Visual outcomes and optical performance of a monofocal intraocular lens and a new-generation multifocal intraocular lens

Alió, Jorge L.; Piñero, David P.; Plaza-Puche, Ana B.; Chan, Maria Joanna Rodriguez

doi:10.1016/j.jcrs.2010.08.043

Cited by 144 publications

(105 citation statements)

References 49 publications

(64 reference statements)

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“…8 In fact, both Muñoz et al 7 and Alió et al [8][9][10] reported that contrast sensitivity in MPlus-implanted patients was similar to that in monofocal IOL-implanted patients at any spatial frequency. [7][8][9][10] Moreover, Alió et al 9,10 reported that eyes implanted with an MPlus MIOL registered higher contrast sensitivity than did eyes implanted with a diffractive MIOL. This feature might also contribute especially for good distance vision, 7 and the immediate visual rehabilitation shown in our results at 1 day postoperatively.…”

Section: Discussionmentioning

confidence: 97%

“…[7][8][9][10] Of the 11 patients, all were completely independent of spectacles for distance vision. For near vision, one patient needed to use eyeglasses occasionally, and one patient needed to use eyeglasses constantly.…”

Section: Preoperative Baseline Datamentioning

confidence: 99%

“…The aim of that design is to reduce sources of light scattering and aberrations that cause disturbing reflections, halos, and glare; several studies have reported the clinical results of that lens design. [7][8][9][10] Although studies have reported that the postoperative contrast sensitivity outcomes using other MIOLs are worse than those with monofocal IOLs, 11,12 Alió et al 8 reported that the postoperative contrast sensitivity outcomes with MPlus are comparable to those of monofocal IOLs.…”

Section: Introductionmentioning

confidence: 99%

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Implantation of refractive multifocal intraocular lens with a surface-embedded near section for cataract eyes complicated with a coexisting ocular pathology

Ouchi

Kinoshita

2015

Eye

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Purpose To evaluate the postoperative outcomes of cataract eyes complicated with coexisting ocular pathologies that underwent implantation of a refractive multifocal intraocular lens (MIOL) with a surfaceembedded near section. Methods LENTIS MPlus (Oculentis GmbH) refractive MIOLs were implanted in 15 eyes with ocular pathologies other than cataract (ie, six high-myopia eyes with an axial length longer than 28 mm, two fundus albipunctatus eyes, two branch retinal-vein occlusion eyes, four glaucoma eyes (one with high myopia), and two keratoconus eyes). Uncorrected or corrected distance and near visual acuity (VA) (UDVA, UNVA, CDVA, and CNVA), contrast sensitivity, and defocus curve were measured at 1 day and 6 months postoperatively, and each patient completed a 6-month postoperative questionnaire regarding vision quality and eyeglass use. Results Thirteen eyes (87%) registered 0 or better in CDVA and 12 eyes (73%) registered better than 0 in CNVA. Contrast sensitivity in the eyes of all patients was comparable to that of normal healthy subjects. No patient required eyeglasses for distance vision, but three patients (20%) required them for near vision. No patient reported poor or very poor vision quality. Conclusion With careful case selection, sectorial refractive MIOL implantation is effective for treating cataract eyes complicated with ocular pathologies.

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Section: Discussionmentioning

confidence: 97%

Section: Preoperative Baseline Datamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Implantation of refractive multifocal intraocular lens with a surface-embedded near section for cataract eyes complicated with a coexisting ocular pathology

Ouchi

Kinoshita

2015

Eye

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“…Recently, a refractive multifocal IOL with rotational asymmetry has been developed and introduced into clinical practice. Their performance is being evaluated and compared with already existing IOL designs [37][38][39]. A diffractive multifocal IOL uses the base lens curvature and the zero and first diffraction orders to simultaneously produce the two focal points [40], [41].…”

Section: Model Eyes For Iol Testingmentioning

confidence: 99%

“…There is a great interest to determine either in a test bench [43], [44] or in clinical studies [45], [46] the conditions and the degree to which the aspheric design in apodized diffractive multifocal IOLs might be advantageous versus a conventional spherical design, particularly when some studies have shown little or no benefit of aspheric IOLs with small pupils [47, [48]. For the assessment of the optical performance of multifocal IOLs, the common metrics (point spread function, modulation transfer function, and visual acuity) have to be measured [38], [49][50][51][52] and also its behaviour in terms of the energy balance between the distance an near images and its variation with the pupil diameter. Very recent studies carried out in an optical bench show a discrepancy between the theoretical prediction of the design and the experimentally measured energy distribution between the two foci in apodized diffractive multifocal IOLs [53].…”

Section: Model Eyes For Iol Testingmentioning

confidence: 99%

New trends in intraocular lens imaging

2011

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As a result of modern technological advances, cataract surgery can be seen as not only a rehabilitative operation, but a customized procedure to compensate for important sources of image degradation in the visual system of a patient, such as defocus and some aberrations. With the development of new materials, instruments and surgical techniques in ophthalmology, great progress has been achieved in the imaging capability of a pseudophakic eye implanted with an intraocular lens (IOL). From the very beginning, optical design has played an essential role in this progress. New IOL designs need, on the one hand, theoretical eye models able to predict optical imaging performance and on the other hand, testing methods, verification through in vitro and in vivo measurements, and clinical validation. The implant of an IOL requires a precise biometry of the eye, a prior calculation from physiological data, and an accurate position inside the eye. Otherwise, the effects of IOL calculation errors or misplacements degrade the image very quickly. The incorporation of wavefront aberrometry into clinical ophthalmology practice has motivated new designs of IOLs to compensate for high order aberrations in some extent. Thus, for instance, IOLs with an aspheric design have the potential to improve optical performance and contrast sensitivity by reducing the positive spherical aberration of human cornea. Monofocal IOLs cause a complete loss of accommodation that requires further correction for either distance or near vision. Multifocal IOLs address this limitation using the principle of simultaneous vision. Some multifocal IOLs include a diffractive zone that covers the aperture in part or totally. Reduced image contrast and undesired visual phenomena, such as halos and glare, have been associated to the performance of multifocal IOLs. Based on a different principle, accommodating IOLs rely on the effort of the ciliary body to increase the effective power of the optical system of the eye in near vision. Finally, we present a theoretical approach that considers the modification of less conventional ocular parameters to compensate for possible refractive errors after the IOL implant.

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Multifocal versus monofocal intraocular lenses after cataract extraction

Calladine

Evans

Shah

et al. 2012

Cochrane Database of Systematic Reviews

100

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BACKGROUND: Good unaided distance visual acuity is now a realistic expectation following cataract surgery and intraocular lens (IOL) implantation. Near vision, however, still requires additional refractive power, usually in the form of reading glasses. Multiple optic (multifocal) IOLs are available which claim to allow good vision at a range of distances. It is unclear whether this benefit outweighs the optical compromises inherent in multifocal IOLs. OBJECTIVES: The objective of this review was to assess the effects of multifocal IOLs, including effects on visual acuity, subjective visual satisfaction, spectacle dependence, glare and contrast sensitivity, compared to standard monofocal lenses in people undergoing cataract surgery. METHODS: Search methods: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register), The Cochrane Library 2012, Issue 2, MEDLINE (January 1946 to March 2012), EMBASE (January 1980 to March 2012), the metaRegister of Controlled Trials (mRCT) (www. controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who. int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 6 March 2012. We searched the reference lists of relevant articles and contacted investigators of included studies and manufacturers of multifocal IOLs for information about additional published and unpublished studies. Selection criteria: All randomised controlled trials comparing a multifocal IOL of any type with a monofocal IOL as control were included. Both unilateral and bilateral implantation trials were included. Data collection and analysis: Two authors collected data and assessed trial quality. Where possible, we pooled data from the individual studies using a random-effects model, otherwise we tabulated data. MAIN RESULTS: Sixteen completed trials (1608 participants) and two ongoing trials were identified. All included trials compared multifocal and monofocal lenses but there was considerable variety in the make and model of lenses implanted. Overall we considered the trials at risk of performance and detection bias because it was difficult to mask patients and outcome assessors. It was also difficult to assess the role of reporting bias. There was moderate quality evidence that similar distance acuity is achieved with both types of lenses (pooled risk ratio, RR for unaided visual acuity worse than 6/6: 0.98, 95% confidence interval, CI 0.91 to 1.05). There was also evidence that people with multifocal lenses had better near vision but methodological and statistical heterogeneity meant that we did not calculate a pooled estimate for effect on near vision. Total freedom from use of glasses was achieved more frequently with multifocal than monofocal IOLs.

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Visual outcomes and optical performance of a monofocal intraocular lens and a new-generation multifocal intraocular lens

Abstract: The new-generation multifocal IOL restored distance, intermediate, and near visual function after cataract surgery. The optical quality with this type of IOL was particularly affected by IOL tilt and decentration.

Cited by 144 publications

References 49 publications

Implantation of refractive multifocal intraocular lens with a surface-embedded near section for cataract eyes complicated with a coexisting ocular pathology

Implantation of refractive multifocal intraocular lens with a surface-embedded near section for cataract eyes complicated with a coexisting ocular pathology

New trends in intraocular lens imaging

Multifocal versus monofocal intraocular lenses after cataract extraction

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