The Hard Facts on GP Contact Lens Care

The article is designed to explain the various steps needed to be undertaken daily to keep gas permeable (GP) contact lenses clean, wettable, and free from pathogens that could cause ocular disease. It explains why the steps need to be performed and what the adverse consequences of failing to perform them might be.Translation of the article: Ruslan Tahaveev (Academy of Medical Optics and Optometry

Verisyse versus Veriflex Phakic Intraocular Lenses: Refractive Outcomes and Endothelial Cell Density 5 Years after Surgery

Purpose. To compare refractive stability, central endothelial cell density (ECD), and complications between Verisyse (Abbott Medical Optics, Netherlands) and Veriflex (Abbott Medical Optics, Netherlands) phakic intraocular lenses (pIOL) over five years.Methods. We retrospectively reviewed the medical records of patients who underwent Verisyse or Veriflex pIOL implantation for surgical correction of myopia. Patients with a 5-year follow-up period were included in the study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent of manifest refraction (SE), and ECD were compared between the groups preoperatively and 1, 3, and 5 years postoperatively.Results. The study included 47 eyes in the Verisyse group and 50 eyes in the Veriflex group. There was no significant difference in mean SE, UDVA, CDVA, and ECD preoperatively or postoperatively. In both groups, there was a statistically significant myopic shift between 1-year and 5-year visits (−0.25 ± 0.30 D and −0.23 ± 0.48 D in the Verisyse and Veriflex groups, respectively). There was no significant difference between the groups in terms of efficacy and safety indexes at 5 years. ECD loss was highest during the first year (3.9% loss in the Verisyse group and 3.9% loss in the Veriflex group,p=0.670). At 5 years, the mean cumulative ECD losses in the Verisyse and Veriflex groups were 7.42% and 7.64%, respectively (p=0.709). Cataracts developed in 2.1% of the eyes in the Verisyse group and in 2.0% of those in the Veriflex group. No sight-threatening complications were observed.Conclusion. Verisyse and Veriflex pIOLs are highly effective for treating high myopia up to 5 years after surgery. Longitudinal studies with longer follow-up periods are necessary to determine the endothelial safety profile.

Clinical outcome and higher order aberrations after bilateral implantation of an extended depth of focus intraocular lens

Purpose: The purpose of this study was to assess the clinical outcome after a bilateral implantation of an extended depth of focus intraocular lens in comparison to a monofocal intraocular lens. Setting: Department of Ophthalmology, Charité—Medical University Berlin, Germany. Patients and Methods: A total of 60 eyes of 30 patients were enrolled in this prospective, single-center study. The cataract patients underwent phacoemulsification with bilateral implantation of a TECNIS® Symfony (Abbott Medical Optics, Santa Ana, CA, USA, 15 patients) or a TECNIS Monofocal ZCB00 (Abbott Medical Optics, Santa Ana, CA, USA, 15 patients). Postoperative evaluations were performed after 1 and 3 months, including visual acuities at far, intermediate, and near distance. Mesopic, scotopic vision, and contrast sensitivity were investigated. Aberrometry was performed using an iTrace aberrometer with a pupil scan size of 5.0 mm. Results: After 3 months, the TECNIS Symfony group reached an uncorrected visual acuity at far distance of −0.02 logMAR compared to −0.06 logMAR in the TECNIS Monofocal group ( p = 0.03). Regarding the uncorrected vision at intermediate and near distance the following values were obtained: intermediate visual acuity −0.13 versus 0.0 logMAR (TECNIS Symfony vs TECNIS Monofocal, p = 0.001) and near visual acuity 0.11 versus 0.26 logMAR (TECNIS Symfony vs TECNIS Monofocal, p = 0.001). Low-contrast visual acuities were 0.27 versus 0.20 logMar (TECNIS Symfony vs TECNIS Monofocal, p = 0.023). Conclusion: The TECNIS Symfony intraocular lens can be considered an appropriate alternative to multifocal intraocular lenses because of good visual results at far, intermediate, and near distance as well as in low-contrast vision.

Comparison of Two Toric IOLs with Different Haptic Design: Optical Quality after 1 Year

Background. The purpose of this prospective, randomised study was to interocularly compare the visual performance after implantation of two different toric IOLs with different haptic design. Methods. 59 subjects with corneal astigmatism greater than 1.25 diopter (D) were implanted with an AT TORBI 709M IOL (Carl Zeiss Meditec AG) in one eye and with a Tecnis toric aspheric IOL (Abbot Medical Optics) in the other eye. Observation procedure was performed 12 months postoperatively. Main outcome measures included uncorrected distance visual acuity (UDVA), manifest refraction, IOL rotation, and IOL position. Results. Mean UCDVA was 0.04 ± 0.14 logMAR for AT TORBI eyes and 0.06 ± 0.15 logMAR for Tecnis eyes (p=0.3). The postoperative spherical equivalent values were significantly lower in the AT TORBI group. Mean toric IOL axis rotation was 3.0 ± 2.26 degrees for AT TORBI eyes and 3.27 ± 2.37 for Tecnis eyes (p=0.5). The mean vertical IOL tilt and vertical decentration values measured with the Visante OCT were significantly larger in the AT TORBI group (p<0.05). Conclusions. Both the Tecnis and the AT TORBI toric IOLs successfully reduced ocular astigmatism. Emmetropia could be better achieved with the AT TORBI IOL, whereas the Tecnis showed better positional stability. This trial is registered with ICMJE NCT03371576.

Auswirkungen der Nahaddition auf die optische Qualität von diffraktiven multifokalen Intraokularlinsen – eine Laborstudie an der optischen Bank

Zusammenfassung Ziel Analyse und Vergleich der optischen Qualität diffraktiver multifokaler Intraokularlinsen (IOL) mit unterschiedlichen Nahadditionen mithilfe einer optischen Bank im Rahmen einer Laborstudie. Methode Die AcrySof® IQ ReSTOR® + 2.5 D SV25T0 (Alcon, USA), die AcrySof® IQ ReSTOR® + 3.0 D SN6AD1 (Alcon, USA) sowie die TECNIS® ZMA00 und ZMB00 (Abbott Medical Optics, USA) mit einer Brechkraft von 21 dpt für die Ferne wurden an der optischen Bank OptiSpheric® IOL PRO (TRIOPTICS GmbH, Wedel) untersucht. Das optische Design dieser Linsen ist ähnlich, die Modelle unterscheiden sich allerdings hinsichtlich ihrer Nahaddition: Die AcrySof IQ ReSTOR + 2.5 D hat eine Nahaddition von + 2,5 dpt, die AcrySof IQ ReSTOR + 3.0 D eine Nahaddition von + 3,0 dpt und beide TECNIS-Linsen eine Nahaddition von + 4,0 dpt. Untersucht wurden die Fläche unterhalb der Kurve der Modulationstransferfunktion (Modulation Transfer Function Area, MTFA) und die Strehl Ratio. Weiterhin wurden die Abbildungseigenschaften der IOL mithilfe von USAF-Target-Bildern (USAF: United States Air Force) qualitativ miteinander verglichen. Ergebnis Die MTFA-Werte für den Fernfokus waren im Median 47,85/42,06/33,57 (2,5 dpt/3,0 dpt/4,0 dpt). Für den Intermediärfokus erreichten die MTFA-Werte 11,05/9,54/8,60. Die MTFA-Werte für den Nahfokus waren 20,11/29,50/33,39. Die Strehl Ratio des Fernfokus betrug 0,48/0,42/0,29. Für den Intermediärfokus war die Strehl Ratio 0,11/0,10/0,09. Die Strehl Ratio des Nahfokus betrug 0,20/0,30/0,34. Die USAF-Target-Bilder korrelierten mit diesen Messwerten. Schlussfolgerung Für den Nahfokus erzielen die ZMA00 und ZMB00 die besten Ergebnisse, während die IQ ReSTOR + 2.5 D am schlechtesten abschneidet. Im Intermediärbereich erreichen alle IOL ähnliche Ergebnisse. Für den Fernfokus erzielt die IQ ReSTOR + 2.5 D die besten Ergebnisse. Da heutzutage diverse Nahadditionen bei diffraktiven multifokalen IOL zur Verfügung stehen, kann die Wahl der richtigen Linse individuell auf die Bedürfnisse jedes Patienten abgestimmt werden.

Effect of Spherical Aberration on the Optical Quality after Implantation of Two Different Aspherical Intraocular Lenses

Purpose. To compare the effect of spherical aberration on optical quality in eyes with two different aspherical intraocular lenses. Methods. 120 eyes of 60 patients underwent phacoemulsification. In patients’ eyes, an aberration-free IOL (Aspira-aA; Human Optics) or an aberration-correcting aspherical IOL (Tecnis ZCB00; Abott Medical Optics) was randomly implanted. After surgery, contrast sensitivity and wavefront measurements as well as tilt and decentration measurements were performed. Results. Contrast sensitivity was significantly higher in eyes with Aspira lens under mesopic conditions with 12 cycles per degree (CPD) and under photopic conditions with 18 CPD (p=0.02). Wavefront measurements showed a higher total spherical aberration with a minimal pupil size of 4 mm in the Aspira group (0.05 ± 0.03) than in the Tecnis group (0.03 ± 0.02) (p=0.001). Strehl ratio was higher in eyes with Tecnis (0.28 ± 0.17) with a minimal pupil size larger than 5 mm than that with Aspira (0.16 ± 0.14) (p=0.04). In pupils with a minimum diameter of 4 mm spherical aberration had a significant effect on Strehl ratio, but not in pupils with a diameter less than 4 mm. Conclusions. Optical quality was better in eyes with the aberration-correcting Tecnis IOL when pupils were large. In contrast, this could not be shown in eyes with pupils under 4 mm or larger. This trial is registered with Clinicaltrials.gov NCT03224728.

Multifocal Toric Intraocular Lenses

Meticulous correction of astigmatism during cataract surgery is mandatory in cases of multifocal intraocular lens (IOL) implantation. Toric multifocal IOLs allow predictable astigmatic correction during cataract surgery. In this editorial, we review our investigation on the Tecnis ZMT IOL (Abbott Medical Optics, CA, US) as well as other recent developments in multifocal toric IOLs.

Aphakia korrekciója irisklip műlencse retropupillaris beültetésével

Introduction and aim: The correction of aphakia might be a challenge for the surgeon. The aim of this study is to describe the authors’ experience with the implantation of the retropupillary iris clip intraocular lens. Method: Patients between January 2014 and December 2015 were included in the retrospective study. Retropupillary implantation of iris clip intraocular lens VRSA 54 (AMO Advanced Medical Optics, USA) was performed in all cases. The minimum follow up period was three months. The stability of the intraocular lens and the intraoperative and postoperative complications and the visual acuity were evaluated. Results: During this time period 11 cases (1 female, 10 males) were included in the study. The mean age at the time of the implantation was 57.7 years (between 25–74 years). In 4 cases the iris clip lens was implanted during the first intervention, in 7 cases during the secondary procedure. In all cases the lens was fixated onto the iris posteriorly. The best corrected visual acuity before the iris clip implantation was 0.43 (0.1–1.0) and postoperatively at the time of the follow up 0.49 (0.04–1.0). Conclusions: With the use of the retropupillary implanted iris clip intraocular lens all of the patients could have been rehabilitated without major complications. Orv. Hetil., 2017, 158(1), 20–24.