Randomized Trial of Multifocal Intraocular Lenses versus Monovision after Bilateral Cataract Surgery

Wilkins, Mark R; Allan, Bruce; Rubin, Gary S.; Findl, Oliver; Hollick, Emma J.; Bunce, Catey; Xing, Wen

doi:10.1016/j.ophtha.2013.07.048

Cited by 107 publications

(85 citation statements)

References 30 publications

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“…Dick et al 14 showed that there is no difference between monofocal and multifocal IOLs in terms of straylight. This is in line with findings from Hofmann et al, 15 Cerviño et al, 16 and Wilkins et al 17 However, de Vries et al 18 found increased straylight of log(s) 0.078 in eyes implanted with the SN6AD3 (Alcon Laboratories, Inc., Fort Worth, TX) and Peng et al 19 found an increase of straylight in eyes implanted with an apodized diffractive IOL. Ehmer et al 20 found increased straylight in diffractive IOLs compared to refractive IOLs.…”

Section: Straylight Measurements/lapid-gortzak Et Alsupporting

confidence: 81%

“…It is clear that multifocal IOLs improve the depth of field at a cost of image quality 30 ; however, there are still many doubts whether multifocality might be related to increase of straylight. Dick et al, 14 Cerviño et al, 16 and Wilkins et al 17 have all shown that there is no difference between monofocal and multifocal IOLs regarding straylight. Hofmann et al 15 and de Vries et al 18 separately reported more straylight by and average of 0.08 log(s) in the multifocal group, which in the report by Hofmann et al did not reach statistical significance.…”

Section: Straylight Measurements/lapid-gortzak Et Almentioning

confidence: 98%

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Straylight Measurements in Two Different Apodized Diffractive Multifocal Intraocular Lenses

Lapid-Gortzak¹,

Łabuz²,

Meulen³

et al. 2015

J Refract Surg

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o r I g I n A L A r t I C L e ultifocal intraocular lenses (IOLs) were introduced in cataract surgery to address the problem of loss of accommodation following lensectomy and implantation of a monofocal IOL. There have been different multifocal designs, including diffractive bifocal, 1 apodized diffractive, 2 trifocal, refractive, zonal refractive, 1 rotational asymmetric refractive, 3 and accommodating IOLs in which the optic or optics need to move to achieve accommodation. 4 Bifocal diffractive apodized IOLs have a circular pattern on the optic surface, which allows for diffraction of incoming light into two main distinct foci. One focus is for distance vision and the secondary focus is for near vision. The diffraction patterns distribute the light to both foci with loss of energy; approximately 18% of light is directed outside the far and near focal points.2 As a result of multiple foci occurring in the eyeball at the same time and interfering with one another, the contrast sensitivity for both far and near foci decreases. 5In apodized diffractive IOLs, the far focus is dominant and receives more light, whereas the near focus receives less light. 2The patterns of the apodization can differ and not only allow changes in depth of focus with relation to the intensity of light distributed between the far and the near foci, but also changes in induced halos, contrast, and quality of vision with relation to the pupil size as a function of light intensity as part of the accommodative triad response. 6,7 M ABSTRACT PURPOSE: To evaluate differences in straylight between eyes implanted with a hydrophilic multifocal IOL (Seelens MF; Hanita Lenses, Hanita, Israel) and a hydrophobic multifocal IOL (SN6AD1; Alcon Laboratories, Inc., Fort Worth, TX). METHODS:In a prospective cohort study, routinely obtained straylight measurements (C-Quant; Oculus Optikgeräte, Wetzlar, Germany) 3 months after standard phacoemulsification for either cataract or refractive lens procedures were compared. Patients were implanted with either the SeeLens MF IOL or the SN6AD1 IOL. Postoperative straylight values, visual acuity, and refractive outcomes were compared. RESULTS:The SeeLens MF IOL was implanted in 84 eyes and the SN6AD1 IOL in 79 eyes. The difference in straylight was 0.08 (P = .01), with the SeeLens MF IOL having less straylight. Postoperative CDVA was logMAR -0.03 ± 0.06 in the SeeLens MF group, and logMAR -0.02 ± 0.08 in the SN6AD1 group. Mean postoperative refraction was +0.01 ± 0.43 and +0.06 ± 0.35 D, respectively. CONCLUSIONS:The Seelens MF IOL showed a straylight of log(s) 0.08 lower than the SN6AD1 IOL. In terms of spherical equivalent and visual acuity the lenses performed equally. More study will aid in understanding the causes and clinical impact of this difference.[J Refract Surg. 2015;31(11):746-751.]

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Section: Straylight Measurements/lapid-gortzak Et Alsupporting

confidence: 81%

Section: Straylight Measurements/lapid-gortzak Et Almentioning

confidence: 98%

Straylight Measurements in Two Different Apodized Diffractive Multifocal Intraocular Lenses

Lapid-Gortzak¹,

Łabuz²,

Meulen³

et al. 2015

J Refract Surg

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“…De Vries et al 23 and Peng et al 33 found a considerable increase in straylight in a multifocal IOL subpopulation compared with their monofocal IOL counterparts. In contrast, Cerviño et al, 26 Wilkins et al, 28 and Hofmann et al 30 report insignificant differences between those groups. Some authors speculate that constriction of the pupil during measurements could be an explanation for the lack of effect.…”

Section: Discussionmentioning

confidence: 91%

“…The raw data supplied by the original authors or the plots analysis was used to determine the 95% confidence interval (CI). 4,11,[21][22][23][24][25][26]28,30,31 To study the consistency of the new pseudophakic reference curve, it was compared to each of the 16 collected articles. The cross-validation technique was applied to avoid the influence of a particular result.…”

Section: Discussionmentioning

confidence: 99%

“…The effect of the type of IOL on straylight has been studied in the literature, especially for diffractive multifocal IOLs versus monofocal IOLs. 23,26,28,30,33 Optically, these IOLs are very different with respect to design and light distribution 37,38 ; however, the literature has not been clear about the differences in straylight. De Vries et al 23 and Peng et al 33 found a considerable increase in straylight in a multifocal IOL subpopulation compared with their monofocal IOL counterparts.…”

Section: Discussionmentioning

confidence: 99%

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Ocular straylight in the normal pseudophakic eye

Łabuz¹,

Reus²,

Berg³

2015

Journal of Cataract and Refractive Surgery

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PURPOSE:To assess normal values for straylight in the pseudophakic eye as a function of age and to develop a model to predict the improvement in straylight after lens extraction based on preoperative straylight levels.SETTING: Rotterdam Ophthalmic Institute, Rotterdam, the Netherlands. DESIGN:Review with retrospective cross-study analysis.METHODS: A literature review was performed to identify relevant papers on straylight and pseudophakia with no patient comorbidities. Sixteen papers met the eligibility criteria and were included in the analysis. The postoperative results were used to define the norm for straylight in pseudophakia. Straylight improvement after lens replacement was assessed by evaluation of preoperative and postoperative values. The age effect was incorporated to determine a model for straylight improvement. RESULTS:The mean postoperative straylight value derived from 16 studies (1869 eyes) was 1.21 log units G 0.21 (SD). Age dependence could be assessed from 13 studies (1533 eyes), resulting in the straylight age-norm curve in pseudophakic eyes as follows: Straylight value Z 0.0044 Â age C 0.89 with G 0.42 log units of 95% confidence interval. A strong correlation was observed between preoperative straylight and its improvement after lens extraction, yielding the following relationship: Straylight improvement Z 1.04 Â preoperative straylight value À 0.006 Â age À 0.84. CONCLUSION:A norm for straylight in the pseudophakic eye was developed that is considerably different from the previously published norm for the phakic eye. The new pseudophakic norm can be used clinically to predict the straylight value after lens replacement and as a reference criterion for clinical studies.

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