Refractive outcomes of femtosecond laser–assisted secondary arcuate incisions in patients with residual refractive astigmatism after trifocal intraocular lens implantations

Lüdeke, Inger; Gonnermann, Johannes; Jørgensen, J. S.; Neuhann, Thomas; McKay, Keith N; Fleischer, Mathias; Galambos, Péter; Lerche, Ralf-Christian

doi:10.1016/j.jcrs.2018.08.024

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…who performed FSAI in multifocal IOL patients three months after lens exchange and observed no changes in SEQ (0.07 ± 0.38 D to 0.05 ± 0.35 D; Lüdeke et al. 2019).…”

Section: Discussionmentioning

confidence: 97%

Precision and refractive predictability of a new nomogram for femtosecond laser‐assisted corneal arcuate incisions

Wendelstein

Hoffmann

Mariacher

et al. 2021

Acta Ophthalmologica

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Purpose: Validating a new nomogram for low to moderate astigmatism (0.75 D to 2.5 D) correction with epithelium-and Bowman-penetrating femtosecond laser-assisted arcuate incisions. Methodology: Prospective, interventional case series at the Augen-und Laserklinik, Castrop-Rauxel, Germany. Cataract patients with low to moderate corneal astigmatism were treated with femtosecond laser-assisted arcuate incisions. Patients with previous refractive corneal treatment were excluded. Outcome assessment was based on manifest refraction, astigmatic vector analysis and visual acuity.Results: The study analysed 43 eyes of 33 patients after three months and 35 eyes of 27 patients after 12 months. After 12 months, 100% of all eyes treated had ≤1.0 D and 97% ≤0.5 D of subjective residual astigmatism. Mean residual astigmatism was 0.27 D. 90% of all eyes were within one line of difference between UDVA and CDVA. SEQ Mean Absolute Error was 0.26 D and SEQ. Mean error was À0.08 AE 0.32 D. CI was 0.98 AE 0.2 D, and Index of Success, 0.20 AE 0.18 D. Conclusion:The Castrop nomogram showed results that are comparable to or better than results presented in the literature for existing nomograms. Our results for astigmatic reduction are comparable to published results for TIOL implantation. It seems to be a predictable and safe measure to reduce manifest astigmatism.

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“…who performed FSAI in multifocal IOL patients three months after lens exchange and observed no changes in SEQ (0.07 ± 0.38 D to 0.05 ± 0.35 D; Lüdeke et al. 2019).…”

Section: Discussionmentioning

confidence: 97%

Precision and refractive predictability of a new nomogram for femtosecond laser‐assisted corneal arcuate incisions

Wendelstein

Hoffmann

Mariacher

et al. 2021

Acta Ophthalmologica

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“…The trifocal IOL provides useful VA at all distances when the refractive astigmatism is 0.75 D or less. Clinically, when the residual astigmatism is assumed to be greater than 0.75 D, surgeons should perform astigmatism correction procedures, including the use of an IOL with a toric component [13][14][15][16][17] and a corneal relaxing incision [17][18][19][20][21][22] ; otherwise, bifocal IOLs may be a better selection for eyes that are assumed to have a postoperative astigmatism within 0.75 D and 1.0 D. Because the present study was a simulation study, however, the effect of residual refractive astigmatism should be confirmed in actual postoperative eyes implanted with the trifocal IOL. Further studies are necessary to examine the effect of residual astigmatism on the performance of trifocal IOLs.…”

Section: Discussionmentioning

confidence: 99%

“…Even for eyes undergoing implantation with a trifocal IOL, astigmatism correction may be performed to reduce the postoperative astigmatism. 21,22 Because the effect of astigmatism on all-distance VA in eyes with trifocal IOLs has not yet been examined, however, the indicated limit for astigmatism correction is unknown.…”

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confidence: 99%

Effect of Refractive Astigmatism on All-Distance Visual Acuity in Eyes With a Trifocal Intraocular Lens

Hayashi

Yoshida

Igarashi

et al. 2021

American Journal of Ophthalmology

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To investigate the effect of refractive astigmatism on all-distance visual acuity (VA) in eyes implanted with a diffractive trifocal or bifocal intraocular lens (IOL).DESIGN: Cross-sectional study. METHODS: Fifty eyes with trifocal IOLs (PanOptix; Alcon) and 50 eyes with bifocal IOLs (ReSTOR D3D) were enrolled. After simulating astigmatism by adding cylindrical lenses of 0, 0.5, 0.75, 1.0, and 1.5 diopters (D), the corrected logarithm of minimal angle of resolution (logMAR) VA was measured using an all-distance vision tester.RESULTS: Mean VAs at most distances significantly worsened in proportion to the added astigmatism (P £ .0111) with no significant differences in near VA at 0.3 m in the trifocal group or in intermediate VA at 0.7 m in the bifocal group. Mean intermediate VA at 0.5 m was significantly better in the trifocal group than in the bifocal group when the astigmatism was 0.75 D or less (P £ .0472), but VA at distances of N and 5.0 m were significantly worse in the trifocal group when the astigmatism was 0.5 D or more (P £ .0457). Useful mean logMAR VA of 0.20 was achieved at all distances when the astigmatism was 0.75 D or less in the trifocal group and 1.0 D or less in the bifocal group.CONCLUSIONS: All-distance VA, particularly distance VA, worsened more in proportion to astigmatism with a trifocal IOL than with a bifocal IOL. Useful VA was achieved when the astigmatism was 0.75 D or less with a trifocal IOL, suggesting that astigmatism correction is necessary when astigmatism is more than 0.75 D.

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“…However, even if the arcuate incisions are performed by femtosecond laser, they are not precise in correcting the spherical refractive error and tend to undercorrect the cylinder. In a retrospective study from Lüdeke et al,9 10% of patients needed additional laser enhancement. Similar to other corneal refractive procedures, long-term regression of the treatment effect may also occur after arcuate incisions.…”

Section: Introductionmentioning

confidence: 95%

<p>A prospective pilot study using a low power piggy-back toric implantable Collamer lens to correct residual refractive error after multifocal IOL implantation</p>

Duncker¹,

Sasse²,

Duncker³

2019

OPTH

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Purpose To assess whether residual refractive error after in-the-bag multifocal intraocular lens (mIOL) implantation can efficaciously and safely be corrected with a piggy-back low power Visian Toric Implantable Collamer Lens ® (VTICL, STAAR Surgical) placed in the ciliary sulcus. Patients and methods Twenty-four eyes of 23 patients (mean age: 57.5 years) with diminished uncorrected distance visual acuity (UDVA) of ≥2 lines due to residual refractive error after mIOL implantation were included in the study. VTICL size was calculated using the standard STAAR Visian ICL calculation software for phakic eyes. Postoperative study visits (1 day, 1 week, 3 months and 6 months after VTICL implantation) included UDVA, corrected distance visual acuity (CDVA), VTICL axis alignment, vault (space between mIOL and VTICL), IOP and documentation of adverse events. Results At 6 months, mean UDVA (logMAR) increased from 0.26 preoperatively to −0.01 ( P <0.001) while mean CDVA remained unchanged. Mean VTICL misalignment from the preoperative target axis was 5.3° and mean vault was 1385 µm. In the initial phase of the study, 2 VTICL had to be exchanged due to oversizing. Conclusion Piggy-back low power VTICL can efficaciously correct residual refractive error after mIOL implantation and significantly increase UDVA. Advantages of this novel surgical approach include: VTICL availability in small diopter steps, no significant surgical-induced astigmatism, atraumatic and reversible procedure.

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Refractive outcomes of femtosecond laser–assisted secondary arcuate incisions in patients with residual refractive astigmatism after trifocal intraocular lens implantations

Cited by 8 publications

References 21 publications

Precision and refractive predictability of a new nomogram for femtosecond laser‐assisted corneal arcuate incisions

Precision and refractive predictability of a new nomogram for femtosecond laser‐assisted corneal arcuate incisions

Effect of Refractive Astigmatism on All-Distance Visual Acuity in Eyes With a Trifocal Intraocular Lens

<p>A prospective pilot study using a low power piggy-back toric implantable Collamer lens to correct residual refractive error after multifocal IOL implantation</p>

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