Predictive factors for photic phenomena after refractive, rotationally asymmetric, multifocal intraocular lens implantation

Tchah, Hungwon; Nam, Kichan; Yoo, Aeri

doi:10.18240/ijo.2017.02.10

Cited by 21 publications

(21 citation statements)

References 25 publications

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“…However, there is a scarcity of studies focusing on factors for the prediction of halo size. 14–16 Therefore, we also analyzed age, postoperative refraction, and pre- and postoperative pupil size as potential predictors of halo size in multifocal IOLs. Moreover, the level of patient discomfort due to the halo was investigated.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Age, Postoperative Refraction, and Pre- and Postoperative Pupil Size on Halo Size and Intensity in Eyes Implanted with a Trifocal or Extended Depth-of-Focus Lens

Teshigawara¹,

Meguro²,

Mizuki³

2021

OPTH

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Halos are a chief source of patient dissatisfaction after multifocal intraocular lens (IOL) implantation. The primary purpose of this study was to investigate the influence of age, postoperative refraction, and pre-and postoperative pupil size on postoperative halo size with a trifocal diffractive IOL (AcrySof IQ PanOptix) and extended depth-of-focus (EDOF) IOL (TECNIS Symfony) to determine whether these factors could predict postoperative halo size. Patients and Methods: This single-center, open-label study conducted between October 2018 and April 2020 in Yokosuka, Japan included 160 patients: 80 with PanOptix and 80 with Symfony IOLs. Size and intensity of the halos were examined binocularly using a computer-based simulator (Eyeland Design Network GmbH) and scored from 0 (minimum) to 10 (maximum) at 1, 3, and 6 months postoperatively, along with the change in each variable for both IOLs. The respective correlations of halo size with age, postoperative refraction, pre-and postoperative pupil size, and discomfort level due to the halo were also investigated 6 months postoperatively. Results: Halo size and intensity were significantly mitigated between 1, 3, and 6 months postoperatively. Throughout the observation period, halo size was significantly larger with PanOptix than with Symphony (P < 0.05), and halo intensity was significantly higher with Symphony than with PanOptix (P < 0.05). The pre-and postoperative pupil size correlated positively with halo size, while age and postoperative refraction were negatively correlated, for both IOLs. Conclusion: Understanding the features and predictive preoperative factors of halos in different types of multifocal IOLs may be useful in improving patient satisfaction.

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Section: Introductionmentioning

confidence: 99%

The Effect of Age, Postoperative Refraction, and Pre- and Postoperative Pupil Size on Halo Size and Intensity in Eyes Implanted with a Trifocal or Extended Depth-of-Focus Lens

Teshigawara¹,

Meguro²,

Mizuki³

2021

OPTH

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“…12 Tchah et al suggested that visual acuity may not always be a good measure of subjective symptoms or patient satisfaction following implantation of multifocal IOL, since it was noticed that although all dissatisfied subjects had subjective visual complaints, their corrected distance visual acuity was 20/20 or better. 5 Welch et al illustrated that the general level of patient satisfaction regarding cataract removal and IOL placement, while high, is still more affected by glare than by any other studied parameter, including UDVA, BCVA, posterior capsular opacification, and anterior capsular overlap of the IOL optic. 13 Concerning the Acrysof IQ ® PanOptix ® , a study in 116 eyes of 58 patients evaluated visual outcomes with a visual satisfaction questionnaire (Catquest 9-SF with 5 added questions), which included photic phenomena, 9 and 12 months after surgery.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Photic Phenomena with a Trifocal IOL

Espaillat

Coelho

Batista

et al. 2021

OPTH

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Aim: To assess predictive factors associated with glares and halos in patients undergoing cataract surgery with PanOptix trifocal IOL implantation. Methods: Single-center retrospective study. One hundred and forty eyes from 70 patients with cataract were bilaterally implanted with a trifocal PanOptix aspherical diffractive lens between 2017 and 2019 and followed-up for six months. All patients were evaluated for refraction, corneal topography, and aberrometry pre-and post-operatively. Patients were assessed at 1 day, 6 days, 1 and 6 months after surgery. One and six months postoperatively patients were asked to complete a satisfaction questionnaire that included photic phenomena assessment. Main outcome measures were photic phenomena at 1 and 6 months of follow-up. Predictors of photic phenomena at 1 and 6 months were also analyzed. Results: A higher corneal coma was associated with more mild halos at 6 months with no association regarding other degrees of severity. The lower the age the higher the glare or halos, the higher the lens thickness and the lower the anterior chamber depth or chord µ the less halos at 1 month. A significant proportion of patients had more none/mild compared to moderate/severe glare and halos both at 1 and 6 months post-operatively. Baseline BCVA was the only predictor of halos at 1 month and glare and halos at 6 months post-surgery. Conclusion: On multivariate regression analyses, the only predictor of photic phenomena was baseline visual acuity, suggesting that patients that have a better visual acuity before surgery are more demanding regarding visual outcomes after surgery.

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“…Preoperative pupillometry can measure: (i) pupil diameter under photopic (small pupil) and mesopic (wide pupil) lighting conditions, (ii) distance between the pupil center and the visual axis (angle kappa), between the corneal center and the visual axis (angle alpha), and/or between the pupil center and the corneal center, and (iii) distance (spatial shift) from the photopic to the mesopic pupil center (pupil center shift -PCS) [31][32][33]. Regarding PCS, two types of PCS can be evaluated: (i) measured PCS, which results from the values measured under photopic and mesopic lighting conditions, and (ii) interpolated PCS, which depicts the predicted spatial shift between a photopic pupil of 2 mm to a scotopic pupil of 7 mm, and can contribute to the better comparability of the measurements [34].…”

Section: Pupillometrymentioning

confidence: 99%

“…• Visual axis, angle kappa: In pseudophakic presbyopic corrections with implantation of mIOLs, the angle kappa (misalignment between the visual and pupillary axis) [100] should be taken into consideration, especially for hyperopic patients with a large angle kappa [101,102]. It has been found that large angle kappa is correlated with more glare and halos after implantation of mIOLs [86,103].…”

Section: Preoperative Examination and Patient Selectionmentioning

confidence: 99%

Pseudophakic Presbyopic Corrections

Labiris¹,

Panagiotopoulou²

2021

Current Cataract Surgical Techniques

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Presbyopia is a prevalent productivity-reducing, age-related visual disorder that results in a progressive near vision impairment. Conventional treatment modalities (ie. presbyopic spectacles or contact lenses) are associated with poor acceptance, productivity loss and negative impact on life quality. However, a variety of surgical methods are available to address presbyopia; among them, multifocal and multifocal toric intraocular lenses (IOLs) and monovision techniques. For the best possible refractive outcomes, the overall management of presbyopic patients is necessary. Specifically, patient selection according to personality and daily activities, topography, aberrometry, astigmatism, pupil and fundus assessment, ophthalmic surface, and premium lens selection should be taken into consideration. Additionally, image-guided surgery could increase the accuracy in multifocal/multifocal toric IOL implantation, and optimize the refractive outcome increasing patient satisfaction. Primary objective of this chapter is to analyze the fundamental preoperative, intraoperative and postoperative management of patients that undergo pseudophakic presbyopic corrections with conventional or digital-marking assisted techniques.

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Predictive factors for photic phenomena after refractive, rotationally asymmetric, multifocal intraocular lens implantation

Abstract: A large pupil center shift and misalignment between the visual and pupillary axis (angle kappa) may play a role in the occurrence of photic phenomena after implantation of rotationally asymmetric MIOLs.

Cited by 21 publications

References 25 publications

The Effect of Age, Postoperative Refraction, and Pre- and Postoperative Pupil Size on Halo Size and Intensity in Eyes Implanted with a Trifocal or Extended Depth-of-Focus Lens

The Effect of Age, Postoperative Refraction, and Pre- and Postoperative Pupil Size on Halo Size and Intensity in Eyes Implanted with a Trifocal or Extended Depth-of-Focus Lens

Predictors of Photic Phenomena with a Trifocal IOL

Pseudophakic Presbyopic Corrections

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