Search Results (11)

Background/Objectives: To assess the optical performance of two refractive premium IOLs across pupil sizes and values of corneal spherical aberration (SA). Methods: Two refractive IOLs were evaluated in this study: Tecnis Eyhance and Mini Well. The surface profiles were obtained to calculate the through-object MTF (TO MTF) curves and simulate optotype images. Entrance pupil sizes ranging from 2 to 5.5 and three corneal models were analyzed in the simulation: an average population aberrated cornea, an aberration-free cornea and a post-Lasik myopic cornea. Results: For Model 1 and pupil sizes between 3.0 and 3.5 mm, Mini Well provided acceptable visual quality from far to near distances, whereas Eyhance struggled to maintain visual quality at distances closer than intermediate. For patients with lower-than-normal corneal SA (i.e., more prolate corneas, such as post-hyperopic LASIK) both IOLs exhibited a hyperopic shift in far focus. Conversely, for patients with higher-than-normal corneal SA (i.e., more oblate corneas, such as post-myopic LASIK), the shift occurred in the myopic direction. Despite the implementation of an optimized IOL power to circumvent any shift, the TO MTF nevertheless reflected the interaction between corneal and IOL SA. Furthermore, the Mini Well demonstrated increased tolerance to less negative SA values, while Eyhance exhibited behavior consistent with a monofocal lens for more positive SA values. Conclusions: Surgeons should consider each patient’s corneal asphericity and typical pupil diameter when selecting and calculating the power of the premium IOLs studied, particularly in patients with a history of refractive surgery. Full article

Background/Objectives: Visual recovery after cataract surgery may be affected by lifestyle and environmental factors. This study aimed to investigate the association between daily outdoor activity and patient-reported visual outcomes after cataract surgery under perioperative management using cyclosporine and rebamipide. Methods: This retrospective study included 90 eyes from patients who underwent standardized cataract surgery with implantation of TECNIS Eyhance intraocular lenses. Patients were divided into two groups based on their average daily outdoor activity during the first postoperative month: Group 1 (≤3 h/day) and Group 2 (>3 h/day). Postoperative assessments included Cataract-related Visual Function Questionnaire (CVFQ) scores, uncorrected and corrected distance visual acuity, and ocular surface parameters such as tear breakup time, Oxford score, SICCA score, and OSDI. Results: Group 1 reported significantly higher CVFQ scores for daytime (p = 0.020) and night-time driving (p = 0.037) compared to Group 2, indicating lower levels of visual discomfort in these tasks. No significant differences were observed between the groups for other CVFQ subcategories or ocular surface parameters. Conclusions: Except for driving-related discomfort, no significant differences were found in CVFQ scores between the groups. No difference in ocular surface parameters can be attributed to the perioperative management using cyclosporine and rebamipide. CVFQ may be a useful tool for assessing subjective visual outcomes after cataract surgery. Full article

Purpose: A novel enhanced monofocal intraocular lens (IOL) has been developed to improve functional intermediate vision, maintaining a distance vision comparable to a standard monofocal lens and avoiding the drawbacks of multifocal IOLs. The aim of this study is to perform optical bench analysis and to evaluate refractive and visual outcomes and patient satisfaction. Methods: This prospective comparative single-center study was conducted in Careggi Hospital, University of Florence (Italy). We included 100 eyes from 50 patients who underwent bilateral cataract surgery. One group received the standard monofocal Tecnis GCB00 IOL, while the other group received the novel enhanced monofocal Evolux IOL. We evaluated binocular visual and refractive outcomes at 6 months after surgery. Binocular defocus curves and contrast sensitivity (CS) were also assessed. Optical quality was also analyzed in terms of higher-order aberrations (HOAs), modulation transfer function (MTF), objective scatter index (OSI), Strehl ratio, effective lens position (ELP), and halo analysis. A Patient-Reported Spectacle Independence Questionnaire (PRSIQ) was performed to assess spectacle independence outcomes. Finally, we analyzed the optical bench of both lenses. Results: All eyes implanted with Evolux achieved excellent distance vision, comparable to that achieved with GCB00. Evolux showed better intermediate and near vision, without any loss of visual quality, contrast sensitivity, or the presence of halos and photic phenomena. The optical bench analysis confirmed the different optical properties of the two lenses and supported the behavior obtained with the clinical defocus curve. Conclusions: These preliminary results show good refractive accuracy and visual outcomes for the enhanced monofocal IOL Evolux after cataract surgery. Further studies are needed to confirm our findings in terms of the number of patients and the period of follow-up. Full article

Objectives: To evaluate the clinical performance and optical quality of a non-diffractive extended-depth-of-focus (EDOF) intraocular lens (IOL), Asqelio™ EDOF (models ETLIO130C/ETPIO130C), in patients undergoing cataract surgery or refractive lensectomy. Methods: This prospective observational, case-control study included patients bilaterally implanted with either the Asqelio™ EDOF IOL (Study Group) or the spherical monofocal TECNIS^® 1-Piece ZCB00 IOL (Control Group). The postoperative outcomes—at 3 months after surgery—included visual acuities at multiple distances, refraction, contrast sensitivity, the optical scatter index (OSI), wavefront aberrations, and patient-reported outcomes (Catquest-9SF and a quality-of-vision questionnaire). Results: Twenty-three patients (46 eyes) in the Asqelio™ EDOF group and 17 patients (34 eyes) in the monofocal control group were enrolled. Postoperatively, 91% of eyes in the EDOF group were within ±0.50 D of the intended spherical equivalent. The binocular uncorrected distance, intermediate, and near visual acuities were 0.00 ± 0.09, 0.13 ± 0.12, and 0.32 ± 0.15 logMAR, respectively. Contrast sensitivity and OSI values were similar between the study and control groups (p > 0.05). Higher-order aberrations were significantly lower in the EDOF group (p < 0.001), but values in both groups were clinically low. No adverse events were reported. Most patients expressed high satisfaction and reported few visual disturbances. Conclusions: The Asqelio™ EDOF IOL provided good refractive predictability, effective uncorrected vision across distance and intermediate ranges, and high patient satisfaction. Contrast sensitivity and optical scatter were comparable to monofocal implants. This lens can be considered a valuable option for patients seeking an extended range of functional vision with minimal side effects. Full article

Objectives: This laboratory study aims to assess the effects of misaligning different trifocal intraocular lenses (IOLs) under varying spectral and corneal spherical aberration (SA) conditions. Methods: With an IOL metrology device under monochromatic and polychromatic conditions, the following models were studied: AT ELANA 841P, AT LISA Tri 839MP, FineVision HP POD F, Acrysof IQ PanOptix, and Tecnis Synergy ZFR00V. The SA was simulated using an aberration-free and average-SA cornea. The modulation transfer function (MTF) was measured at different pupil sizes for the on- and off-axis lens positions. Results: The IOLs exhibited varying responses to decentration up to 1 mm, showing the lowest impact in polychromatic light. The least affected was AT ELANA, with an MTF loss of 15.7% to 28.4% at 50 lp/mm across the studied conditions. It was followed by PanOptix and FineVision, with the MTF loss ranging from 19.1% to 36.0% and from 21.2% to 46.6%. AT LISA showed a more substantial reduction, i.e., 41.2% to 64.8%, but it was still lower than that of Synergy (51.1% to 78.8%). When decentration was induced at a 4.5 mm distance, its effect was more evident in conditions that were closer to each IOL’s SA correction. A tilt of 5° had a lesser impact than 1 mm decentration, with the effect being more severe at 4.5 mm. Conclusions: The off-axis position affects the optical quality of trifocal IOLs. Low- rather than high-SA-correcting trifocals perform better under misalignment. In polychromatic light, the impact of misalignment is less evident, suggesting a potential mitigating effect of chromatic aberration. Full article

Background: To evaluate the clinical outcomes and patient satisfaction after implantation of an enhanced monofocal intraocular lens (TECNIS Eyhance ICB00) in patients with idiopathic epiretinal membrane (ERM) who underwent cataract surgery with pars plana vitrectomy (PPV). Methods: This is a single-center, retrospective, comparative study. In total, 61 eyes of 61 patients with idiopathic ERM and cataracts were included. We measured the uncorrected near and intermediate visual acuity (UNVA and UIVA), uncorrected and corrected distance visual acuity (UDVA and CDVA), central macular thickness, defocus curves, and contrast sensitivity 3–6 months after the surgery. Overall patient satisfaction was assessed using a questionnaire at the 1-month follow-up visit. Results: The ICB00 group showed better near and intermediate visual acuity than the monofocal group (TECNIS ZCB00); however, no statistically significant differences were found between the groups. The ICB00 group exhibited wider defocus curves at near to far distances (−3.0 to +2.0 D) than the ZCB00 group. There were no significant differences in the results of the contrast sensitivity test, dysphotopsia, spectacle dependence, or patient satisfaction between the two groups. Conclusions: In combined PPV and cataract surgery for ERM patients, ICB00 resulted in good visual acuity with a smoother defocus curve compared to the ZCB00 group. Full article

This study compares the efficacy, safety, and patient-reported outcomes of three intraocular implants (IOL): Tecnis Synergy IOL, AcrySof IQ PanOptix Trifocal, and Tecnis Symfony EDOF IOL. Participants achieving 20/20 or better uncorrected binocular visual acuity were as follows: Synergy—67% distance, 64% intermediate, and 47% near; PanOptix—73% distance, 73% intermediate, and 50% near; and Symfony—63% distance, 75% intermediate, and 22% near. Symfony demonstrated superior intermediate visual acuity compared to Synergy (p = 0.0182) for those achieving 20/25 or better. Both Synergy and PanOptix showed superiority over Symfony for near visual acuity (p < 0.0001). Halos were statistically more common in Synergy participants compared to PanOptix (p = 0.0013) and Symfony (p < 0.0001). Each trial lens outperformed its monofocal IOL in terms of independence from glasses or contacts, with Synergy and PanOptix showing statistical significance over Symfony. Comparing contrast sensitivities and defocus curves was challenging due to data variance and as such, standardization of United States Food and Drug Administration (US-FDA) data reporting is key for better comparison of outcomes among different IOL platforms. Full article

The purpose of this study was to compare the visual performance and optical quality between three new enhanced monofocal intraocular lenses (IOLs). This retrospective study included patients affected by cataracts with corneal astigmatism less than 0.75 D and no ocular comorbidities who underwent cataract surgery with bilateral implantation of Tecnis Eyhance ICB00 (Johnson & Johnson Vision Care, Inc., Jacksonville, FL, USA), Vivinex Impress XY1-EM (Hoya Surgical Optics, Singapore) or IsoPure 123 (PhysIOL, Liege, Belgium) IOLs. Three months postoperatively, monocular and binocular uncorrected and corrected distant, and intermediate and near visual acuities were measured. Binocular defocus curve, photopic contrast sensitivity, Point Spread Function (PSF), low order aberrations (LOAs), high order aberrations (HOAs), objective scatter index (OSI), halo and glare perception were also evaluated. This study included a total of 72 eyes from 36 patients. Visual acuity outcomes, PSF, LOAs, HOAs and OSI were similar between groups. There were no statistically significant differences in terms of photopic contrast sensitivity, halo or glare perception. In patients without ocular comorbidities, the Eyhance ICB00 IOL, the Vivinex Impress IOL and the Isopure IOL—even though based on different optical properties—provided similar results in terms of visual acuity, contrast sensitivity and intraocular aberrations, with no influence on photic phenomena. Full article

Presbyopia correction through implantation of a trifocal intraocular lens (IOL) is a modality offered to both cataract and refractive-lens exchange patients. To maximize postoperative satisfaction, IOL selection needs to be made based on patients’ requirements aligned with the available technology. Five Trifocal IOLs were assessed in this study, and their differentiating features were identified: Triumf POD L GF, AT Lisa Tri, Tecnis Synergy, AcrySof IQ PanOptix, and Acriva Trinova Pro C. The optical quality was assessed using the modulation-transfer-function principle. Simulated defocus curves were derived from a non-linear formula. Far-focus simulated visual acuity (simVA) was 0.03 logMAR or better for all the studied IOLs, showing minimal differences. However, each IOL’s intermediate focus position differed across a range from 61 cm to 80 cm; and for the near focus, it was 36 cm to 44 cm. Triumf demonstrated improved intermediate point at the expense of the near focus resulting in a lower predicted near VA. PanOptix exhibited the shortest range of vision without a clear distinction between intermediate and near-point. The remaining lenses presented three foci of comparable optical quality and, thus, simVA performance. Each model, however, revealed a different aperture-change response. Trinova function improved at intermediate but was worse at near for larger pupils. The opposite was observed for AT Lisa. Synergy’s optical quality change was predominantly associated with lower pupil diameter. In conclusion, the trifocal IOLs can be differentiated according to their secondary-foci position, light-energy distribution, and pupil-size-related behavior. The observed differences may translate directly into a clinical effect showing that the trifocal IOLs vary in their ability to deliver optimal vision at different distances, with some providing improved intermediate while others favor reading distance. The knowledge gained through this objective testing can support IOL selection, postoperative patient counselling and increase the chance of spectacle independence after surgery. Full article

This study compares the visual and refractive performance of the TECNIS Synergy (DFR00V-DFW150-225-300-375) multifocal intraocular lens (IOL) and the AcrySof IQ PanOptix (TFAT00-30-40-50-60) multifocal IOL. Patients who underwent phacoemulsification and cataract extraction and received either a multifocal Synergy or PanOptix IOL were included. Monocular uncorrected distance (UDVA), intermediate (UIVA), near (UNVA), and corrected distance (CDVA) visual acuities were assessed at three and six months postoperatively. Secondary outcome measures of photic phenomena were also assessed. A total of 140 patients (224 eyes) were included in this study, with 69 patients (105 eyes) in the Synergy group and 71 patients (119 eyes) in the PanOptix group. There were no statistically significant differences in UIVA or CDVA measurements across all time points. When assessing UDVA, at three months postoperatively, there were more eyes in the PanOptix group with vision better than 20/40 (p = 0.04). At three and six months postoperatively, the average UNVA was superior in the Synergy group (p = 0.01, 0.002). While the Synergy group reported more night vision disturbances at one and three months (p = 0.01, 0.03), the PanOptix group had more night vision disturbances at six months (p = 0.02). Although not statistically significant, the AcrySof IQ PanOptix multifocal IOL demonstrated better UDVA and UIVA sooner postoperatively than the TECNIS Synergy multifocal IOL. The Synergy IOL provided statistically better UNVA compared to the PanOptix IOL at three and six months postoperatively. Synergy patients reported more early photic phenomena than PanOptix patients, which later diminished. Full article

Background and Objectives: To evaluate the performance of intraocular lenses (IOLs) using power calculation formulas on different types of IOL. Materials and Methods: 120 eyes and four IOL types (BioLine Yellow Accurate Aspheric IOL (i-Medical), TECNIS ZCB00, TECNIS ZA9003 (Johnson & Johnson) (3-piece IOL) and Softec HD (Lenstec)) were analyzed. The performance of Haigis, Barret Universal II and SKR-II formulas were compared between IOL types. The mean prediction error (ME) and mean absolute prediction error (MAE) were analyzed. Results: The overall percentage of eyes predicted within ±0.25 diopters (D) was 40.8% for Barret; 39.2% Haigis and 31.7% for SRK-II. Barret and Haigis had a significantly lower MAE than SRK-II (p < 0.05). The results differed among IOL types. The largest portion of eyes predicted within ±0.25 D was with the Barret formula in ZCB00 (33.3%) and ZA9003 (43.3%). Haigis was the most accurate in Softec HD (50%) and SRK-II in Biolline Yellow IOL (50%). ZCB00 showed a clinically significant hypermetropic ME compared to other IOLs. Conclusions: In general, Barret formulas had the best performance as a universal formula. However, the formula should be chosen according to the type of IOL in order to obtain the best results. Constant optimizations are necessary for the Tecnis IOL ZCB00 and ZA9003, as all of the analyzed formulas achieved a clinically significant poor performance in this type of IOL. ZCB00 also showed a hypermetropic shift in ME in all the formulas. Full article