Multifocal intraocular lens with a surface-embedded near section: Short-term clinical outcomes

McAlinden, Colm; Moore, Johnny

doi:10.1016/j.jcrs.2010.08.055

Cited by 84 publications

(53 citation statements)

References 9 publications

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“…Surgical presbyopia corrections have seen several developments from the monovision and multifocal ablation techniques, to the modern hybrid methods combining the benefits of several techniques. Corneal inlays and intraocular lenses have also been a popular alternative treatment for presbyopia 2 . Monovision techniques 3 usually involve correcting the dominant eye for distance as opposed to crossed monovision 4 where the dominant eye is corrected for near vision.…”

Section: Introductionmentioning

confidence: 99%

Presbyopic LASIK Using Hybrid Bi-Aspheric Micro-Monovision Ablation Profile for Presbyopic Corneal Treatments

Luger

McAlinden

Buckhurst

et al. 2015

American Journal of Ophthalmology

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Section: Introductionmentioning

confidence: 99%

Presbyopic LASIK Using Hybrid Bi-Aspheric Micro-Monovision Ablation Profile for Presbyopic Corneal Treatments

Luger

McAlinden

Buckhurst

et al. 2015

American Journal of Ophthalmology

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“…Segmented refractive multifocal IOLs with a rotationally asymmetric surface embedded near section have proven to provide comfortable far and near functional vision. 2 In addition, this design allows the reduction of the sources of scattering, halos, and glare. 21 Aberrometry is an important clinical tool for objective diagnosis and eye examination.…”

Section: Discussionmentioning

confidence: 99%

“…2 While examining patients implanted with a rotationally asymmetric multifocal IOL such as the Lentis Mplus IOL using a standard commercial Hartmann-Shack wavefront sensor, it is not possible to simultaneously obtain sharp focal spot images from near and far correcting regions of the multifocal IOL. This is due to the fact that the spots arising from the near correcting portion of the IOL are not well focused when measurements are performed with far fixation because these focal spots are affected by the multifocal IOL power distribution in the near correcting portion.…”

Section: New Methods For Wavefront Reconstructionmentioning

confidence: 99%

Evaluation of the True Wavefront Aberrations in Eyes Implanted With a Rotationally Asymmetric Multifocal Intraocular Lens

Akondi¹,

Pérez-Merino²,

Martinez-Enriquez³

et al. 2017

J Refract Surg

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ataract is successfully treated by replacement of the crystalline lens with an intraocular lens (IOL). Monofocal IOLs are preferably set for far vision and reading glasses are used for near vision. The dependency on glasses after cataract surgery can be eliminated with the help of multifocal IOLs that provide multiple foci and thereby enable functional simultaneous vision at far, intermediate, and near distances. Most designs of multifocal IOLs are diffractive, refractive, or hybrid. 1A rotationally asymmetric refractive multifocal IOL design has gained popularity in the past decade. This design provides two distinct foci with its two definite correcting zones for far and near vision. In general, there is a smooth transition between the two zones. The Lentis Mplus IOL (Oculentis GmbH, Berlin, Germany) is based on this design and has demonstrated good near and distance visual outcomes and good contrast sensitivity.2 The presence of a large magnitude intraocular primary coma has been reported in patients implanted with this multifocal IOL, which is usually attributed to its vertical asymmetric optical geometry. 3,4 In addition, it is believed that the presence of this optical defect allows an extended depth of focus that would grant adequate vision at various distances. On the other hand, it is assumed that this additional coma causes C ABSTRACT PURPOSE: Standard evaluation of aberrations from wavefront slope measurements in patients implanted with a rotationally asymmetric multifocal intraocular lens (IOL), the Lentis Mplus (Oculentis GmbH, Berlin, Germany), results in large magnitude primary vertical coma, which is attributed to the intrinsic IOL design. The new proposed method analyzes aberrometry data, allowing disentangling the IOL power pupillary distribution from the true higher order aberrations of the eye. METHODS:The new method of wavefront reconstruction uses retinal spots obtained at both the near and far foci. The method was tested using ray tracing optical simulations in a computer eye model virtually implanted with the Lentis Mplus IOL, with a generic cornea or with anterior segment geometry obtained from custom quantitative spectral-domain optical coherence tomography in a real patient. The method was applied to laser ray tracing aberrometry data at near and far fixation obtained in a patient implanted with the Lentis Mplus IOL. RESULTS:Higher order aberrations evaluated from simulated and real retinal spot diagrams following the new reconstruction approach matched the nominal aberrations (approximately 98%). Previously reported primary vertical coma in patients implanted with this IOL lost significance with the application of the proposed reconstruction.CONCLUSIONS: Custom analysis of ray tracing-based retinal spot diagrams allowed decoupling of the true higher order aberrations of the patient's eye from the power pupillary distribution of a rotationally asymmetric multifocal IOL, therefore providing the appropriate phase map to accurately evaluate through-focus optical quality.[J Refract Surg. 20...

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“…Recently, a refractive multifocal IOL with rotational asymmetry has been developed and introduced into clinical practice. Their performance is being evaluated and compared with already existing IOL designs [37][38][39]. A diffractive multifocal IOL uses the base lens curvature and the zero and first diffraction orders to simultaneously produce the two focal points [40], [41].…”

Section: Model Eyes For Iol Testingmentioning

confidence: 99%

New trends in intraocular lens imaging

2011

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As a result of modern technological advances, cataract surgery can be seen as not only a rehabilitative operation, but a customized procedure to compensate for important sources of image degradation in the visual system of a patient, such as defocus and some aberrations. With the development of new materials, instruments and surgical techniques in ophthalmology, great progress has been achieved in the imaging capability of a pseudophakic eye implanted with an intraocular lens (IOL). From the very beginning, optical design has played an essential role in this progress. New IOL designs need, on the one hand, theoretical eye models able to predict optical imaging performance and on the other hand, testing methods, verification through in vitro and in vivo measurements, and clinical validation. The implant of an IOL requires a precise biometry of the eye, a prior calculation from physiological data, and an accurate position inside the eye. Otherwise, the effects of IOL calculation errors or misplacements degrade the image very quickly. The incorporation of wavefront aberrometry into clinical ophthalmology practice has motivated new designs of IOLs to compensate for high order aberrations in some extent. Thus, for instance, IOLs with an aspheric design have the potential to improve optical performance and contrast sensitivity by reducing the positive spherical aberration of human cornea. Monofocal IOLs cause a complete loss of accommodation that requires further correction for either distance or near vision. Multifocal IOLs address this limitation using the principle of simultaneous vision. Some multifocal IOLs include a diffractive zone that covers the aperture in part or totally. Reduced image contrast and undesired visual phenomena, such as halos and glare, have been associated to the performance of multifocal IOLs. Based on a different principle, accommodating IOLs rely on the effort of the ciliary body to increase the effective power of the optical system of the eye in near vision. Finally, we present a theoretical approach that considers the modification of less conventional ocular parameters to compensate for possible refractive errors after the IOL implant.

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Multifocal intraocular lens with a surface-embedded near section: Short-term clinical outcomes

Abstract: Postoperative visual acuity was good with high-level contrast sensitivity, producing significant improvement in quality of life.

Cited by 84 publications

References 9 publications

Presbyopic LASIK Using Hybrid Bi-Aspheric Micro-Monovision Ablation Profile for Presbyopic Corneal Treatments

Presbyopic LASIK Using Hybrid Bi-Aspheric Micro-Monovision Ablation Profile for Presbyopic Corneal Treatments

Evaluation of the True Wavefront Aberrations in Eyes Implanted With a Rotationally Asymmetric Multifocal Intraocular Lens

New trends in intraocular lens imaging

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