Premium intraocular lenses: The past, present and future

Zvorničanin, Jasmin

doi:10.1016/j.joco.2018.04.003

Cited by 88 publications

(90 citation statements)

References 86 publications

(182 reference statements)

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“…Since Harold Ridley implanted the first intraocular lens (IOL) made of poly-methyl-methacrylate (PMMA) in 1949 [1] there have been significant improvements in surgical techniques, material developments [2], accuracy of preoperative measurements [3], and intraocular lens technology [4] in order to achieve complete spectacle independence after cataract surgery. Nowadays, different IOL designs are available in the market [5] such as toric IOLs to correct pre-existing corneal astigmatism, multifocal and accommodative to simultaneously provide good distance and near vision and aspheric IOLs to provide a better optical quality than the traditional IOLs with spherical optical design [6,7]. Aspheric designs are not limited to monofocal lenses; multifocal IOLs, toric IOLs or toric-multifocal IOLs and accommodative configurations may also include an aspheric surface [8].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the optical performance for aspheric intraocular lenses in relation with tilt and decenter errors

et al. 2020

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To evaluate and compare the effect of misalignment and tilt on the optical performance of different aspheric intraocular lens (IOL) designs. Methods Three aspheric IOLs with a different quantity of spherical aberration (SA) have been designed and the effect of IOL misalignment and tilt on the imaging quality of an eye model has been numerically assessed using a commercial optical design software. The prototypes have been manufactured by lathe turning and tested in vitro using the same optical bench (PMTF, Lambda-X) that complies with International Organization for Standardization standard 11979-2 requirements. Image quality was evaluated from the modulation transfer functions (MTFs), through-focus modulation transfer functions (TF-MTFs), root mean square (RMS) values of defocus, astigmatism and coma, and images of the United States Air Force (USAF) target were taken. A comparison with the optical performance of spherical IOLs has also been performed. Results Intraocular lens misalignment and tilt increased wavefront aberrations; the effect of misalignment on root mean square (RMS) astigmatism and coma was positively correlated with the spherical aberration of the IOL. Aberration-free IOLs showed the highest MTF for all misalignment values and for IOLs with negative SA correction the MTF decays below 0.43 when they are decentered 0.50 mm. Conclusions Aspherical IOLs are more sensitive than spherical IOLs to misalignment or tilt, depending on their SA correction. The optical degradation caused by IOL misalignment had a greater effect on IOL designs with a higher amount of negative spherical aberration. In contrast, the effect of tilt on the optical performance was less sensitive to the IOL design.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the optical performance for aspheric intraocular lenses in relation with tilt and decenter errors

et al. 2020

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“…Presbyopia-correcting IOLs can be largely categorized depending on the optical principle and the number of foci generated [1][2][3]. Most IOLs use a diffractive-refractive optic, while others utilize different optical designs to provide multifocality [4,5].…”

Section: Introductionmentioning

confidence: 99%

Laboratory evaluation of the optical properties of two extended-depth-of-focus intraocular lenses

et al. 2020

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Background: To experimentally compare the optical performance of two different Extended-Depth-of-Focus (EDOF) intraocular lenses (IOLs) using a standardized optical bench setup. Methods: In this experimental study, following IOLs were assessed: the TECNIS® Symfony ZXR00 (Johnson&Johnson, Santa Ana, USA) and the AT LARA 829MP (Carl Zeiss Meditec, Jena, Germany) IOLs. The through-focus modulation transfer function (MTF) values were measured at a spatial frequency of 50 lp/mm and at aperture sizes of 2, 3, and 4.5 mm. Each IOL was measured while centered using ISO 11979-2 Model 1 (aberration-free) and Model 2 (+ 0.28 μm spherical aberration) corneas. United States Air Force (USAF) target images were also recorded for a qualitative evaluation. Results: At 2 mm pupil with ISO1 cornea, the primary and secondary foci of both IOLs appeared to merge, providing an elongated depth of focus. At 3 and 4.5 mm pupil sizes, the through-focus MTF curves of both IOLs showed a bifocal-like V-pattern. While the Symfony IOL showed an overall superior MTF values when measured with the ISO2 cornea, the opposite propensity could be observed with the AT LARA IOL. This optical behavior could be qualitatively confirmed by the USAF target images. Conclusions: Although the two EDOF IOLs share similarities in their optical properties, the main difference lies in their optical design and performance with respect to spherical aberration. Such characteristics should be taken into account during IOL and patient selection.

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“…Our results show that residents can achieve excellent visual outcomes after ATIOL surgery similar to those reported by experienced surgeons. [13][14][15] The majority of patients achieved good UDVA, UIVA and UNVA (88%, 93%, and 71%, respectively) at the POM3+ timepoint. Our UDVA results with ATIOLs are comparable to the UDVA results of resident-performed standard cataract surgery reported in several studies.…”

Section: Discussionmentioning

confidence: 94%

“…[6][7][8] Among the studied ATIOLs, AIOLs had good UIVA but did not perform as well for UDVA and UNVA at POM3+, which is similar to experienced surgeons' results in the literature. 15 This may also explain residents' lower preferences for this model. In both the wet-lab and operating room, we observed that AIOLs require additional surgical dexterity compared to the other ATIOL models, especially with the insertion maneuver.…”

Section: Discussionmentioning

confidence: 95%

<p>Surgical Curriculum for Presbyopia-Correcting Intraocular Lenses: Resident Experiences and Surgical Outcomes</p>

Riaz¹,

Williams²,

Farooq³

et al. 2020

OPTH

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Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/OHbPTPD6Kjw Objective: To describe a stepwise surgical curriculum that was implemented to teach novice surgeons about currently available advanced technology intraocular lenses (ATIOLs) for correction of presbyopia and to report the experiences and surgical results of ATIOL surgery performed by residents who engaged in the curriculum. Design, Setting, and Participants: Third-year ophthalmology residents participated in a curriculum incorporating didactic lectures (with objective assessment and wet-lab practice) and observation of attending-performed ATIOL surgeries prior to performing ATIOL surgery as primary surgeon under direct supervision. Post-operative outcomes studied were best corrected distance visual acuity (BCDVA) and uncorrected distance (UDVA), intermediate (UIVA) near (UNVA) visual acuity and correction of astigmatism with at least 3 months of follow-up (POM3+). Residents were also given a survey to assess experiences with the surgical curriculum, preparedness for use of ATIOLs post-residency, and ATIOL practice pattern post-residency. Results: A total of 12 residents from four consecutive classes completed the curriculum. Residents overall had a favorable opinion of the curriculum and felt well prepared to use ATIOLs after training. Graduates who currently perform cataract surgery felt comfortable using all available ATIOLs. A total of 100 eyes from 72 patients met the inclusion criteria for analysis in the study. At the POM3+ timepoint, 88% of eyes had UDVA of 20/30 or better, 93% had UIVA of 20/30 or better, and 71.2% had UNVA of 20/30 (J2) or better. Among eyes that received an astigmatism-correcting ATIOL, 91% had <1 diopter of astigmatism after surgery. Conclusion: Resident surgeons learned to perform ATIOL surgery (medical knowledge) and achieve strong surgical outcomes (patient care) with all currently available ATIOLs after completion of a stepwise curriculum. Educators may be encouraged to incorporate an ATIOL curriculum based on the results of this study. The curriculum presented is a prototype and may be further improved with future experiences and studies.

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Premium intraocular lenses: The past, present and future

Cited by 88 publications

References 86 publications

Evaluation of the optical performance for aspheric intraocular lenses in relation with tilt and decenter errors

Evaluation of the optical performance for aspheric intraocular lenses in relation with tilt and decenter errors

Laboratory evaluation of the optical properties of two extended-depth-of-focus intraocular lenses

<p>Surgical Curriculum for Presbyopia-Correcting Intraocular Lenses: Resident Experiences and Surgical Outcomes</p>

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