Dataset Information

Clinical Outcomes of a Non-Diffractive Extended Depth-of-Focus IOL in Eyes with Mild Glaucoma.

ABSTRACT:

Purpose

To evaluate the clinical outcomes of a non-diffractive, wavefront-shaping extended depth-of-focus (EDOF) intraocular lens (IOL) in eyes with mild open-angle glaucoma (OAG).

Setting

Private practice; Sioux Falls, South Dakota.

Design

Prospective, open-label, interventional study.

Methods

In total, 52 eyes of 26 patients with mild OAG were enrolled and completed the study. All patients were bilaterally implanted with a non-diffractive, wavefront-shaping EDOF IOL. Seventy-seven percent of the patients were implanted with a trabecular microbypass stent at the time of surgery. Primary outcome measures included binocular corrected and uncorrected distance visual acuity (CDVA and UDVA), uncorrected intermediate and near visual acuity (UIVA and UNVA) and contrast sensitivity as measured by a Pelli-Robson chart. A subjective questionnaire was also administered to patients.

Results

At 4 months postoperative, the mean binocular UDVA and CDVA was 0.03 ± 0.12 and -0.06 ± 0.07, respectively. The mean UIVA and UNVA were 0.18 ± 0.12 and 0.31 ± 0.18, respectively. Eighty-five percent of the subjects achieved ≥20/25 UDVA and 77% of the subjects achieved ≥20/32 UIVA at 4 months postoperative. The mean binocular mesopic contrast sensitivity was 1.76 ± 0.16 at a spatial frequency of 1 cycle-per-degree (cpd). Eighty-five percent of the subjects reported they would choose the same lens and 1 subject reported they would choose a different IOL if it meant reduced spectacle independence.

Conclusion

The non-diffractive, wavefront-shaping EDOF IOL can be safely implanted in eyes with mild, pre-perimetric open-angle glaucoma with favorable uncorrected distance and intermediate visual acuity. The contrast sensitivity measurements were favorable and the subjective questionnaire revealed satisfactory spectacle independence and patient satisfaction.

SUBMITTER: Ferguson TJ

PROVIDER: S-EPMC10024873 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Clinical Outcomes of a Non-Diffractive Extended Depth-of-Focus IOL in Eyes with Mild Glaucoma.

Ferguson Tanner J TJ Wilson Caroline W CW Shafer Brian M BM Berdahl John P JP Terveen Daniel C DC

Clinical ophthalmology (Auckland, N.Z.) 20230315

<h4>Purpose</h4>To evaluate the clinical outcomes of a non-diffractive, wavefront-shaping extended depth-of-focus (EDOF) intraocular lens (IOL) in eyes with mild open-angle glaucoma (OAG).<h4>Setting</h4>Private practice; Sioux Falls, South Dakota.<h4>Design</h4>Prospective, open-label, interventional study.<h4>Methods</h4>In total, 52 eyes of 26 patients with mild OAG were enrolled and completed the study. All patients were bilaterally implanted with a non-diffractive, wavefront-shaping EDOF IO ...[more]

PMID: 36945324

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Project description:IntroductionPatients implanted with a range-of-vision intraocular lens (IOL) (multifocal or extended depth of focus, EDOF) may be more susceptible to visual disturbances from poor tear film quality, and prophylactic treatment of meibomian gland dysfunction (MGD) has been recommended. The purpose was to evaluate whether vectored thermal pulsation (LipiFlow™) treatment prior to cataract surgery with a range-of-vision IOL safely improves postoperative outcomes.MethodsThis is a prospective, randomized, open-label, crossover, multicenter study of patients with mild-to-moderate MGD and cataract. The test group underwent LipiFlow treatment prior to cataract surgery and implantation of an EDOF IOL, while the control group did not. Both groups were evaluated 3 months postoperatively, after which the control group received LipiFlow treatment (crossover). The control group was re-evaluated 4 months postoperatively.ResultsA total of 121 subjects were randomized, with 117 eyes in the test group and 115 eyes in the control group. At 3 months after surgery, the test group had a significantly greater improvement from baseline in total meibomian gland score compared with the control group (P = 0.046). At 1 month after surgery, the test group had a significant decrease in corneal (P = 0.04) and conjunctival (P = 0.002) staining compared to the control group. At 3 months after surgery, the test group had significantly lower incidence of being bothered by halos compared with the control group (P = 0.019). The control group had a significantly lower incidence of being bothered by multiple or double vision compared with the test group (P = 0.016). After crossover, patients had significant improvement in vision (P = 0.03) and total meibomian gland score (P < 0.0001). No safety concerns or relevant safety findings were uncovered.ConclusionPresurgical LipiFlow treatment of patients implanted with range-of-vision IOLs improved meibomian gland function and postoperative ocular surface health. This supports guidelines recommending proactive diagnosis and management of MGD in patients with cataracts to improve patient experience.Trial registrationThe study was registered on www.Clinicaltrialsgov (NCT03708367).

Project description:PurposeMini-monovision is a vision correction technique that allows for a broader spectrum of spectacle independence while minimizing anisometropia. This systemic review aims to evaluate the clinical outcomes of pseudophakic mini-monovision with three types of intraocular lenses (IOLs): monofocal, enhanced monofocal, and extended depth of focus (EDOF).MethodsA comprehensive literature search was conducted using PubMed and MEDLINE to identify studies reporting mini-monovision outcomes within the three categories of IOLs up to July 2024. Inclusion criteria were studies with more than 20 patients, target refraction to achieve mini-monovision difference in the fellow eye, and minimum follow-up of 3 months. The primary outcome measure was uncorrected binocular intermediate visual acuity (UCIVA). The secondary outcomes were binocular uncorrected distance visual acuity (UCDVA), binocular uncorrected near visual acuity (UCNVA), patient-reported outcomes measures (PROMs), spectacle independence, contrast sensitivity, photic phenomenon, enhancement surgeries and IOL exchange.ResultsA total of 113 studies were screened, of which 19, with a total of 1,530 patients, were eligible for inclusion in this review. Mean logMAR binocular UCIVA was 0.16 ± 0.01, 0.11 ± 0.06, 0.08 ± 0.07 (p = 0.41), and mean logMAR UCDVA was 0.08 ± 0.05, 0.04 ± 07, 0.04 ± 0.04 (p = 0.36), in the monofocal, enhanced monofocal, and EDOF groups, respectively. The mean spectacle independence rate was 51% ± 22.1, 55% ± 35.4 and 63.4% ± 24.6 (p = 0.05), respectively, in the monofocal, enhanced monofocal and EDOF groups. A comparable low incidence of halos and glare was observed when enhanced monofocal lenses were evaluated against traditional monofocal lenses. EDOF lenses have, however, demonstrated mixed results. The complications, IOL exchange, and excimer laser enhancement rates were low across all groups.ConclusionWhile enhanced monofocal and EDOF IOLs may provide slightly better binocular intermediate visual outcomes and higher spectacle independence compared to monofocal lenses with regards to mini-monovision and intermediate vision performance, the differences are not statistically significant. All three IOL types exhibit high patient satisfaction rates when choosing a mini-monovision approach with decreased dependence on spectacles.

Dataset Information

Clinical Outcomes of a Non-Diffractive Extended Depth-of-Focus IOL in Eyes with Mild Glaucoma.

Purpose

Setting

Design

Methods

Results

Conclusion

Publications

Clinical Outcomes of a Non-Diffractive Extended Depth-of-Focus IOL in Eyes with Mild Glaucoma.

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