Dissatisfaction after implantation of multifocal intraocular lenses

Vries, Niels E. de; Webers, Carroll A.B.; Touwslager, Wouter; Bauer, Noël; Brabander, John de; Berendschot, Tos T. J. M.; Nuijts, Rudy M.M.A.

doi:10.1016/j.jcrs.2010.11.032

Cited by 393 publications

(314 citation statements)

References 36 publications

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“…Regardless of the type of MIOL, one of the major concerns for surgeons is the presence of residual astigmatism that is considered a source of dissatisfaction after the implantation of a MIOL [8]. Small amounts of astigmatism may limit the visual performance significantly [9].…”

Section: Discussionmentioning

confidence: 99%

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Residual Astigmatism Threshold and Patient Satisfaction with Bifocal, Trifocal and Extended Range of Vision Intraocular Lenses (IOLs)

Carones¹

2017

OJOph

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Purpose: To compare the impact of induced astigmatism with four different types of multifocal intraocular lenses (MIOLs). Method: Prospective, comparative, interventional, mono-centered study, including 80 eyes of patients with implantation of four different MIOLs: AcrySof ReSTOR +2.5 D (20 eyes), AcrySof ReSTOR +3.0 D (20 eyes), AcrySof Panoptix (20 eyes) (Alcon Laboratories, Inc., Fort Worth, TX, USA), and Tecnis Symfony ZRX00 (Abbott Medical Optics, Santa Ana, USA) (20 eyes). Patients were followed up for 3 months after surgery. Major parameters were uncorrected (UDVA) and corrected (CDVA) distance visual acuity, subjective refraction and patient satisfaction. Results: Differences between IOLs with regard to the impact of the cylinder sign and axis on visual acuity and patient satisfaction were not significant. With mild added negative cylinder, AcrySof ReSTOR +2.5 D and Tecnis Symfony IOLs maintained the baseline visual acuity, while it was mildly reduced with AcrySof ReSTOR +3.0 D and Panoptix IOLs. With moderate induced cylinder, the Tecnis Symfony IOL maintained good visual acuity and patient associated satisfaction. Panoptix IOL was the IOL most affected by the induced astigmatism with regard to dissatisfaction and visual acuity. The highest tolerance to the astigmatic distortion and blurriness induced with a −1.50 D cylinder was obtained with the Tecnis Symfony IOL. Tecnis Symfony IOL showed less dissatisfaction and less reduction of visual acuity than the other MIOLs. Conclusion: Simulated residual cylinders after the implantation of the Tecnis Symfony IOL up to 1.0 D have a very mild and not clinically relevant impact on visual acuity or patient satisfaction. The ERV IOL showed a better tolerance to unexpected postoperative residual errors than diffractive bifocal and trifocal IOLs.

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Section: Discussionmentioning

confidence: 99%

“…The extended range of vision (ERV) IOL is a new promising alternative to provide an effective and continuous range of optimum vision from far to near. This IOL is based on the combination of a diffractive pattern and the compensation for chromatic aberration and primary spherical aberration of the eye [6] [7] [8].…”

Section: Introductionmentioning

confidence: 99%

Residual Astigmatism Threshold and Patient Satisfaction with Bifocal, Trifocal and Extended Range of Vision Intraocular Lenses (IOLs)

Carones¹

2017

OJOph

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“…However, the bag-in-the-lens could only be implanted in 70% of the eyes (Tassignon et al 2014). A lot of studies have focused directly on the analysis of the governing factors for patient satisfaction or dissatisfaction after MIOL implantation and attempted to find criteria for patient selection (Walkow & Klemen 2001;Blaylock et al 2008;Kohnen et al 2008;Pepose 2008;Woodward et al 2009;De Vries et al 2011). It has been confirmed that the main complaints in dissatisfied patients are blurred vision and photic phenomena (Woodward et al 2009;De Vries et al 2011).…”

Section: Introductionmentioning

confidence: 99%

The importance of angle kappa evaluation for implantation of diffractive multifocal intra‐ocular lenses using pseudophakic eye model

Karhanová

Pluháček

Mlčák

et al. 2014

Acta Ophthalmologica

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ABSTRACT.Purpose: To determine the critical value of the angle kappa in connection with a higher risk of photic phenomena for the AcrySof ReSTOR and Tecnis multifocal intra-ocular lens (MIOL) on a standardized pseudophakic eye model. To analyse the impact of biometric value changes on the critical angle kappa. Methods: Geometrical optic rules applied to a suitable optical model of the pseudophakic eye were used to calculate the critical value of the angle kappa for the Tecnis and three types of the AcrySof ReSTOR MIOLs. The angle kappa was defined as critical if the incident ray passed through the first ring's edge area. The influence of different positive optical corneal power (K), effective lens position (ELP) and axial length (AL) on the critical angle kappa (j c ) was investigated. The dependence of j c on one of the parameters was studied for standardized values of the remaining parameters. Results: The highest value of the critical angle kappa was evaluated for the Tecnis MIOL. The increase in ELP and K caused an increase in j c under the given conditions. On the contrary, an increase in AL led to lower values of j c . Conclusion: We demonstrated the dependence of the critical angle kappa on the central part of the MIOL and on biometric parameters of the eye, especially on the effective lens position. According to these results, we conclude that shallow anterior chamber depth in connection with a higher angle kappa is an important risk factor for pronounced photic phenomena after implantation of a diffractive MIOL.

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“…Diffractive MF IOLs have concentric optical zones with different dioptric power, enabling patients to have good visual acuity at multiple focal points [3]. The drawbacks associated with this type of IOL design are loss of contrast sensitivity, increase in higher order aberrations, and night-time glare and halos [8,9]. Aychoua et al [10] recently reported a clinically relevant reduction of visual sensitivity as assessed with standard automated perimetry in patients with MF IOL.…”

Section: Discussionmentioning

confidence: 99%

The impact of multifocal intraocular lens in retinal imaging with optical coherence tomography

et al. 2014

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Multifocal intraocular lenses (MF IOLs) have concentric optical zones with different dioptric power, enabling patients to have good visual acuity at multiple focal points. However, several optical limitations have been attributed to this particular design. The purpose of this study is to access the effect of MF IOLs design on the accuracy of retinal optical coherence tomography (OCT). Cross-sectional study conducted at the Refractive Surgery Department of Central Lisbon Hospital Center. Twenty-three eyes of 15 patients with a diffractive MF IOL and 27 eyes of 15 patients with an aspheric monofocal IOL were included in this study. All patients underwent OCT macular scans using Heidelberg Spectralis Ò . Macular thickness and volume values and image quality (Q factor) were compared between the two groups. There were no statistically significant differences between both groups regarding macular thickness or volume measurements. Retinal OCT image quality was significantly lower in the MF IOL group (p \ 0.01). MF IOLs are associated with a significant decrease in OCT image quality. However, this fact does not seem to compromise the accuracy of spectral domain OCT retinal measurements.

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Dissatisfaction after implantation of multifocal intraocular lenses

Abstract: The cause of dissatisfaction after implantation of a multifocal IOL can be identified and effective treatment measures taken in most cases.

Cited by 393 publications

References 36 publications

Residual Astigmatism Threshold and Patient Satisfaction with Bifocal, Trifocal and Extended Range of Vision Intraocular Lenses (IOLs)

Residual Astigmatism Threshold and Patient Satisfaction with Bifocal, Trifocal and Extended Range of Vision Intraocular Lenses (IOLs)

The importance of angle kappa evaluation for implantation of diffractive multifocal intra‐ocular lenses using pseudophakic eye model

The impact of multifocal intraocular lens in retinal imaging with optical coherence tomography

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