with two powers, a bifocal 26,101,103 and other phase step combinations can be used to generate trifocal designs. [104][105][106] These diffractive designs can be distinguished from the previously described concentric refractive lenses because every location across the lens contributes to each power, and thus these lenses are often referred to as 'full aperture' designs, [107][108][109][110] in which the relative amount of energy in the distance and near images does not necessarily vary with pupil size, as it does with concentric refracting designs. [97][98][99] Diffractive optics have been incorporated into several IOLs, 26,101,103,106,111,112 but have had limited commercial success as contact lenses (for example, Echelon 113,114 and Diffrax 115 ).…”

Section: Lens Power Variationsmentioning

confidence: 99%

Correction of presbyopia: old problems with old (and new) solutions

Kollbaum

Bradley

2020

Clinical and Experimental Optometry

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We live in a three‐dimensional world and the human eye can focus images from a wide range of distances by adjusting the power of the eye's lens (accommodation). Progressive senescent changes in the lens ultimately lead to a complete loss of this ability by about age 50, which then requires alternative strategies to generate high‐quality retinal images for far and close viewing distances. This review paper highlights the biomimetic properties and underlying optical mechanisms of induced anisometropia, small apertures, dynamic lenses, and multi‐optic lenses in ameliorating the visual consequences of presbyopia. Specifically, the advantages and consequences of non‐liner neural summation leveraged in monovision treatments are reviewed. Additionally, the value of a small pupil is quantified, and the impact of pinhole pupil location and their effects on neural sensitivity are examined. Different strategies of generating multifocal optics are also examined, and specifically the interaction between ocular and contact or intraocular lens aberrations and their effect on resulting image quality are simulated. Interestingly, most of the novel strategies for aiding presbyopic and pseudophakic eyes (for example, monovision, multifocality, pinhole pupils) have emerged naturally via evolution in a range of species.

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Clinical outcomes with a diffractive trifocal intraocular lens

Abstract: The AcrySof IQ Panoptix intraocular lens is able to restore visual function with an acceptable intermediate and near vision after cataract surgery with good contrast sensitivity and an improvement in the near activity visual questionnaire.

Cited by 59 publications

References 25 publications

<p>Refractive and Visual Outcomes After Bilateral Implantation of a Trifocal Intraocular Lens in a Large Population</p>

<p>Refractive and Visual Outcomes After Bilateral Implantation of a Trifocal Intraocular Lens in a Large Population</p>

<p>Comparing Visual Acuity, Low Contrast Acuity and Contrast Sensitivity After Trifocal Toric and Extended Depth of Focus Toric Intraocular Lens Implantation</p>

Correction of presbyopia: old problems with old (and new) solutions

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