Effect of pupil size on higher-order aberrations in high-myopic pseudophakic eyes with posterior staphyloma

Purpose. To compare visual performance and visual quality outcomes after phacoemulsification with two different clear corneal incision (CCI) distances anterior to the limbus in senile cataract patients. Methods. Retrospective case series. Patients who had undergone phacoemulsification were divided into two groups according to the CCI distances anterior to the limbus. The CCI distances in group A range from 1 mm to 1.5 mm, while those in group B range from 0.5 mm to 1 mm. The visual acuity, refraction, surgically induced astigmatism (SIA), corneal aberrations, anterior segment parameters, and subjective vision quality were evaluated. Results. This study enrolled 54 eyes, with 27 eyes per group. Both groups had significant improvement in postoperative uncorrected visual acuity (UCVA) and corrected distance visual acuity (CDVA) (P<0.05). There were no statistically significant between-group differences in postoperative UDVA, CDVA, SIA, corneal aberrations, anterior segment parameters, or VF-QOL questionnaire performance (P>0.05). Conclusions. The phacoemulsification with CCI distances ranging from 0.5 mm to 1.5 mm is an effective and safe therapy to senile cataract. The CCI distance anterior to the limbus that ranges from 0.5 mm to 1.5 mm is recommended for routine phacoemulsification.

Section: Discussionmentioning

confidence: 99%

Comparison of Outcomes after Phacoemulsification with Two Different Corneal Incision Distances Anterior to the Limbus

Wang

Zhao

Yang

et al. 2019

“…This is the first prospective study of the visual outcomes and patient satisfaction after bilateral implantation of the AT LISA 909M TMIOL in high myopes. Previous cataract research of high myopic eyes focused primarily on monofocal IOL implantation [ 18 , 22 , 27 , 28 ] or did not report the outcomes regarding the type of IOL used [ 19 , 22 , 29 , 30 ]. The results showed that cataract surgery in highly myopic eyes was associated with worse VA, poorer CS, or higher risk of retinal complications compared to eyes with an average AL.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies showed that highly myopic eyes had worse CS than other eyes under phakic [ 33 , 37 ], monofocal pseudophakic [ 27 ], and multifocal pseudophakic [ 32 ] conditions. It was a general agreement that the reduced sensitivity of the postreceptoral processes [ 18 , 37 ] or morphological changes in retina [ 18 , 22 , 27 , 37 ] in highly myopic eyes may play a role.…”

Section: Discussionmentioning

confidence: 99%

“…This prospective, observational case series included patients who had bilateral implantation of the AT LISA 909M TMIOL after cataract surgery between May 2011 and March 2015 at the Hong Kong Sanatorium and Hospital. The inclusion criteria were an AL of 26 mm or longer [ 18 – 22 ], corneal astigmatism exceeding one dioptre (D), and a follow-up period of six months or more. The exclusion criteria were systemic diseases that may affect the postoperative VA (e.g., uncontrolled diabetes mellitus), capsule or zonular abnormalities that may affect postoperative IOL centration or tilt (e.g., pseudoexfoliation syndrome and Marfan's syndrome), and a history of corneal refractive surgery.…”

Section: Methodsmentioning

confidence: 99%

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Visual Performance after Bilateral Implantation of a Four-Haptic Diffractive Toric Multifocal Intraocular Lens in High Myopes

Chang

Chan

et al. 2016

Background. The vision with diffractive toric multifocal intraocular lenses after cataract surgery in long eyes has not been studied previously. Objectives. To report visual performance after bilateral implantation of a diffractive toric multifocal intraocular lens in high myopes. Methods. Prospective, observational case series to include patients with axial length of ≥26 mm and corneal astigmatism of >1 dioptre who underwent bilateral AT LISA 909M implantation. Postoperative examinations included photopic and mesopic distance, intermediate, and near visual acuity; photopic contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); and spectacle independence rate. Results. Twenty-eight eyes (14 patients) were included. Postoperatively, mean photopic monocular uncorrected distance, intermediate, and near visual acuities (logMAR) were 0.12 ± 0.20 (standard deviation), 0.24 ± 0.16, and 0.29 ± 0.21, respectively. Corresponding binocular values were −0.01 ± 0.14, 0.13 ± 0.12, and 0.20 ± 0.19, respectively. One eye (4%) had one-line loss in vision. Under mesopic condition, intermediate vision and near vision decreased significantly (all P ≤ 0.001). Contrast sensitivity at all spatial frequencies did not improve significantly under binocular condition (all P > 0.05). Median scores for halos, night glare, starbursts, and satisfaction were 0.50, 0.00, 0.00, and 4.25, respectively. Ten patients (71%) reported complete spectacle independence. Conclusions. Bilateral implantation of the intraocular lens in high myopes appeared to be safe and achieved good visual performance and high satisfaction.

“…Recently, a growing body of literature has suggested that ocular aberration might play a role in myopia pathogenesis [ 5 – 7 ] and impact the outcome of interventions [ 8 , 9 ]. It is well known that ocular aberration is very dynamic and tends to be influenced by a series of factors, such as pupil size [ 10 , 11 ] and accommodation status [ 12 – 14 ]. These influencing factors impose more challenges for aberration measurements in children than in adults because children usually have greater pupil sizes and a more sensitive accommodation tonus.…”

Section: Introductionmentioning

confidence: 99%

Reliability of Ocular Aberration Measurements in Children with Moderate and Low Myopia under Scotopic Conditions

Cui

et al. 2018

Purpose To investigate the reliability of ocular aberration measurement in myopic children under scotopic conditions and to validate the mathematical Zernike pupil scaling-down technique. Methods Ocular aberrations of 45 myopic children were examined under scotopic conditions via iTrace aberrometer. The intra- and intersession repeatability was evaluated for both the measured values with the true pupil sizes and the estimated ones that were determined by scaling down the pupil sizes to the largest integer value across all measurements. Results The intra- and intersession difference of clinically measured aberration was generally insignificant, and the ICCs for each aberration component exhibited good to excellent reliability (ICCs > 0.4). Similar results were found for the estimated aberration using the scaling-down technique. Although the majority of the estimated Zernike components were comparable with the corresponding measured one, the estimated values of defocus, coma, and the corresponding total aberrations were found significantly smaller than the measured values (all P < 0.01). Conclusions The ocular aberration measurements in myopic children under the circumstances described are reliable. The scaling-down technique is a useful option for comparing the results obtained from different pupil sizes, but the estimated Zernike coefficients were not always comparable with the corresponding measured values.