AIM： To compare a trifocal intraocular lens （IOL） and a bifocal IOL implantation in improving visual function after cataract surgery. METHODS： Eligible literatures were systematically searched through EMBASE and P...AIM： To compare a trifocal intraocular lens （IOL） and a bifocal IOL implantation in improving visual function after cataract surgery. METHODS： Eligible literatures were systematically searched through EMBASE and PubMed databases. The inclusion criteria were prospective comparative clinical trials on cataract surgery comparing trifocal IOL with bifocal IOL implantation that assessed visual acuity, contrast sensitivity and subjective vision quality. The effects were computed as standardized mean differences and pooled using fixed-effect or random-effect models. RESULTS： Four prospective randomized controlled trials （RCTs） and five cohorts provided data were included by a systematic review, comprising 265 eyes implanted with trifocal IOLs and 264 eyes implanted with bifocal IOLs. Monocular distance visual acuity （VA） showed a statistically significant but small difference that favored trifocal IOLs （MD=.0.06; 95%CI, -0.10 to -0.02; Z=2.90, P=0.004 for uncorrected distance VA, and MD- -0.02; 95%CI, -0.03 to .0.00; Z=2.02, P=0.04 for corrected distance VA）, but the data did not suggest that the effect of trifocal IOL implantation would clinically outperform bifocal IOL implantation. There was no significant difference in monocular near VA （MD=.0.01; 95%CI, -0.07 to 0.04; Z=0.42, P=-0.68 for distance-corrected near VA, and MD=-0.01; 95%CI, -0.06 to 0.03; Z=0.55, P=0.58 for corrected near VA） or refraction between two groups. Contrast sensitivity and subjective visual quality had no conclusive results. CONCLUSION： All results indicate that trifocal IOL and bifocal IOL had similar levels of monocular distance and near VA.展开更多
Purpose: To compare the impact of induced astigmatism with four different types of multifocal intraocular lenses (MIOLs). Method: Prospective, comparative, interventional, mono-centered study, including 80 eyes of pat...Purpose: To compare the impact of induced astigmatism with four different types of multifocal intraocular lenses (MIOLs). Method: Prospective, comparative, interventional, mono-centered study, including 80 eyes of patients with implantation of four different MIOLs: AcrySof ReSTOR +2.5 D (20 eyes), AcrySof ReSTOR +3.0 D (20 eyes), AcrySof Panoptix (20 eyes) (Alcon Laboratories, Inc., Fort Worth, TX, USA), and Tecnis Symfony ZRX00 (Abbott Medical Optics, Santa Ana, USA) (20 eyes). Patients were followed up for 3 months after surgery. Major parameters were uncorrected (UDVA) and corrected (CDVA) distance visual acuity, subjective refraction and patient satisfaction. Results: Differences between IOLs with regard to the impact of the cylinder sign and axis on visual acuity and patient satisfaction were not significant. With mild added negative cylinder, AcrySof ReSTOR +2.5 D and Tecnis Symfony IOLs maintained the baseline visual acuity, while it was mildly reduced with AcrySof ReSTOR +3.0 D and Panoptix IOLs. With moderate induced cylinder, the Tecnis Symfony IOL maintained good visual acuity and patient associated satisfaction. Panoptix IOL was the IOL most affected by the induced astigmatism with regard to dissatisfaction and visual acuity. The highest tolerance to the astigmatic distortion and blurriness induced with a -1.50 D cylinder was obtained with the Tecnis Symfony IOL. Tecnis Symfony IOL showed less dissatisfaction and less reduction of visual acuity than the other MIOLs. Conclusion: Simulated residual cylinders after the implantation of the Tecnis Symfony IOL up to 1.0 D have a very mild and not clinically relevant impact on visual acuity or patient satisfaction. The ERV IOL showed a better tolerance to unexpected postoperative residual errors than diffractive bifocal and trifocal IOLs.展开更多
AIM：To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens（IOL）during a 12-month follow-up.METHODS：Prospective comparative study including75 eyes of 38 patients（44-...AIM：To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens（IOL）during a 12-month follow-up.METHODS：Prospective comparative study including75 eyes of 38 patients（44-70y）undergoing uneventful cataract surgery.Each patient was randomly assigned to one type of IOL,bifocal（35 eyes）or trifocal（40 eyes）.Visual,refractive,and contrast sensitivity changes were evaluated in a 12-month follow-up.The binocular defocus curve was also measured at 12mo postoperatively.RESULTS：No statistically significant differences between groups were found in postoperative uncorrected and corrected distance visual acuities（P≥0.276）.Postoperative corrected near visual acuity（33 cm）was significantly better in the trifocal group during all follow-up（P≤0.004）as well as 6-month uncorrected near（P=0.008）and distancecorrected near visual acuities（P=0.016）（33/40 cm）.Significantly better uncorrected intermediate and distance corrected-intermediate visual acuity were found during all follow-up in the trifocal group（P〈0.001）,which was consistent with differences among groups in binocular defocus curve.Differences among groups in contrast sensitivity were minimal,being only significant at 6 months for some low to medium spatial frequencies（P≤0.006）.CONCLUSION：Bifocal and trifocal diffractive IOLs are able to provide an effective visual restoration which is maintained during a 12-month follow-up,with a clear benefit of the trifocal IOL for the intermediate vision.展开更多
●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical tria...●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)展开更多
AIM: To investigate the early outcomes of vision, objective visual quality and their correlation after cataract surgery with trifocal intraocular lens implantation.METHODS: The visual examination and objective visual ...AIM: To investigate the early outcomes of vision, objective visual quality and their correlation after cataract surgery with trifocal intraocular lens implantation.METHODS: The visual examination and objective visual quality analysis using Optical Quality Analysis System(OQAS) at 1 mo and 3 mo, and defocus curve examination at 3 mo were performed in 20 patients(27 eyes) after phacoemulsification combined with trifocal intraocular lens implantation surgery.RESULTS: The uncorrected distant(UD), intermediate and near visual acuity(VA) were significantly improved after surgery(P<0.001). UDVA at 1 mo after the surgery was slightly better than that after 3 mo(P=0.026). The defocus curve after 3 mo indicated that the peak of distant vision was close to 0 logMAR, and UDVA was lower than 0.3 logMAR in the range of-1.5 D to-3.0 D. The modulation transfer function(MTF) cutoff frequency, strehl ratio(SR), Optical Quality Analysis System values(OVs), includes OV100, OV20 and OV9 after the surgery were significantly better than before surgery(P<0.001), but the objective scattering index(OSI) was significantly decreased(P<0.001). UDVA at 3 mo after the surgery had correlations with MTF cutoff, OSI, OV100 and OV20(r=-0.400, 0.431,-0.437,-0.411, P=0.039, 0.025, 0.023, 0.033). The uncorrected intermediate VA after 3 mo of the surgery had correlations with OSI and OV100(r=0.478,-0.411, P=0.012, 0.033). CONCLUSION: Trifocal intraocular lens implantation can provide good distant, intermediate and near VA, and the vision shows a well correlation with objective visual quality during early surgery.展开更多
Purpose: To compare the visual and refractive outcomes, patient satisfaction and spectacle independence between three novel designs of diffractive IOLs. Method: Prospective study including 150 patients with implantati...Purpose: To compare the visual and refractive outcomes, patient satisfaction and spectacle independence between three novel designs of diffractive IOLs. Method: Prospective study including 150 patients with implantation of three IOLs: trifocal diffractive IOL AT LISA tri 839 MP (ATLISA, n = 50), trifocal diffractive IOL PhysIOL FineVision (FineVision, n = 50) and the extended range of vision IOL Tecnis Symfony ZRX00 (Symfony, n = 50). Patients were followed up for 6 months after surgery. Major parameters were monocular and binocular uncorrected (UDVA) and corrected (CDVA) distance, uncorrected (UIVA) and distance corrected (DCIVA) intermediate (80 cm), and uncorrected (UNVA) and distance corrected (DCNVA) near (40 cm) visual acuities (UNVA), contrast sensitivity (CS), defocus curve as well as patient satisfaction and spectacle use. Results: Mean postoperative decimal UDVA was 1.01 for Symfony, 0.96 for ATLISA and 0.95 for the FineVision IOL. Postoperative UIVA was 0.95 with Symfony, 0.72 with ATLISA and 0.85 with the FineVision IOL. Postoperative UNVA was 0.96 with the FineVision, 0.72 with the ATLISA and 0.63 with the Symfony IOL. The Symfony defocus curve showed the smoothest profile. Mean mesopic CS was 0.84 log units with the Symfony, 0.83 with the ATLISA (0.83) and 0.65 with the FineVision IOL. Mean photopic CS with the Symfony, ATLISA and FineVision was 1.05, 0.85 and 0.69 log units, respectively. Twenty percent of the patients with the ATLISA and FineVision IOLs and 5.6% of the Symfony patients reported halos and glare as troublesome or disabling. Reading glasses were frequently used by 5.6% of the Symfony patients. All patients with the trifocal IOLs reported to be spectacle-free for any distance. Conclusion: All 3 IOLs produce excellent results with high levels of spectacle independence. The Symfony produces better levels of distance and intermediate visual acuity, whereas the trifocal IOLs produced better near vision. Higher frequency of dysphotopsia was seen with the trifocal IOLs.展开更多
AIM:To analyze postoperative clinical results after implantation of trifocal intraocular lenses(IOLs)in highly myopic eyes with different axial lengths(ALs).METHODS:This retrospective study describes 61 eyes of 44 pat...AIM:To analyze postoperative clinical results after implantation of trifocal intraocular lenses(IOLs)in highly myopic eyes with different axial lengths(ALs).METHODS:This retrospective study describes 61 eyes of 44 patients that were implanted with trifocal diffractive IOLs(AT LISA tri 839 MP).Twenty-one eyes(15 patients)were included in the AL<26 mm group,19 eyes(13 patients)in the AL≥26 mm and<28 mm group,and 21 eyes(16 patients)in the AL≥28 mm group.Postoperative outcomes,including corrected and uncorrected distance visual acuity(UDVA),intermediate and near visual acuity at 167 cd/m2 luminance,depth of focus at 85 cd/m2 luminance,and objective optical quality parameters assessed using the Optical Quality Analysis System(OQAS),were compared among the groups at 3 mo.RESULTS:There were no significant differences in the mean UDVA,uncorrected intermediate visual acuity,uncorrected near visual acuity,corrected distance visual acuity,distance-corrected intermediate visual acuity,and distance-corrected near visual acuity(DCNVA)among the three groups(P>0.05).Better near and intermediate visual acuity(from-1.5 D to-3.0 D)were noted on the defocus curve of the AL<26 mm group(P<0.01 vs AL≥28 mm group).Significantly higher objective scatter index(OSI)values and lower modulation transfer function(MTF)cut-off values,Strehl ratio(SR),and OQAS values(OVs)were observed in the AL≥28 mm group(P<0.01 vs AL<26 mm group).All OQAS parameters had statistically significant correlations with DCNVA and visual acuity at the vergence of-2.5 D(P<0.05 to P<0.01).CONCLUSION:Implantation of trifocal IOLs provides good short-term visual and refractive outcomes in highly myopic eyes with different ALs.However,the near vision decreases in the extremely myopic eyes at lower luminance,which is associated with the lower objective optical quality in these eyes.展开更多
Background:Independence from all optical aids,and freedom from unwanted symptoms,following cataract and lens surgery remains the ultimate goal of both patient and surgeon.The development of trifocal IOL technology pro...Background:Independence from all optical aids,and freedom from unwanted symptoms,following cataract and lens surgery remains the ultimate goal of both patient and surgeon.The development of trifocal IOL technology provides an ever-increasing range of options.The purpose of our study is to understand the predictability,safety and efficacy of a new trifocal intraocular lens(IOL)following cataract or refractive lens exchange(RLE)surgery.Methods:This was a retrospective consecutive case series of patients undergoing cataract extraction or RLE followed by implantation of the Alcon IQ Panoptix IOL.Pre and postoperative refractive and visual parameters were recorded and evaluated.As the cohort followed a normal distribution,standard parametric tests were used.Paired t-test was used to compare the difference between target and postoperative refractive errors.The incidence of intraoperative and postoperative complications was also reported.Results:The IOL was implanted in 66 eyes of 33 patients.Mean postoperative spherical equivalent(SE)refraction was-0.08±0.25 dioptres(D).This was not significantly different from the target refraction(p=0.841).Sixty-five percent of patients were within±0.25 D of the target SE refraction with 100%within±0.50 D of intended correction.Mean postoperative uncorrected distance visual acuity(UDVA)was 0.01±0.10 LogMAR.All patients achieved an unaided distance acuity of 20/40 or better postoperatively.Binocularly,100%saw 0.20 LogMAR or better at near without correction and 88.9%achieved this level for uncorrected intermediate visual acuity.No intraoperative complications were noted.Five patients complained of moderate haloes in the early postoperative period.Conclusion:The AcrySof IQ Panoptix IOL provides functional uncorrected visual acuity at distance,intermediate and near positions.Our results remain equivalent with existing trifocal IOL outcomes and provide surgeons with a further IOL alternative for the patient motivated to obtain true spectacle independence.Surgeons should consider indi展开更多
Objective: To apply trifocal distraction osteogenesis in canine model of skull segmental defects and to provide reference for clinical treatment. Methods: Six labrador dogs were selected in this study and divided into...Objective: To apply trifocal distraction osteogenesis in canine model of skull segmental defects and to provide reference for clinical treatment. Methods: Six labrador dogs were selected in this study and divided into observation group and control group randomly. Each group contained 3 dogs. Skull segmental defects models were established by surgery, and dogs in bservation group received trifocal distraction osteogenesis treatment. Bone density was observed and compared between two groups during treatment. Results: There were no significant difference in bone density between two groups on th 1st day ( P>0.05). The bone density of observation group on the 30th day, and 60th day were higher than that of control group ( P<0.01). Conclusions: Trifocal distraction osteogenesis has significant clinical effect, and it would be widely used in clinical treatment.展开更多
·AIM:To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens(IOL)and asymmetric refractive multifocal IOL.·METHODS:The prospective nonrandom,comparative stu...·AIM:To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens(IOL)and asymmetric refractive multifocal IOL.·METHODS:The prospective nonrandom,comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs:AT LISA tri 839 MP(30 eyes;Carl Zeiss Meditec,Germany)and LS-313 MF30(30 eyes;Oculentis GmbH,Germany).Visual acuity,refractive outcome,contrast sensitivity,defocus curves,quality of vision,and optical phenomena were evaluated at3 mo postoperatively.·RESULTS:There were no statistical differences between groups in uncorrected distance visual acuity(P=0.13)and uncorrected near visual acuity(P=0.54).In contrast,uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group(P=0.02).No significant statistical between-group difference was detected in cylinder(P=0.43).Compared to trifocal group,spherical refraction and spherical equivalent in refractive multi focal group were more myopic(P<0.01).Under photopic conditions,no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree(cpd).The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group(P=0.01,P=0.034,respectively).The questionnaires of quality of vision and optical phenomena showed no differences between groups.·CONCLUSION:Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity.Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.展开更多
Dear Editor,I am Dr.Ye Shen from the Department of Ophthalmology,the First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou,China.I write to share my experience of full-vision maintenance in patien...Dear Editor,I am Dr.Ye Shen from the Department of Ophthalmology,the First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou,China.I write to share my experience of full-vision maintenance in patient with extrahigh myopia from implantable collamer lens （ICL） to trifocal intraocular lens （IOL） implantation.展开更多
基金Supported by National Natural Science Foundation of China(No.81741058No.81460163+10 种基金No.81400427No.81300786)Fundamental Research Funds for the Central Universities(No.xjj2015015)Research Grants from Shaanxi Provincial Department of Science and Technology(No.2016KJXX-12No.2016JM8029)Specialized Research Fund for the Doctoral Program of Higher Education(No.20133601120012)Research Grants from Jiangxi Provincial Department of Science and Technology(No.20142BAB215029No.20132BAB205024No.20142BDH80005)Research Grants from Education Department of Jiangxi Province(No.GJJ14094No.GJJ13175)
文摘AIM： To compare a trifocal intraocular lens （IOL） and a bifocal IOL implantation in improving visual function after cataract surgery. METHODS： Eligible literatures were systematically searched through EMBASE and PubMed databases. The inclusion criteria were prospective comparative clinical trials on cataract surgery comparing trifocal IOL with bifocal IOL implantation that assessed visual acuity, contrast sensitivity and subjective vision quality. The effects were computed as standardized mean differences and pooled using fixed-effect or random-effect models. RESULTS： Four prospective randomized controlled trials （RCTs） and five cohorts provided data were included by a systematic review, comprising 265 eyes implanted with trifocal IOLs and 264 eyes implanted with bifocal IOLs. Monocular distance visual acuity （VA） showed a statistically significant but small difference that favored trifocal IOLs （MD=.0.06; 95%CI, -0.10 to -0.02; Z=2.90, P=0.004 for uncorrected distance VA, and MD- -0.02; 95%CI, -0.03 to .0.00; Z=2.02, P=0.04 for corrected distance VA）, but the data did not suggest that the effect of trifocal IOL implantation would clinically outperform bifocal IOL implantation. There was no significant difference in monocular near VA （MD=.0.01; 95%CI, -0.07 to 0.04; Z=0.42, P=-0.68 for distance-corrected near VA, and MD=-0.01; 95%CI, -0.06 to 0.03; Z=0.55, P=0.58 for corrected near VA） or refraction between two groups. Contrast sensitivity and subjective visual quality had no conclusive results. CONCLUSION： All results indicate that trifocal IOL and bifocal IOL had similar levels of monocular distance and near VA.
文摘Purpose: To compare the impact of induced astigmatism with four different types of multifocal intraocular lenses (MIOLs). Method: Prospective, comparative, interventional, mono-centered study, including 80 eyes of patients with implantation of four different MIOLs: AcrySof ReSTOR +2.5 D (20 eyes), AcrySof ReSTOR +3.0 D (20 eyes), AcrySof Panoptix (20 eyes) (Alcon Laboratories, Inc., Fort Worth, TX, USA), and Tecnis Symfony ZRX00 (Abbott Medical Optics, Santa Ana, USA) (20 eyes). Patients were followed up for 3 months after surgery. Major parameters were uncorrected (UDVA) and corrected (CDVA) distance visual acuity, subjective refraction and patient satisfaction. Results: Differences between IOLs with regard to the impact of the cylinder sign and axis on visual acuity and patient satisfaction were not significant. With mild added negative cylinder, AcrySof ReSTOR +2.5 D and Tecnis Symfony IOLs maintained the baseline visual acuity, while it was mildly reduced with AcrySof ReSTOR +3.0 D and Panoptix IOLs. With moderate induced cylinder, the Tecnis Symfony IOL maintained good visual acuity and patient associated satisfaction. Panoptix IOL was the IOL most affected by the induced astigmatism with regard to dissatisfaction and visual acuity. The highest tolerance to the astigmatic distortion and blurriness induced with a -1.50 D cylinder was obtained with the Tecnis Symfony IOL. Tecnis Symfony IOL showed less dissatisfaction and less reduction of visual acuity than the other MIOLs. Conclusion: Simulated residual cylinders after the implantation of the Tecnis Symfony IOL up to 1.0 D have a very mild and not clinically relevant impact on visual acuity or patient satisfaction. The ERV IOL showed a better tolerance to unexpected postoperative residual errors than diffractive bifocal and trifocal IOLs.
文摘AIM：To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens（IOL）during a 12-month follow-up.METHODS：Prospective comparative study including75 eyes of 38 patients（44-70y）undergoing uneventful cataract surgery.Each patient was randomly assigned to one type of IOL,bifocal（35 eyes）or trifocal（40 eyes）.Visual,refractive,and contrast sensitivity changes were evaluated in a 12-month follow-up.The binocular defocus curve was also measured at 12mo postoperatively.RESULTS：No statistically significant differences between groups were found in postoperative uncorrected and corrected distance visual acuities（P≥0.276）.Postoperative corrected near visual acuity（33 cm）was significantly better in the trifocal group during all follow-up（P≤0.004）as well as 6-month uncorrected near（P=0.008）and distancecorrected near visual acuities（P=0.016）（33/40 cm）.Significantly better uncorrected intermediate and distance corrected-intermediate visual acuity were found during all follow-up in the trifocal group（P〈0.001）,which was consistent with differences among groups in binocular defocus curve.Differences among groups in contrast sensitivity were minimal,being only significant at 6 months for some low to medium spatial frequencies（P≤0.006）.CONCLUSION：Bifocal and trifocal diffractive IOLs are able to provide an effective visual restoration which is maintained during a 12-month follow-up,with a clear benefit of the trifocal IOL for the intermediate vision.
文摘●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)
基金Supported by Key Research and Development Project of Shaanxi Province (No.2017SF-246)Science and Technology Planning Project of Xi’an City (No.2017116SF/ YX010)
文摘AIM: To investigate the early outcomes of vision, objective visual quality and their correlation after cataract surgery with trifocal intraocular lens implantation.METHODS: The visual examination and objective visual quality analysis using Optical Quality Analysis System(OQAS) at 1 mo and 3 mo, and defocus curve examination at 3 mo were performed in 20 patients(27 eyes) after phacoemulsification combined with trifocal intraocular lens implantation surgery.RESULTS: The uncorrected distant(UD), intermediate and near visual acuity(VA) were significantly improved after surgery(P<0.001). UDVA at 1 mo after the surgery was slightly better than that after 3 mo(P=0.026). The defocus curve after 3 mo indicated that the peak of distant vision was close to 0 logMAR, and UDVA was lower than 0.3 logMAR in the range of-1.5 D to-3.0 D. The modulation transfer function(MTF) cutoff frequency, strehl ratio(SR), Optical Quality Analysis System values(OVs), includes OV100, OV20 and OV9 after the surgery were significantly better than before surgery(P<0.001), but the objective scattering index(OSI) was significantly decreased(P<0.001). UDVA at 3 mo after the surgery had correlations with MTF cutoff, OSI, OV100 and OV20(r=-0.400, 0.431,-0.437,-0.411, P=0.039, 0.025, 0.023, 0.033). The uncorrected intermediate VA after 3 mo of the surgery had correlations with OSI and OV100(r=0.478,-0.411, P=0.012, 0.033). CONCLUSION: Trifocal intraocular lens implantation can provide good distant, intermediate and near VA, and the vision shows a well correlation with objective visual quality during early surgery.
文摘Purpose: To compare the visual and refractive outcomes, patient satisfaction and spectacle independence between three novel designs of diffractive IOLs. Method: Prospective study including 150 patients with implantation of three IOLs: trifocal diffractive IOL AT LISA tri 839 MP (ATLISA, n = 50), trifocal diffractive IOL PhysIOL FineVision (FineVision, n = 50) and the extended range of vision IOL Tecnis Symfony ZRX00 (Symfony, n = 50). Patients were followed up for 6 months after surgery. Major parameters were monocular and binocular uncorrected (UDVA) and corrected (CDVA) distance, uncorrected (UIVA) and distance corrected (DCIVA) intermediate (80 cm), and uncorrected (UNVA) and distance corrected (DCNVA) near (40 cm) visual acuities (UNVA), contrast sensitivity (CS), defocus curve as well as patient satisfaction and spectacle use. Results: Mean postoperative decimal UDVA was 1.01 for Symfony, 0.96 for ATLISA and 0.95 for the FineVision IOL. Postoperative UIVA was 0.95 with Symfony, 0.72 with ATLISA and 0.85 with the FineVision IOL. Postoperative UNVA was 0.96 with the FineVision, 0.72 with the ATLISA and 0.63 with the Symfony IOL. The Symfony defocus curve showed the smoothest profile. Mean mesopic CS was 0.84 log units with the Symfony, 0.83 with the ATLISA (0.83) and 0.65 with the FineVision IOL. Mean photopic CS with the Symfony, ATLISA and FineVision was 1.05, 0.85 and 0.69 log units, respectively. Twenty percent of the patients with the ATLISA and FineVision IOLs and 5.6% of the Symfony patients reported halos and glare as troublesome or disabling. Reading glasses were frequently used by 5.6% of the Symfony patients. All patients with the trifocal IOLs reported to be spectacle-free for any distance. Conclusion: All 3 IOLs produce excellent results with high levels of spectacle independence. The Symfony produces better levels of distance and intermediate visual acuity, whereas the trifocal IOLs produced better near vision. Higher frequency of dysphotopsia was seen with the trifocal IOLs.
文摘AIM:To analyze postoperative clinical results after implantation of trifocal intraocular lenses(IOLs)in highly myopic eyes with different axial lengths(ALs).METHODS:This retrospective study describes 61 eyes of 44 patients that were implanted with trifocal diffractive IOLs(AT LISA tri 839 MP).Twenty-one eyes(15 patients)were included in the AL<26 mm group,19 eyes(13 patients)in the AL≥26 mm and<28 mm group,and 21 eyes(16 patients)in the AL≥28 mm group.Postoperative outcomes,including corrected and uncorrected distance visual acuity(UDVA),intermediate and near visual acuity at 167 cd/m2 luminance,depth of focus at 85 cd/m2 luminance,and objective optical quality parameters assessed using the Optical Quality Analysis System(OQAS),were compared among the groups at 3 mo.RESULTS:There were no significant differences in the mean UDVA,uncorrected intermediate visual acuity,uncorrected near visual acuity,corrected distance visual acuity,distance-corrected intermediate visual acuity,and distance-corrected near visual acuity(DCNVA)among the three groups(P>0.05).Better near and intermediate visual acuity(from-1.5 D to-3.0 D)were noted on the defocus curve of the AL<26 mm group(P<0.01 vs AL≥28 mm group).Significantly higher objective scatter index(OSI)values and lower modulation transfer function(MTF)cut-off values,Strehl ratio(SR),and OQAS values(OVs)were observed in the AL≥28 mm group(P<0.01 vs AL<26 mm group).All OQAS parameters had statistically significant correlations with DCNVA and visual acuity at the vergence of-2.5 D(P<0.05 to P<0.01).CONCLUSION:Implantation of trifocal IOLs provides good short-term visual and refractive outcomes in highly myopic eyes with different ALs.However,the near vision decreases in the extremely myopic eyes at lower luminance,which is associated with the lower objective optical quality in these eyes.
文摘Background:Independence from all optical aids,and freedom from unwanted symptoms,following cataract and lens surgery remains the ultimate goal of both patient and surgeon.The development of trifocal IOL technology provides an ever-increasing range of options.The purpose of our study is to understand the predictability,safety and efficacy of a new trifocal intraocular lens(IOL)following cataract or refractive lens exchange(RLE)surgery.Methods:This was a retrospective consecutive case series of patients undergoing cataract extraction or RLE followed by implantation of the Alcon IQ Panoptix IOL.Pre and postoperative refractive and visual parameters were recorded and evaluated.As the cohort followed a normal distribution,standard parametric tests were used.Paired t-test was used to compare the difference between target and postoperative refractive errors.The incidence of intraoperative and postoperative complications was also reported.Results:The IOL was implanted in 66 eyes of 33 patients.Mean postoperative spherical equivalent(SE)refraction was-0.08±0.25 dioptres(D).This was not significantly different from the target refraction(p=0.841).Sixty-five percent of patients were within±0.25 D of the target SE refraction with 100%within±0.50 D of intended correction.Mean postoperative uncorrected distance visual acuity(UDVA)was 0.01±0.10 LogMAR.All patients achieved an unaided distance acuity of 20/40 or better postoperatively.Binocularly,100%saw 0.20 LogMAR or better at near without correction and 88.9%achieved this level for uncorrected intermediate visual acuity.No intraoperative complications were noted.Five patients complained of moderate haloes in the early postoperative period.Conclusion:The AcrySof IQ Panoptix IOL provides functional uncorrected visual acuity at distance,intermediate and near positions.Our results remain equivalent with existing trifocal IOL outcomes and provide surgeons with a further IOL alternative for the patient motivated to obtain true spectacle independence.Surgeons should consider indi
基金supported by Shanghai Municipal Science and Technology Commission, International Cooperation Projects (No. 10410702100)
文摘Objective: To apply trifocal distraction osteogenesis in canine model of skull segmental defects and to provide reference for clinical treatment. Methods: Six labrador dogs were selected in this study and divided into observation group and control group randomly. Each group contained 3 dogs. Skull segmental defects models were established by surgery, and dogs in bservation group received trifocal distraction osteogenesis treatment. Bone density was observed and compared between two groups during treatment. Results: There were no significant difference in bone density between two groups on th 1st day ( P>0.05). The bone density of observation group on the 30th day, and 60th day were higher than that of control group ( P<0.01). Conclusions: Trifocal distraction osteogenesis has significant clinical effect, and it would be widely used in clinical treatment.
基金Supported by Key Research and Development Projects of Shaanxi Province(No.2017SF-246)Science and Technology Planning Project of Xi’an(No.2017116SF/YX010No.201805097YX5SF31)。
文摘·AIM:To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens(IOL)and asymmetric refractive multifocal IOL.·METHODS:The prospective nonrandom,comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs:AT LISA tri 839 MP(30 eyes;Carl Zeiss Meditec,Germany)and LS-313 MF30(30 eyes;Oculentis GmbH,Germany).Visual acuity,refractive outcome,contrast sensitivity,defocus curves,quality of vision,and optical phenomena were evaluated at3 mo postoperatively.·RESULTS:There were no statistical differences between groups in uncorrected distance visual acuity(P=0.13)and uncorrected near visual acuity(P=0.54).In contrast,uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group(P=0.02).No significant statistical between-group difference was detected in cylinder(P=0.43).Compared to trifocal group,spherical refraction and spherical equivalent in refractive multi focal group were more myopic(P<0.01).Under photopic conditions,no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree(cpd).The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group(P=0.01,P=0.034,respectively).The questionnaires of quality of vision and optical phenomena showed no differences between groups.·CONCLUSION:Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity.Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.
基金Supported partly by the General Natural Science Projects,Department of Education,Zhejiang Province,China(No.Y201636718)
文摘Dear Editor,I am Dr.Ye Shen from the Department of Ophthalmology,the First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou,China.I write to share my experience of full-vision maintenance in patient with extrahigh myopia from implantable collamer lens （ICL） to trifocal intraocular lens （IOL） implantation.
