Visual outcome and patient satisfaction after multifocal intraocular lens implantation: Aspheric versus spherical design

Vries, Niels E. de; Webers, Carroll A.B.; Verbakel, Frenne; Brabander, John de; Berendschot, Tos T. J. M.; Cheng, Yanny Y. Y.; Doors, Muriël; Nuijts, Rudy M.M.A.

doi:10.1016/j.jcrs.2010.05.030

Cited by 36 publications

(21 citation statements)

References 39 publications

(39 reference statements)

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“…Several authors have used the phakic straylight reference curve in their research to compare the straylight value in pseudophakic eyes. 10,21,24,26,29,30 However, when comparing the pseudophakic curve with the phakic curve, there are important differences. Straylight levels are stable in young phakic eyes and increase considerably above the age of 50 years; thus, the phakic reference is approximated by a logarithmic function.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

Ocular straylight in the normal pseudophakic eye

Łabuz¹,

Reus²,

Berg³

2015

Journal of Cataract and Refractive Surgery

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“…No differences in straylight have been detected for spherical compared to aspheric IOLs. 14,15 In a study in which subject age was taken into account, multiple linear regression analysis using log straylight as the dependent variable revealed that both age and IOL type had an effect on the amount of straylight generated. 11 Few studies have centered on obtaining objective halo size measurements in subjects implanted with an intraocular lens.…”

mentioning

confidence: 99%

Disk halo size measured in individuals with monofocal versus diffractive multifocal intraocular lenses

Puell

Pérez-Carrasco

Hurtado-Ceña

et al. 2015

Journal of Cataract and Refractive Surgery

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PURPOSE:To compare disk halo size in response to a glare source in eyes implanted with an aspheric apodized diffractive multifocal intraocular lens (IOL) or aspheric monofocal IOL.SETTING: Rementeria Ophthalmological Clinic, Madrid, Spain.DESIGN: Prospective randomized masked study. METHOD:Halo radius was measured using a vision monitor (MonCv3) with low-luminance optotypes in 39 eyes that had cataract surgery and the bilateral implant of an Acrysof Restor SN6AD1 multifocal IOL or Acrysof IQ monofocal IOL 6 to 9 months previously. The visual angle subtended by the disk halo radius was calculated in minutes of arc (arcmin). Patient complaints of halo disturbances were recorded. Monocular uncorrected distance visual acutity (UDVA) and corrected distance visual acuity (CDVA) were measured using high-contrast (96%) and lowcontrast (10%) logMAR letter charts. RESULTS:The study comprised 39 eyes of 39 subjects (aged 70 to 80 years); 21 eyes had a multifocal IOL and 18 eyes a monofocal IOL. Mean halo radius was 35 arcmin larger in the multifocal IOL group than the monofocal group (P < .05). Greater halo effects (P < .05) were reported in the multifocal IOL group. Mean monocular high-contrast UDVA and low-contrast UDVA did not vary significantly between groups, whereas mean monocular high-contrast CDVA and low-contrast CDVA were significantly worse at 0.12 and 0.13 logMAR (P < .01) in the multifocal than in the monofocal IOL group, respectively. A significant positive correlation (r Z 0.72, P < .001) was detected by multiple linear regression between the halo radius and low-contrast UDVA in the multifocal IOL group. CONCLUSIONS:The diffractive multifocal IOL gave rise to a larger disk halo size, which was correlated with a worse low-contrast UDVA. The authors have no commercial or proprietary interests in the devices used in this study or manufacturing companies. J Cataract Refract Surg 2015; -:---Q 2015 ASCRS and ESCRSCurrent diffractive multifocal intraocular lenses (IOLs) provide satisfactory distance, intermediate, and near visual acuity, reducing spectacle dependency.1 However, adverse subjective visual phenomena, such as glare and halos, are often reported by patients with multifocal IOLs, especially when driving at night. 1Theoretical optical design predictions suggest that multifocal IOLs will induce more light scatter than monofocal IOLs.2 In a refractive-diffraction IOL designed to simultaneously yield focused images of near and far objects, 3 forward scattered light from a glare source forms a veil of luminance over the retina.Disk halos form because the out-of-focus image has a larger diameter than the sharp image on the retina. 4 The unwanted effect of the light in the out-of-focus image may be visually disturbing, depending on 2 factors: the distance along the optical axis between these 2 images (the greater the distance between the 2 separate focal points along the optical axis, the greater will be the diffusion or blur circle surrounding the primary focus), and their relative energy distribution (the ene...

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“…De Vries et al 21 showed that there was no difference between spherical and aspheric multifocal IOLs with a similar material and Straylight Measurements/Lapid-Gortzak et al diffractive pattern with respect to the mean straylight value. Van Gaalen et al reported similar outcomes, but their study included only monofocal IOLs.…”

Section: Straylight Measurements/lapid-gortzak Et Almentioning

confidence: 97%

“…The comparison of multifocal apodized diffractive IOLs from the same manufacturer, differing only in its effect on spherical aberration, have shown no difference in straylight. 21 Most of these studies were done with small cohorts, and have shown different results in terms of straylight when using different types of lenses. As a result, the effect of multifocality on straylight is unclear.…”

Section: Straylight Measurements/lapid-gortzak Et Almentioning

confidence: 99%

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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Visual outcome and patient satisfaction after multifocal intraocular lens implantation: Aspheric versus spherical design

Abstract: Patients with the aspheric multifocal IOL had significantly better near vision than patients with the multifocal spherical IOL. The UDVA, CDVA, intraocular straylight, night-vision symptoms, and contrast sensitivity were similar between the 2 groups.

Cited by 36 publications

References 39 publications

Ocular straylight in the normal pseudophakic eye

Ocular straylight in the normal pseudophakic eye

Disk halo size measured in individuals with monofocal versus diffractive multifocal intraocular lenses

Straylight Measurements in Two Different Apodized Diffractive Multifocal Intraocular Lenses

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