Patient-Perceived and Laboratory-Measured Halos Associated with Diffractive Bifocal and Trifocal Intraocular Lenses

Alba-Bueno, Francisco; Garzón, Nuria; Vega, F.; Poyales, Francisco; Millán, Marı́a S.

doi:10.1080/02713683.2017.1379541

Cited by 40 publications

(42 citation statements)

References 19 publications

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“…This observation is also supported by the QoV questionnaire results, particularly for the bothersome score. In trifocal IOLs, this phenomenon can be explained by the superposition of the near and distance foci [ 32 ] but the same mechanism should not explain the findings in the extended depth of focus IOL. The potential involvement of scattered light in the echelletes of the diffractive achromatizing surface is a hypothesis that should be investigated in future studies.…”

Section: Discussionmentioning

confidence: 99%

Through-Focus Vision Performance and Light Disturbances of 3 New Intraocular Lenses for Presbyopia Correction

Escandón-Garcia

Ribeiro

McAlinden

et al. 2018

Journal of Ophthalmology

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Purpose To compare the through-focus visual performance in a clinical population of pseudophakic patients implanted with two new trifocal intraocular lenses (IOLs) and one extended depth of focus IOL. Methods Prospective, nonrandomized, examiner-masked case series. Twenty-three patients received the FineVision® and seven patients received the PanOptix™ trifocal IOLs. Fifteen patients received the Symfony extended depth of focus IOL. Mean age of patients was 63 ± 8 years. Through-focus visual acuity was measured from –3.00 to +1.00 D vergences. Contrast sensitivity was measured with and without a source of glare. Light disturbances were evaluated with the Light Distortion Analyzer. Results Though-focus evaluation showed that trifocal IOLs performed significantly better at near distance (33 and 40 cm), and extended depth of focus performed significantly better at intermediate distance (1.0 m). Contrast sensitivity function with glare and dysphotopsia was similar between the three IOLs and subjective response to questionnaire showed a significantly higher score (worse performance) for the extended depth of focus IOL compared to both trifocal IOLs in the bothersome subscale (p < 0.05). Conclusions Trifocal IOLs grant better performance at near distance while extended depth of focus IOL performs better at intermediate distance. Objective dysphotopsia measured with the Light Distortion Analyzer is not reduced in extended depth of focus IOL compared to trifocal IOLs.

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Section: Discussionmentioning

confidence: 99%

Through-Focus Vision Performance and Light Disturbances of 3 New Intraocular Lenses for Presbyopia Correction

Escandón-Garcia

Ribeiro

McAlinden

et al. 2018

Journal of Ophthalmology

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“…Adverse events of MIOLs include reduced contrast sensitivity, halos around point sources of light, multiple or ghosting images, and glare [ 7 ]. Halos and glare, also known as dysphotopsias, are intrinsically associated to the monofocal [ 103 ] or multifocal IOL technologies [ 98 , 99 , 104 ], resulting in one of the most important complains [ 99 , 103 ]. However, despite being intrinsically associated to the technology, not all the patients refer disturbances associated to dysphotopsias, probably because these phenomena are only perceived under certain conditions, such as driving at night looking at a bright light source against a dark background [ 104 ] due to neural adaptation [ 105 ] or due to patients' personality [ 100 ].…”

Section: Objective Technologies For Lens Evaluationmentioning

confidence: 99%

From Presbyopia to Cataracts: A Critical Review on Dysfunctional Lens Syndrome

Fernández¹,

Rodríguez‐Vallejo²,

Martínez³

et al. 2018

Journal of Ophthalmology

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Dysfunctional lens syndrome (DLS) is a term coined to describe the natural aging changes in the crystalline lens. Different alterations in the refractive properties and transparency of the lens are produced during the development of presbyopia and cataract, such as changes in internal high order aberrations or an increase in ocular forward scattering, with a potentially significant impact on clinical measures, including visual acuity and contrast sensitivity. Objective technologies have emerged to solve the limits of current methods for the grading of the lens aging, which have been linked to the DLS term. However, there is still not a gold standard or evidence-based clinical guidelines around these new technologies despite multiple research studies have correlated their results with conventional methods such as visual acuity or the lens opacification system (LOCS), with more scientific background around the ocular scattering index (OSI) and Scheimpflug densitometry. In either case, DLS is not a new evidence-based concept that leads to new knowledge about crystalline lens aging but it is a nomenclature change of two existing terms, presbyopia and cataracts. Therefore, this term should be used with caution in the scientific peer-reviewed literature.

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“…defocus VA curves) of pseudophakic patients [3][4][5], we have studied the ability of the EE metric to predict clinical VA outcomes of patients implanted with three different designs of diffractive IOLs. TF-EE curves have proved to provide valuable information about the optical quality of IOLs being tested: particularly, for multifocal or ERV diffractive lenses, the energy distribution between the foci [11], longitudinal chromatic aberration [10], chromatic distribution of energy in each focus [8], halo size, [12,13], and so on. However, energy-based metrics such as the EE have been rarely studied as predictor of VA [16,17] and, to the best of our knowledge, no results from experimental in-vitro EE measurements and clinical in-vivo VA assessments have been reported yet.…”

Section: Discussionmentioning

confidence: 99%

“…In the experimental practice, the energy efficiency can be approached by the LIB measurement [7,8], which is useful to describe the through-focus (TF) performance of diffractive IOLs [8][9][10]. It helps to characterize the energy distribution between the foci of multifocal IOLs, and its variation with pupil [11], all of which is strongly related with the formation of haloes [12] and has an impact on photic phenomena [13] affecting pseudophakic patients. The EE metric may evaluate the depth of focus too and hence, describe the extended depth of focus (EDOF) IOLs that would facilitate an extended range of vision (ERV) once implanted.…”

Section: Introductionmentioning

confidence: 99%

Equivalence of two optical quality metrics to predict the visual acuity of multifocal pseudophakic patients

Armengol

Garzón

Vega

et al. 2020

Biomed. Opt. Express

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This article studies the relationship between two metrics, the area under the modulation transfer function (MTFa) and the energy efficiency (EE), and their ability to predict the visual quality of patients implanted with multifocal intraocular lenses (IOLs). The optical quality of IOLs is assessed in vitro using two metrics, the MTFa and EE. We measured them for three different multifocal IOLs with parabolic phase profile using image formation, through-focus (TF) scanning, three R, G, B wavelengths, and two pupils. We analyzed the correlation between MTFa and EE. In parallel, clinical defocus curves of visual acuity (VA) were measured and averaged from sets of patients implanted with the same IOLs. An excellent linear correlation was found between the MTFa and EE for the considered IOLs, wavelengths and pupils (R 2 > 0.9). We computed the polychromatic TF-MTFa, TF-EE, and derived mathematical relationships between each metrics and clinical average VA. MTFa and EE proved to be equivalent metrics to characterize the optical quality of the studied multifocal IOLs and also in terms of clinical VA predictability.

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Patient-Perceived and Laboratory-Measured Halos Associated with Diffractive Bifocal and Trifocal Intraocular Lenses

Cited by 40 publications

References 19 publications

Through-Focus Vision Performance and Light Disturbances of 3 New Intraocular Lenses for Presbyopia Correction

Through-Focus Vision Performance and Light Disturbances of 3 New Intraocular Lenses for Presbyopia Correction

From Presbyopia to Cataracts: A Critical Review on Dysfunctional Lens Syndrome

Equivalence of two optical quality metrics to predict the visual acuity of multifocal pseudophakic patients

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