TL;DR
Mini-monovision with Clareon® monofocal IOLs and ISBCS provides good binocular uncorrected intermediate vision with high patient satisfaction with high patient satisfaction.
Purpose Describe visual outcomes, rotational stability, and patient experience with a new, trifocal, toric intraocular lens (IOL), CNWTTx (Alcon, Fort Worth, TX.) Patients and methods Prospective, cohort study in a private practice in Salt Lake City, UT. Patients 45 years and older with visually significant cataracts, bilateral regular corneal astigmatism requiring a T3‐T6 IOL power lens, no other significant eye disease undergoing sequential cataract surgery with Clareon PanOptix Toric IOL (CNWTTx) followed for 3 months postoperatively. Primary endpoints: monocular corrected distance visual acuity (CDVA), distance‐corrected intermediate visual acuity (DCIVA), and distance‐corrected near visual acuity (DCNVA). Secondary endpoints: rotational position of the IOL and a patient satisfaction survey. Results Twenty‐five patients were recruited into the study and 22 received bilateral Clareon PanOptix Toric IOLs. At 3‐month postoperative visit, visions were monocular mean CDVA of LogMAR (LM) 0.004, mean DCIVA of LM 0.110, and mean DCNVA of LM 0.056. 89% of patients had 0.5 diopters or less of residual astigmatism. Mean lens rotation was 1.67° at 1 month, and no lenses had rotated more than 5°. The majority of patients “never” used glasses at near (88%), at arm’s length (100%) and at a distance (92%). In spite of 25% of patients noting photopic phenomena either “most of the time” or “always,” a majority (88%) of patients were either “satisfied” or “very satisfied” with their vision, and 92% would have the same lens implanted again. Conclusion The CNWTTx lens results in excellent visual acuities at distance, intermediate, and near, leading to high rates of spectacle independence. The lens is rotationally stable, and patients are subjectively satisfied with their visual outcomes.
PURPOSE To evaluate visual outcomes with particular attention to visual acuity of a segmental refractive multifocal intraocular lens, the ACUNEX VarioMax (Teleon Surgical). METHODS This prospective, non-randomized, non-comparative study was conducted at the Department of Ophthalmology, University Hospital, Goethe University, Frankfurt, Germany. Thirty-four eyes (17 patients) were included. Inclusion criteria were bilateral cataract, age older than 30 years, and predicted corneal astigmatism ≤0.75 diopters (D) postoperatively. Exclusion criteria were prior ocular surgeries, amblyopia, or potential postoperative corrected distance visual acuity worse than 0.3 logarithm of the minimum angle of resolution (logMAR). Uncorrected visual acuities for distance, intermediate, and near and distance-corrected visual acuities at 4 m, 80 cm and 40 cm, contrast sensitivity, defocus curve, and questionnaires on optical quality, quality of life, and spectacle independence were assessed after 3 months. RESULTS The mean monocular uncorrected distance visual acuity was 0.02 ± 0.09 logMAR at 4 m, uncorrected intermediate visual acuity was 0.15 ± 0.12 logMAR at 80 cm and uncorrected near visual acuity was 0.24 ± 0.10 logMAR at 40 cm. Defocus curve testing showed a distance-corrected binocular visual acuity range between 0.00 and -2.50 D (from -0.06 to 0.12 logMAR). Median contrast sensitivity under photopic and mesopic conditions was 1.48 ± 0.18 and 1.25 ± 0.29 logCS, respectively. CONCLUSIONS This segmental multifocal intraocular lens provides good visual acuity at all distances, particularly providing good intermediate visual acuity and depth of focus. It showed good contrast sensitivity and high spectacle independence with a high degree of patient satisfaction.
PURPOSE To compare the visual field (VF) outcomes after implantation of monofocal, bifocal and trifocal Intraocular Lenses (IOL) from the same manufacturer platform. SETTING Shandong Eye HospitalDesign: prospective, non-randomized, controlled study. METHODS A total of 102 patients (123 eyes) with age-related cataract were divided into monofocal, bifocal, and trifocal IOL groups. Best-corrected visual acuity (BCVA), refraction, Humphrey 30-2 standard automated perimetry (SAP), and defocus curve were assessed preoperatively and 3 months postoperatively. Outcome measures included visual field index (VFI), mean deviation (MD), and pattern standard deviation (PSD), as well as regional mean sensitivity (MS) in 3 predefined visual field regions: central (0°-5°, zone I), paracentral (6°-15°, zone II), and peripheral (16°-30°, zone III). RESULTS All three IOL groups showed significant postoperative improvements in BCVA, VFI, MD, PSD, and MS in all zones (P < 0.05). Postoperative MS did not differ significantly among groups in zone I. In zone II, MS was higher in the bifocal and trifocal groups than in the monofocal group, with no significant difference between bifocal and trifocal IOLs. In zone III, MS was highest in the trifocal group, followed by the bifocal and monofocal groups (P < 0.05). Intergroup differences in ΔMS were not significant in zone I but were greater in zone II for bifocal and trifocal IOLs. For zone III, ΔMS was significantly larger in the trifocal group than in the monofocal group. CONCLUSION Postoperative VF sensitivity improved after all three IOL types. Central MS did not differ significantly among groups, whereas multifocal IOLs, particularly trifocal IOLs, showed higher MS in paracentral and peripheral zones.
AIM To evaluate changes in visual acuity and accommodation function following femtosecond laser-assisted in situ keratomileusis (FS-LASIK) combined with monovision in patients aged over 40y. METHODS This prospective, non-randomized cohort study included patients who were divided into an FS-LASIK binocular group (full correction) and an FS-LASIK monovision group. The binocular group consisted of Group 1 (15 patients) with simple myopia and Group 2 (12 patients) with myopia and presbyopia. The monovision group (Group 3) included 13 patients with myopia and presbyopia. Parameters assessed included the uncorrected distance visual acuity (UCVA), the uncorrected near visual acuity (UNVA), contrast sensitivity (CS), binocular cross-cylinder (BCC), accommodative amplitude (AMP), positive relative accommodation (PRA), negative relative accommodation (NRA), and accommodative facility (AF). Patient satisfaction was evaluated at 3mo postoperatively. RESULTS A total of 40 patients (80 eyes) were enrolled (mean age 43.63±3.666y; 12 males). At 3mo after FS-LASIK, UCVA improved significantly in all patients (P<0.001), while UNVA remained comparable to preoperative levels (P>0.05). BCC in Group 3 decreased by 0.30±0.43 compared to preoperative levels, showing a statistically significant difference (P=0.037). The AMP in Group 3 showed an increasing trend with greater improvement in the nondominant eye than in the dominant eye (P>0.05). Patient satisfaction was high in all groups. CONCLUSION FS-LASIK combined with monovision is an effective treatment for patients aged over 40y with myopia and presbyopia, which not only improves visual acuity but also achieves high patient satisfaction and improves postoperative BCC.
SMILE with micro-monovision had an impact on accommodative function in the early postoperative stage in myopic patients with presbyopia, and patients exhibited good distance and near vision, maintained binocular visual functions, and reported high subjective satisfaction.
Purpose To assess and compare visual quality and subjective outcomes of the toric and nontoric versions of a trifocal intraocular lens (IOL) combining a diffractive extended depth of focus (EDoF) profile with a diffractive multifocal pattern. Methods This prospective cohort study included patients bilaterally implanted with the TECNIS Synergy or TECNIS Synergy Toric II IOL. At 3 months postoperatively, monocular and binocular uncorrected distance visual acuity (UDVA), corrected visual acuity (VA) at 100%, 50%, and 10% contrast, and binocular defocus curves were evaluated. A five‐point Likert scale questionnaire assessed satisfaction at different distances, perception of halos, and willingness to choose the same lens again. Results A total of 114 eyes (52 nontoric and 62 toric) were analyzed. Monocular UDVA was 0.02 ± 0.07 logMAR (nontoric) and 0.08 ± 0.11 logMAR (toric) (p = 0.02), while binocular UDVA was −0.05 ± 0.06 logMAR and −0.02 ± 0.10 logMAR, respectively (p = 0.13). Defocus curves showed VA better than 0.1 logMAR from +1.0 to −2.5 D in both groups. No significant differences in contrast sensitivity were observed between groups at any level (p > 0.05). Over 80% of patients in each group reported being satisfied or very satisfied at all distances. Halos were described as not or only slightly bothersome by 42% of patients. A small percentage expressed a low likelihood of choosing the same lens again (4% nontoric, 9% toric). Conclusion Both IOL models provided similar and effective visual restoration from distance to near. Despite some reported visual disturbances, patient satisfaction and visual quality were high and comparable between the toric and nontoric lenses when appropriately aligned.