Premium IOLs in Glaucoma

Ichhpujani, Parul; Bhartiya, Shibal; Sharma, Abha

doi:10.5005/jp-journals-10008-1138

Cited by 25 publications

(21 citation statements)

References 37 publications

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“…Despite often long-term ophthalmic care, glaucoma patients would appear to hold similar expectations of an improved range of vision following cataract surgery. 5,6 Trabeculectomy has long been considered the gold standard for glaucoma patients where medical and laser treatments have been unable to control intraocular pressure (IOP). 7 Although trabeculectomy and other invasive glaucoma surgical approaches provide a proven track record in reducing and maintaining IOP, successful visual rehabilitation may be compromised by surgically induced anatomical changes leading to residual defocus and astigmatic errors.…”

Section: Introductionmentioning

confidence: 99%

Refractive Outcomes After Trabecular Micro-Bypass Stents (iStent Inject) with Cataract Extraction in Open-Angle Glaucoma

Ioannidis

Töteberg‐Harms

Hamann

et al. 2020

OPTH

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Purpose: Simultaneous cataract and glaucoma surgery has traditionally been challenging for the anterior segment surgeon. The introduction of minimally invasive glaucoma surgery (MIGS) in conjunction with cataract surgery appears safe and effective in lowering intraocular pressure. Although a significant visual impact leading from the combined procedure is unexpected, we aim to describe the refractive outcomes in a cohort of patients undergoing simultaneous cataract removal and iStent inject and discuss the potential implications of combined surgery in patients with co-existent glaucoma. Patients and Methods: This is a retrospective consecutive case series inclusive of patients undergoing combined femtosecond laser-assisted cataract surgery and the insertion of two trabecular micro-bypass stents (iStent inject). Visual acuity, refraction and astigmatic vector analysis were collated and analysed from the preoperative and 4 weeks postoperative visits. Results: One hundred and six eyes of 89 patients from 2 surgeons were included in the original cohort. The mean absolute difference from target refraction was 0.36 ± 0.25D. 73.9% of eyes were within ± 0.5D of the refractive target and 98.9% of eyes were within ± 1.00D. 73.8% of eyes had 0.5D or less residual refractive astigmatism following the procedure. Conclusion: We present a novel cohort of glaucoma patients undergoing combined trabecular micro-bypass stents (iStent inject) and cataract surgery achieving excellent refractive outcomes. The results of this study indicate that this second-generation device is refractively neutral.

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Section: Introductionmentioning

confidence: 99%

Refractive Outcomes After Trabecular Micro-Bypass Stents (iStent Inject) with Cataract Extraction in Open-Angle Glaucoma

Ioannidis

Töteberg‐Harms

Hamann

et al. 2020

OPTH

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“…Therefore, some authors consider monofocal aspheric IOLs and yellow aspheric IOLs as premium IOLs. 16 The square edges of optic in premium IOL are designed to prevent posterior capsule opacification (PCO). The size of the IOL and haptic design are also considered to be very important factors for postoperative IOL stability.…”

Section: Resultsmentioning

confidence: 99%

“…Different macular and optic nerve head diseases are associated with decreased contrast sensitivity. 5 , 16 Although the multifocal IOLs can be used as an aid for magnification in eyes with age-related macular degeneration (ARMD), the surgeon must be cautious while in multifocal IOLs there is a split between near and distance foci. In some cases, this could result in further contrast sensitivity reduction and even poorer vision than with monofocal IOLs.…”

Section: Resultsmentioning

confidence: 99%

“…Only glaucoma suspects and ocular hypertensive patients with no disk or visual field damage who have been stable for a longer period of time should be candidates for multifocal IOLs. 16 Preoperative ocular coherence tomography and perimetry evaluation could rule out subtle or occult pathology while in cases of significant or progressive pathologies, multifocal IOLs are contraindicated. 7 Furthermore, in patients with posterior eye segment changes, the visualization of macula and optic nerve will be impaired after both toric and multifocal IOL implantation, and this could result in various difficulties in later diagnostic as well as therapeutic procedures.…”

Section: Resultsmentioning

confidence: 99%

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Premium intraocular lenses: The past, present and future

Zvorničanin

2018

Journal of Current Ophthalmology

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PurposeTo present potential benefits as well as limitations of premium intraocular lens (IOL) use, and provide insight in future of premium cataract surgery.MethodsBibliographic research was performed in PubMed/Medline database, and the most recently updated papers were evaluated. Keywords used were: premium intraocular lens, multifocal intraocular lens, toric intraocular lens, toric multifocal intraocular lens, accommodative intraocular lens, and the respective brand names.ResultsMultifocal IOLs provide uncorrected distance visual acuity (UDVA) of 0.03 logMAR in 82.3%–95.7% of patients and overall spectacle independence in 81%–85% of patients. Toric IOLs provide UDVA of 0.3 logMAR in 70%–95% of patients, residual astigmatism of 1 D or less is noted in 67%–88% of patients, and spectacle independence is reported in 60%–85% of patients. Toric multifocal IOLs provide UDVA of 0.3 logMAR in 92%–97% of patients, and spectacle independence is reported in 79%–90% of patients. Accommodative IOLs represent intensively developing field in ophthalmology, and the results are still variable depending on the IOL model.ConclusionsPremium IOL technology and advanced surgical techniques have significantly improved postoperative visual outcomes. Future developments will potentiate development of new premium IOL designs that will provide spectacle independence and excellent visual outcomes after cataract surgery.

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“…These patients are also predisposed to intraoperative zonular dialysis. Toric IOL implantation in such patients may not be successful, as the lens and bag may rotate, or tilt once implanted, altering the patients’ vision 117. For this reason, the use of toric IOL in patients with PXF should be avoided.…”

Section: Resultsmentioning

confidence: 99%

Consensus on the management of astigmatism in cataract surgery

Núñez¹,

Henríquez²,

Escaf³

et al. 2019

OPTH

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This project was aimed at achieving consensus on the management of astigmatism during cataract surgery by ophthalmologists from Latin America using modified Delphi technique. Relevant peer-reviewed literature was identified, and 21 clinical research questions associated with the definition, classification, measurement, and treatment of astigmatism during cataract surgery were formulated. Twenty participants were divided into seven groups, and each group was assigned three questions to which they had to respond in written form, after thoroughly reviewing the literature. The assigned questions with corresponding responses by each group were discussed with other participants in round 4 – presentation of findings. The consensus was achieved if approval was obtained from at least 80% of participants. The present paper provides several agreements and recommendations for management of astigmatism during cataract surgery, which could potentially minimize the variability in practice patterns and help ophthalmologists adopt optimal practices for cataract patients with astigmatism and improve patient satisfaction.

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Premium IOLs in Glaucoma

Cited by 25 publications

References 37 publications

<p>Refractive Outcomes After Trabecular Micro-Bypass Stents (iStent <em>Inject</em>) with Cataract Extraction in Open-Angle Glaucoma</p>

<p>Refractive Outcomes After Trabecular Micro-Bypass Stents (iStent <em>Inject</em>) with Cataract Extraction in Open-Angle Glaucoma</p>

Premium intraocular lenses: The past, present and future

<p>Consensus on the management of astigmatism in cataract surgery</p>

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