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Presbyopia, Laser, Cataract and Refractive Surgery: State-of-the-Art Research

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (31 March 2025) | Viewed by 1976

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Dr. Ivo Guber

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Department of Ophthalmology, University of Geneva, Rue de Alcide-Jentzer 22, 1205 Geneva, Switzerland
Interests: corneal grafts; cataract surgery; refractive surgery; LASIK; PRK; intraocular lenses; phakic lenses
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Dear Colleagues,

I am delighted to present a new Special Issue entitled “Presbyopia, Laser, Cataract and Refractive Surgery: State-of-the-Art Research”.

Recent technological developments and advanced surgical techniques have radically changed the daily practice of eye surgeons, with new treatment options making surgery safer, faster, and more precise. The advent of novel diagnostic tools, particularly those employed in the anterior segment, has enhanced patient management and the precise monitoring of disease progression, leading to an improvement in postoperative surgical outcomes.

This Special Issue provides a multidisciplinary forum focusing on the role of diagnostic and surgical procedures in this subfield of ophthalmology.

The published papers will describe new developments in these areas. This Special Issue welcomes the submission of high-quality articles containing original research results, as well as review articles of exceptional merit.

Dr. Ivo Guber
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

corneal grafts
cataract surgery
refractive surgery
presbyopia
laser
intraocular lenses

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Published Papers (4 papers)

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Research

9 pages, 700 KiB

Open AccessArticle

Comparison of Visual Performance Between Two Diffractive Trifocal Intraocular Lenses

by Gloria Segura-Duch, David Oliver-Gutierrez, Mar Arans, Susana Duch-Tuesta, Carlos Carpena-Torres, Gonzalo Carracedo and David Andreu-Andreu

J. Clin. Med. 2025, 14(9), 3128; https://doi.org/10.3390/jcm14093128 - 30 Apr 2025

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Abstract

Background/Objectives: This study aimed to compare the visual outcomes of two diffractive trifocal intraocular lenses (IOLs): the Bi-Flex Liberty 677MY (Medicontur; Zsámbék, Hungary) and the FineVision POD F (BVI Medical; Waltham, MA, USA). Methods: A prospective study with a 3-month follow-up was conducted. A total of 62 patients were divided into two groups according to the type of lens implanted: 31 patients with the Liberty lens (61.1 ± 6.4 years) and 31 patients with the Finevision lens (61.9 ± 6.8 years). Three measurement sessions were conducted (baseline, 1 month, and 3 months). These sessions included measurements of the subjective refraction, visual acuity, and defocus curve. Both eyes of each patient were operated on and included in the statistical analysis. Results: Three months after surgery, monocular visual acuity with the Liberty lens was statistically greater than with the Finevision lens at defocus values of −2.00 D (50 cm) and −2.50 D (40 cm) (p < 0.01). In this regard, the near visual acuity results (40–50 cm) with the Liberty lens showed greater variability compared to those of the Finevision lens. Binocularly, however, the Finevision lens demonstrated a statistically significant improvement in visual acuity than the Liberty lens at a defocus of −1.50 D (67 cm) (p = 0.01). Both IOLs provided visual acuities better than 0.20 logMAR for a defocus range from distance (0.00 D) to near (−3.50 D). Conclusions: Future studies are needed to investigate which patient ocular parameters could predict improved near vision with the Liberty lens or intermediate vision with the Finevision lens. Full article

(This article belongs to the Special Issue Presbyopia, Laser, Cataract and Refractive Surgery: State-of-the-Art Research)

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11 pages, 9741 KiB

Open AccessArticle

Objective Rotational Analysis of EVO Toric ICLs Using Infrared Retinal Retroillumination Imaging

by Antonio Cano-Ortiz, Álvaro Sánchez-Ventosa, Timoteo González-Cruces, Marta Villalva-González, Juan José Prados-Carmona, Rosa Castillo-Eslava, Miguel Ángel Sánchez-Tena, Cristina Alvarez-Peregrina and Alberto Villarrubia-Cuadrado

J. Clin. Med. 2025, 14(9), 2895; https://doi.org/10.3390/jcm14092895 - 23 Apr 2025

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Abstract

Background/Objectives: To objectively evaluate the rotational stability, refractive predictability, and visual outcomes of toric EVO ICL using automated infrared retinal retroillumination imaging. Setting/Venue: The research was conducted in a specialized ophthalmic surgery center. Design: Longitudinal analytical prospective study. Methods: The methodology included preoperative and postoperative assessments of visual acuity, subjective refraction, corneal topography, and anterior segment OCT. The implantation and alignment process utilized advanced digital centration techniques. Postoperative evaluations were conducted at 1 and 3. Results: The study found a mean incision surgically induced astigmatism (SIA) of 0.32 D, and a refractive SIA average of 2.02 D, closely matching the preoperative refractive astigmatism (target-induced astigmatism—TIA) mean of 2.07 D, resulting in a correction index (CI) of 0.96. Rotational stability was high, with 72% of lenses showing less than 5° rotation and 96% under 10° at the 1-month follow-up. No significant correlations were observed between lens rotation and postoperative vault size or horizontal compression, indicating independent factors. The discrepancy between theoretical and observed rotations suggested that the calculation method slightly underestimated actual rotation, which did not significantly affect visual outcomes. Graphical analysis demonstrated minimal impact of lens rotation on uncorrected distance visual acuity (UDVA), confirming the procedure’s efficacy and safety. Conclusions: Toric EVO ICL implants provide high rotational stability, excellent refractive predictability, and satisfactory visual outcomes. The study underscores the importance of precise implantation and the minimal influence of lens rotation on postoperative refractive errors. Full article

(This article belongs to the Special Issue Presbyopia, Laser, Cataract and Refractive Surgery: State-of-the-Art Research)

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8 pages, 215 KiB

Open AccessArticle

Evaluation of Reliability of Formulas for Intraocular Lens Power Calculation After Hyperopic Refractive Surgery

by Rosa Boccia, Michele Lanza, Giuseppe Luciano, Italo Fattore, Luigi Serra, Salvatore Ambrosio, Francesco Abbate and Francesca Simonelli

J. Clin. Med. 2025, 14(6), 1990; https://doi.org/10.3390/jcm14061990 - 15 Mar 2025

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Abstract

Background: We evaluate the accuracy of intraocular lens (IOL) power calculation in the following formulas—Barrett True-K No History (BTKNH), EVO 2.0 Post-Hyperopic LASIK/PRK (EVO 2.0), Haigis-L, Pearl-DGS, and Shammas (SF)—with patients who have undergone cataract surgery at the Eye Unit of University of Campania Luigi Vanvitelli, Naples, Italy, and had prior hyperopic laser refractive surgery. Methods: A monocentric, retrospective, comparative study, including the charts of patients who had undergone cataract surgery and previous hyperopic laser refractive surgery, was retrospectively reviewed. Patients with no other ocular or systemic disease which might interfere with visual acuity results and no operative complications or combined surgery were enrolled. The mean absolute prediction error (MAE) was calculated for each formula and compared. Subgroup analysis based on the axial length and mean keratometry was performed. Results: A total of 107 patients (107 eyes) were included. The MAE calculated with SF provided less accurate (p < 0.05) results when compared to both BTKNH and EVO 2.0 formulas. The MAE obtained using Haigis-L, EVO 2.0, Pearl-DGS, and BTKNH showed no significant differences. Conclusions: The analysis of the accuracy of the selected formulas shows no clear advantage in using one specific formula in standard cases, but in eyes where it is mandatory to reach the target refraction, SF should be avoided. Full article

(This article belongs to the Special Issue Presbyopia, Laser, Cataract and Refractive Surgery: State-of-the-Art Research)

14 pages, 6076 KiB

Open AccessArticle

Fast and Slow Response of the Accommodation System in Young and Incipient-Presbyope Adults During Sustained Reading Task

by Ebrahim Safarian Baloujeh, António Queirós, Rafael Navarro and José Manuel González-Méijome

J. Clin. Med. 2025, 14(4), 1107; https://doi.org/10.3390/jcm14041107 - 9 Feb 2025

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Abstract

Objectives: To investigate the dynamics of accommodation during and immediately after a sustained reading task on a digital device across various age groups under monocular and binocular conditions. Methods: Seventeen subjects were selected and divided into three age groups: young adults (n = 4, age: 21.3 ± 3.2 years), adults (n = 4, age: 34 ± 3.56 years), and incipient presbyopes (n = 9, age: 45 ± 3.61 years). Dynamic accommodation and disaccommodation were objectively measured using the WAM-5500 open-view autorefractor during 2 min of distance fixation (Maltese cross at 6 m), 5 min of sustained near reading on a teleprompter app at the nearest readable distance, and 2 min of distance vision. Six sequential temporal landmarks were identified. Quantitative metrics for accommodation lag (AL), slope of slow accommodation (SSA), slope of slow disaccommodation (SSD), peak velocity of accommodation (PVA) and peak velocity of disaccommodation (PVD) were obtained as absolute values of spherical equivalent refractive (SER) change. Results: SSA, SSD, and AL were significantly and positively correlated with age (ρ = 0.75, 0.73, 0.51, respectively; p ≤ 0.038). For subjects under 45 years of age SSA and SSD increased quadratically with age, while for those above 45 years, both SSA and SSD decreased linearly. Linear regression of PVA and PVD with age indicated that the disaccommodation mechanism is faster than accommodation (slope = –0.15 and –0.23, respectively). PVA was significantly faster under monocular than binocular conditions (p = 0.124). Conclusions: Incipient presbyopes demonstrate a complex response in both accommodation and disaccommodation. The accommodation system responds quickly, but there is also a slower response that can provide up to an additional 1D of accommodative response during sustained near reading tasks. It is hypothesized that the crystalline lens exhibits hysteresis in returning to its unaccommodated state, due to its viscoelastic properties, which means it takes time to relax. Full article

(This article belongs to the Special Issue Presbyopia, Laser, Cataract and Refractive Surgery: State-of-the-Art Research)

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