Journal of Clinical Medicine

Editorial

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3 pages, 186 KiB

Open AccessEditorial

Presbyopia: What We Do Know and What We Do Not Know in 2022

by Andrzej Grzybowski and Maciej Gawęcki

J. Clin. Med. 2023, 12(3), 794; https://doi.org/10.3390/jcm12030794 - 19 Jan 2023

Cited by 1 | Viewed by 1170

Abstract

The subject of presbyopia has accompanied clinical ophthalmic practices around the world for centuries [...] Full article

(This article belongs to the Special Issue Hot Topics in PRESBYOPIA 2021)

Research

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10 pages, 1001 KiB

Open AccessArticle

Analysis of Korean Retinal Specialists’ Opinions on Implanting Diffractive Multifocal Intraocular Lenses in Eyes with Underlying Retinal Diseases

by Jung-Hwa Lee, Mingui Kong, Joon-Hong Sohn, Beom-Jin Cho, Kee-Yong Choi and Sang-Mok Lee

J. Clin. Med. 2022, 11(7), 1836; https://doi.org/10.3390/jcm11071836 - 26 Mar 2022

Cited by 7 | Viewed by 2534

Abstract

Multifocal intraocular lenses (MF-IOLs) are increasingly implanted as the need for good near- and intermediate-distance vision increases. Although retinal disease is known to be a relative contraindication for MF-IOL implantation, there are no detailed guidelines for MF-IOL implantation with respect to the type [...] Read more.

Multifocal intraocular lenses (MF-IOLs) are increasingly implanted as the need for good near- and intermediate-distance vision increases. Although retinal disease is known to be a relative contraindication for MF-IOL implantation, there are no detailed guidelines for MF-IOL implantation with respect to the type and severity of retinal diseases/statuses. In this study, because retinal diseases can affect the performance of MF-IOLs, we analyzed the opinions of 111 retinal specialists, who were members of the Korean Retina Society, on the implantation of diffractive MF-IOLs in eyes with 15 retinal diseases/statuses using a web-based survey. For each underlying condition, retinal specialists were asked to rate their approval regarding implantation of MF-IOLs on a scale from 1 (completely disapprove) to 7 (completely approve), under the assumption that there were no known contraindications except for a given retinal disease/status. As a result, retinal specialists disapproved MF-IOL implantation (median value of Likert score < 4) in the eyes with wet age-related macular degeneration, dry age-related macular degeneration with geographic atrophy, proliferative diabetic retinopathy, nonproliferative diabetic retinopathy with macular edema, previous macula-off retinal detachment, previous retinal vein occlusion, and epiretinal membrane, but the scores varied by disease/status. The factors that affected the specialists’ opinions were the type of practice and the frequency of MF-IOL implantation (p = 0.013 and p = 0.021, respectively; one-way ANOVA). Full article

(This article belongs to the Special Issue Hot Topics in PRESBYOPIA 2021)

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9 pages, 2151 KiB

Open AccessArticle

Polychromatic Assessment of a Refractive Segmented EDOF Intraocular Lens

by Scott García, Luís Salvá, Salvador García-Delpech, Anabel Martínez-Espert, Vicente Ferrando and Diego Montagud-Martínez

J. Clin. Med. 2022, 11(6), 1480; https://doi.org/10.3390/jcm11061480 - 08 Mar 2022

Cited by 6 | Viewed by 1903

Abstract

This study aimed to evaluate in vitro performance refractive segmented EDOF intraocular lenses under polychromatic light using an optical bench that complies with the ISO 11979-2 Norm. The through focus modulation transfer function (TF-MTF) of the Femtis Comfort LS-313 MF15 (Oculentis GmbH, Berlin, [...] Read more.

This study aimed to evaluate in vitro performance refractive segmented EDOF intraocular lenses under polychromatic light using an optical bench that complies with the ISO 11979-2 Norm. The through focus modulation transfer function (TF-MTF) of the Femtis Comfort LS-313 MF15 (Oculentis GmbH, Berlin, Germany) IOL was evaluated for IOLs with three different base powers. The effect of the asymmetry of the segmented designs was evaluated with 3 different wavelengths and with polychromatic light at a 3.0 mm and 5.0 mm pupil diameter. It was demonstrated that the TF-MTF curves exhibit a bifocal profile that, in practice, results in an EDOF design. As a consequence of the LCA, the TF-MTF values in white light were lower than in monochromatic light. Images of the USAF test chart were obtained to confirm the prediction of the TF-MTFs. We found that Femtis Comfort is a bifocal low-addition IOL and this fact can result in an EDOF effect which was obtained previously in clinical trials. Moreover, we showed that the base power influences the IOL optical quality, which results as more effective for high powers (hyperopic eyes) than for low powers (myopic eyes). The LCA of the segmented refractive design was very low and presumably not clinically relevant. Full article

(This article belongs to the Special Issue Hot Topics in PRESBYOPIA 2021)

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10 pages, 1600 KiB

Open AccessArticle

In Vitro Chromatic Performance of Three Presbyopia-Correcting Intraocular Lenses with Different Optical Designs

by Diego Montagud-Martínez, Vicente Ferrando, Anabel Martínez-Espert, Salvador Garcia-Delpech, Juan A. Monsoriu and Walter D. Furlan

J. Clin. Med. 2022, 11(5), 1212; https://doi.org/10.3390/jcm11051212 - 24 Feb 2022

Cited by 10 | Viewed by 1889

Abstract

Most of the new premium models of intraocular lenses for presbyopia correction use diffractive optics in their optical design. The presence of multiple foci and the difference of the diffractive efficiency for different wavelengths have a great impact in the lens optical performance. [...] Read more.

Most of the new premium models of intraocular lenses for presbyopia correction use diffractive optics in their optical design. The presence of multiple foci and the difference of the diffractive efficiency for different wavelengths have a great impact in the lens optical performance. In this context, there is a limited information available for clinicians to understand the optical principles that differentiate each design and their potential influence on clinical outcomes. Optical bench studies with polychromatic light are necessary to solve this limitation. In this work, a custom made optical bench was employed to assess with polychromatic light the through the focus optical quality of three different IOL designs: trifocal, EDOF effect; and enhanced monofocal. By using different and complimentary approaches: images of the USAF test, axial PSFs and TF-MTFs, each design revealed its intrinsic features, which were not previously reported for these IOLs models in a comparative way. It was found that the chromatic aberration plays a very important role in the performance of each IOL. Our results could help clinicians to understand the optical principle of each lens and also provide useful information for choosing the lens that best suits the needs of the individual patient. Full article

(This article belongs to the Special Issue Hot Topics in PRESBYOPIA 2021)

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14 pages, 1079 KiB

Open AccessArticle

The Influence of Angle Alpha, Angle Kappa, and Optical Aberrations on Visual Outcomes after the Implantation of a High-Addition Trifocal IOL

by Guadalupe Cervantes-Coste, André Tapia, Claudia Corredor-Ortega, Mariana Osorio, Rafael Valdez, Martha Massaro, Cecilio Velasco-Barona and Roberto Gonzalez-Salinas

J. Clin. Med. 2022, 11(3), 896; https://doi.org/10.3390/jcm11030896 - 08 Feb 2022

Cited by 17 | Viewed by 3707

Abstract

The aim of our investigation was to examine the possible correlations between optical aberrations, angle kappa, angle alpha, and visual outcomes following cataract surgery. In total, 56 eyes of 28 patients were implanted with the Liberty 677MY trifocal intraocular lens (IOL). Pre- and [...] Read more.

The aim of our investigation was to examine the possible correlations between optical aberrations, angle kappa, angle alpha, and visual outcomes following cataract surgery. In total, 56 eyes of 28 patients were implanted with the Liberty 677MY trifocal intraocular lens (IOL). Pre- and postoperative higher-order aberrations, coma, astigmatism, angle alpha, and angle kappa were registered, along with uncorrected and corrected visual acuities at multiple distances. Visual acuity and contrast sensitivity defocus curves were plotted, and the areas under the curve were calculated 1 and 3 months postoperatively. Excellent visual outcomes were found at all distances. Patients reported low levels of dysphotopsia, and 96.4% of patients achieved complete spectacle independence. While angle kappa significantly decreased during cataract surgery (p = 0.0007), angle alpha remained unchanged (p = 0.5158). Angle alpha correlated with postoperative HOAs and had a negative impact on near vision (p = 0.0543). Preoperative corneal HOA and coma had a strong adverse effect on future intermediate and near vision. Residual astigmatism significantly affected postoperative intermediate vision (p = 0.0091). Our results suggest that angle kappa is not an optimal predictive factor for future visual outcomes, while angle alpha and the preoperative screening of optical aberrations might help patient selection prior to multifocal IOL implantation. Full article

(This article belongs to the Special Issue Hot Topics in PRESBYOPIA 2021)

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15 pages, 1998 KiB

Open AccessArticle

Comparison of Clinical Outcomes, Visual Quality and Visual Function of Two Presbyopia-Correcting Intraocular Lenses Made from the Same Material, but with Different Design and Optics

by Ladislav Viktor Nováček, Marie Němcová, Kateřina Tyx, Kristýna Lahodová, Leoš Rejmont, Pavel Rozsíval and Pavel Studený

J. Clin. Med. 2021, 10(15), 3268; https://doi.org/10.3390/jcm10153268 - 24 Jul 2021

Cited by 5 | Viewed by 2495

Abstract

This semi-prospective, parallel, comparative investigation evaluated the clinical outcomes and quality of vision (contrast sensitivity, visual function, dysphotopsia, spectacle use, overall satisfaction) after mono- or bilateral implantation of two presbyopia-correcting intraocular lenses (IOL)—the Liberty^® 677MY or the AT LISA^® tri 839M—in [...] Read more.

This semi-prospective, parallel, comparative investigation evaluated the clinical outcomes and quality of vision (contrast sensitivity, visual function, dysphotopsia, spectacle use, overall satisfaction) after mono- or bilateral implantation of two presbyopia-correcting intraocular lenses (IOL)—the Liberty^® 677MY or the AT LISA^® tri 839M—in 50 eyes of 25 cataract patients. Clinical outcomes were assessed 3 and 12 months postoperatively. Eighty-nine percent of eyes implanted with the Liberty IOL and 59% of eyes implanted with the AT LISA IOL achieved a refractive outcome ±0.5 diopters of the target (emmetropia). Refractive outcomes were stable with both lenses. The proportions of eyes with 20/20 uncorrected distance visual acuity (UDVA) and 20/20 uncorrected near visual acuity (UNVA) were higher in the Liberty group than in the AT LISA group (UDVA: 56% vs. 41%; UNVA: 83% vs. 66%). Optical quality assessment results were comparable for the two IOLs. Superior photopic contrast sensitivity was found with the Liberty lens. The rate of Nd:YAG capsulotomy at the 12-month follow-up was 16.7% in the Liberty group and 40.6% for the AT LISA IOL. Considering that both lenses are made from the same material, we propose that the noted differences in clinical outcomes may derive from differences in design and optical surface between the two IOLs. Full article

(This article belongs to the Special Issue Hot Topics in PRESBYOPIA 2021)

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Review

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13 pages, 607 KiB

Open AccessReview

Pharmacological Treatment in Presbyopia

by Andrzej Grzybowski and Varis Ruamviboonsuk

J. Clin. Med. 2022, 11(5), 1385; https://doi.org/10.3390/jcm11051385 - 03 Mar 2022

Cited by 12 | Viewed by 9485

Abstract

Pharmacological treatment of presbyopia may be an alternative for those who want a spectacle-free scenario and an easy-to-use method with lower risk of irreversible ocular adverse events. There are two main agents, miotics and lens softeners, investigated as agents for the pharmacological treatment. [...] Read more.

Pharmacological treatment of presbyopia may be an alternative for those who want a spectacle-free scenario and an easy-to-use method with lower risk of irreversible ocular adverse events. There are two main agents, miotics and lens softeners, investigated as agents for the pharmacological treatment. Miotic agents treat presbyopia by creating a pinhole effect which may increase the depth of focus at all working distances. The miotic agents have been studied for application to only one eye for monovision or both eyes. Their effect is temporary with common adverse events, such as headache and dim vision at nighttime, with no known long-term safety and efficacy. There have been studies on the miotic agents in combination with other agents for additive treatment effects or lessening adverse events, however, these combination effects are not clear. Lens softeners increase the elasticity of the lens, which is targeted at one of the etiologic mechanisms of presbyopia. There is only one lens softener being investigated in only a few trials. The results were inconclusive. The recent approval of 1.25% pilocarpine for treatment of presbyopia by the US FDA may be an important milestone for investigation of real-world data of pharmacological treatment of presbyopia. Full article

(This article belongs to the Special Issue Hot Topics in PRESBYOPIA 2021)

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14 pages, 785 KiB

Open AccessReview

Ocular Surface Changes Associated with Ophthalmic Surgery

by Lina Mikalauskiene, Andrzej Grzybowski and Reda Zemaitiene

J. Clin. Med. 2021, 10(8), 1642; https://doi.org/10.3390/jcm10081642 - 12 Apr 2021

Cited by 18 | Viewed by 2650

Abstract

Dry eye disease causes ocular discomfort and visual disturbances. Older adults are at a higher risk of developing dry eye disease as well as needing for ophthalmic surgery. Anterior segment surgery may induce or worsen existing dry eye symptoms usually for a short-term [...] Read more.

Dry eye disease causes ocular discomfort and visual disturbances. Older adults are at a higher risk of developing dry eye disease as well as needing for ophthalmic surgery. Anterior segment surgery may induce or worsen existing dry eye symptoms usually for a short-term period. Despite good visual outcomes, ocular surface dysfunction can significantly affect quality of life and, therefore, lower a patient’s satisfaction with ophthalmic surgery. Preoperative dry eye disease, factors during surgery and postoperative treatment may all contribute to ocular surface dysfunction and its severity. We reviewed relevant articles from 2010 through to 2021 using keywords “cataract surgery”, ”phacoemulsification”, ”refractive surgery”, ”trabeculectomy”, ”vitrectomy” in combination with ”ocular surface dysfunction”, “dry eye disease”, and analyzed studies on dry eye disease pathophysiology and the impact of anterior segment surgery on the ocular surface. Full article

(This article belongs to the Special Issue Hot Topics in PRESBYOPIA 2021)

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