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 including 75 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 distance-corrected 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.

• Publikační typ
• časopisecké články MeSH

A 71-year-old woman with Fuchs endothelial dystrophy in the right eye had uneventful phacoemulsification cataract surgery with implantation of a single-piece intraocular lens (IOL) (CT47S) in January 2012. Because of corneal problems and vision loss, uneventful Descemet-stripping automated endothelial keratoplasty (DSAEK) was performed in May 2013. Four months later, a new corneal lamella (repeat DSAEK) was implanted with reinjection of an air bubble into the anterior chamber. Six months after the initial DSAEK, the patient complained of blurred vision. On examination, the cornea was transparent but the IOL presented opacification in the central area. The opacified IOL was explanted and analyzed by light microscopy, which showed the presence of thin granular deposits distributed in an overall round pattern that stained positive for calcium. The opacification of hydrophilic acrylic IOLs is a complication that can occur after uneventful endothelial keratoplasty, especially when rebubbling is necessary.

• MeSH
• akrylové pryskyřice MeSH
• fakoemulzifikace MeSH
• Fuchsova endoteliální dystrofie chirurgie   MeSH
• hydrofobní a hydrofilní interakce MeSH
• implantace nitrooční čočky MeSH
• injekce nitrooční MeSH
• kalcinóza etiologie   patologie   chirurgie   MeSH
• lidé MeSH
• nitrooční čočky * MeSH
• odstranění implantátu MeSH
• poruchy zraku etiologie   patologie   chirurgie   MeSH
• přední komora oční chirurgie   MeSH
• selhání protézy * MeSH
• senioři MeSH
• vápník analýza   MeSH
• vzduch * MeSH
• zadní lamelární keratoplastika * MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

PURPOSE: To describe the clinical and microscopic findings in 2 different patients of 2 cases of late opacification of the hydrophilic acrylic intraocular lens (IOL) Ioflex. METHODS: Two eyes of 2 patients (73 and 74 years old) had an uneventful phacoemulsification surgery with implantation of the Ioflex IOL (power +21.5 D). At 5 years after surgery, a dense IOL opacification was detected in both cases with significant visual degradation. The IOLs were explanted and analyzed by microscopy. RESULTS: In both cases, a satisfactory visual recovery was achieved (corrected distance visual acuity of 6/9 and 6/12). Microscopic examination of the explanted IOLs revealed multiple small granules on the surface/subsurface of the lens. Although histochemical or surface analyses were not performed, the aspect appears consistent with a process of calcification of this lens design. Other findings included few surface contaminants, such as fibers, crystals that may correspond to dry viscoelastic and/or salt solutions, as well as pigments and dust-like deposits. CONCLUSIONS: Opacification of the posterior chamber hydrophilic acrylic IOL Ioflex probably related to calcification can appear several years after its implantation and requires IOL exchange due to the significant visual loss induced. More studies are required to understand the causes of this complication.

• MeSH
• akrylové pryskyřice * MeSH
• fakoemulzifikace MeSH
• hydrofobní a hydrofilní interakce MeSH
• implantace nitrooční čočky MeSH
• lidé MeSH
• nitrooční čočky * MeSH
• selhání protézy * MeSH
• senioři MeSH
• zraková ostrost MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Geografické názvy
• Evropa MeSH

• Publikační typ
• časopisecké články MeSH

PURPOSE: To evaluate the visual, refractive, contrast-sensitivity, and aberrometric outcomes during a 1-year follow-up after implantation of a trifocal intraocular lens (IOL). SETTING: Premium Clinic, Teplice, Czech Republic. DESIGN: Prospective case series. METHODS: This study included eyes of patients having cataract surgery with implantation of the trifocal IOL model AT Lisa tri 839MP. Distance, intermediate (66 and 80 cm), and near (33 and 40 cm) vision; contrast sensitivity; aberrometric outcomes; and the defocus curve were evaluated during a 12-month follow-up. The level of posterior capsule opacification (PCO) was also evaluated. RESULTS: In 120 eyes (60 patients), 1 month postoperatively, an improvement was observed in all visual parameters (P ≤ .03) except corrected near and intermediate visual acuities (both P ≥ .05). From 1 month to 12 months postoperatively, small but statistically significant changes were observed in uncorrected and corrected distance and near visual acuities (all P ≤ .03) and in uncorrected intermediate visual acuity (P = .01). In the defocus curve, no significant differences were found between visual acuities corresponding to defocus levels of -1.0 diopter (D) and -2.0 D (P = .22). The level of ocular spherical aberration decreased statistically significantly at 6 months (P < .001). Ocular and internal higher-order aberrations increased minimally but significantly from 6 to 12 months postoperatively (P < .001). The mean 12-month PCO score was 0.32 ± 0.44 (SD). Four eyes (3.3%) required neodymium:YAG capsulotomy. CONCLUSION: The trifocal IOL provided complete and stable visual restoration after cataract surgery during a 12-month follow-up, with good levels of visual quality. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

• MeSH
• aberometrie MeSH
• citlivost na kontrast fyziologie   MeSH
• dospělí MeSH
• fakoemulzifikace * MeSH
• implantace nitrooční čočky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• nitrooční čočky * MeSH
• prospektivní studie MeSH
• protézy - design MeSH
• pseudofakie patofyziologie   MeSH
• refrakce oka fyziologie   MeSH
• rohovkové aberace patofyziologie   MeSH
• senioři MeSH
• zkalení zadního pouzdra čočky diagnóza   MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: To evaluate the visual, refractive, contrast sensitivity, and aberrometric outcomes as well as the patient quality of life and photic phenomena disturbances after cataract surgery with implantation of a new trifocal toric intraocular lens (IOL). SETTINGS: Premium Clinic, Regional Hospital in Havlickuv Brod, Czech Republic, and Vissum and Universidad Miguel Hernández, Alicante, Spain. DESIGN: Prospective consecutive series of cases. METHODS: The study involved eyes with corneal astigmatism of 1.25 D or more that were having cataract surgery with implantation of the trifocal toric IOL AT Lisa tri toric 939MP (Carl Zeiss Meditec). Visual outcomes and astigmatic changes analyzed by Alpins vector analysis were evaluated at 3 months postoperatively. Contrast sensitivity, quality of life, and photic phenomena were also evaluated. RESULTS: The study involved a total of 30 eyes of 16 patients, age 37 to 64 years. A significant improvement with surgery was observed in uncorrected distance, intermediate, and near visual acuity (P ≤ .01). A significant decrease in the refractive cylinder was observed postoperatively (P < .01), with all eyes showing a postoperative astigmatism below 1.00 D. The difference between targeted and surgically induced astigmatism was small (0.06 ± 0.30 D) but statistically significant (P = .04). The mean magnitude of angle of error was 5.80 ± 8.47 degrees. The low levels of higher-order aberrations found postoperatively were consistent with the good levels of contrast sensitivity achieved. Regarding quality of life, low to moderate levels of difficulty in performing various types of vision-related tasks were found. CONCLUSIONS: The trifocal toric IOL evaluated provides effective restoration of visual function after cataract surgery, with associated high levels of visual acuities and quality of life. FINANCIAL DISCLOSURE: The authors have no proprietary or commercial interest in the medical devices that are involved in this manuscript.

• MeSH
• citlivost na kontrast fyziologie   MeSH
• dospělí MeSH
• fakoemulzifikace * MeSH
• implantace nitrooční čočky * MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• nitrooční čočky * MeSH
• prospektivní studie MeSH
• protézy - design MeSH
• průzkumy a dotazníky MeSH
• pseudofakie patofyziologie   MeSH
• refrakce oka fyziologie   MeSH
• rohovkové aberace patofyziologie   MeSH
• spokojenost pacientů MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

PURPOSE: To evaluate refractive and visual parameters related to distance, intermediate, and near vision after cataract surgery and the optical quality of a new diffractive trifocal intraocular lens (IOL). SETTING: Vissum Instituto Oftalmologico de Alicante, Alicante, Spain. DESIGN: Case series. METHODS: Patients had bilateral refractive lens exchange and multifocal diffractive IOL (AT Lisa tri 839 MP) implantation. A complete ophthalmology examination was performed preoperatively and postoperatively. The follow-up was 6 months. The main outcome measures were uncorrected distance (UDVA) and corrected distance (CDVA), intermediate, and near visual acuities; keratometry; manifest refraction; and aberrations (total, corneal, internal). RESULTS: The study comprised 60 eyes of 30 patients (mean age 57.9 years ± 7.8 [SD]; range 42 to 76 years). There was significant improvement in UDVA, uncorrected intermediate visual acuity, uncorrected near visual acuity, CDVA, and distance-corrected intermediate and near visual acuity. The postoperative refractive status was within the range of +1.00 to -1.00 diopter. Total internal aberrations decreased significantly (P<.001). CONCLUSIONS: The trifocal IOL improved near, intermediate, and distance vision in presbyopic patients. The use of 3 foci provided significant intermediate visual results without sacrificing near or distance vision.

• MeSH
• aberometrie MeSH
• citlivost na kontrast fyziologie   MeSH
• dospělí MeSH
• fakoemulzifikace * MeSH
• implantace nitrooční čočky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nitrooční čočky * MeSH
• percepce hloubky fyziologie   MeSH
• protézy - design MeSH
• pseudofakie patofyziologie   MeSH
• refrakce oka fyziologie   MeSH
• rohovková topografie MeSH
• senioři MeSH
• spokojenost pacientů MeSH
• výsledek terapie MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• capsulorhexis MeSH
• fakoemulzifikace * MeSH
• grampozitivní bakteriální infekce diagnóza   mikrobiologie   terapie   MeSH
• implantace nitrooční čočky MeSH
• léčebná irigace metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci oční čočky diagnóza   mikrobiologie   terapie   MeSH
• oční infekce bakteriální diagnóza   mikrobiologie   terapie   MeSH
• odsávání metody   MeSH
• polymethylmethakrylát MeSH
• pooperační komplikace * MeSH
• Propionibacterium acnes izolace a purifikace   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• dopisy MeSH
• kazuistiky MeSH

BACKGROUND: To evaluate the intraocular lens (IOL) position by analyzing the postoperative axis of internal astigmatism as well as the higher-order aberration (HOA) profile after cataract surgery following the implantation of a diffractive multifocal toric IOL METHODS: Prospective study including 51 eyes with corneal astigmatism of 1.25D or higher of 29 patients with ages ranging between 20 and 61 years old. All cases underwent uneventful cataract surgery with implantation of the AT LISA 909 M toric IOL (Zeiss). Visual, refractive and corneal topograpy changes were evaluated during a 12-month follow-up. In addition, the axis of internal astigmatism as well as ocular, corneal, and internal HOA (5-mm pupil) were evaluated postoperatively by means of an integrated aberrometer (OPD Scan II, Nidek). RESULTS: A significant improvement in uncorrected distance and near visual acuities (p < 0.01) was found, which was consistent with a significant correction of manifest astigmatism (p < 0.01). No significant changes were observed in corneal astigmatism (p = 0.32). With regard to IOL alignment, the difference between the axes of postoperative internal and preoperative corneal astigmatisms was close to perpendicularity (12 months, 87.16° ± 7.14), without significant changes during the first 6 months (p ≥ 0.46). Small but significant changes were detected afterwards (p = 0.01). Additionally, this angular difference correlated with the postoperative magnitude of manifest cylinder (r = 0.31, p = 0.03). Minimal contribution of intraocular optics to the global magnitude of HOA was observed. CONCLUSIONS: The diffractive multifocal toric IOL evaluated is able to provide a predictable astigmatic correction with apparent excellent levels of optical quality during the first year after implantation.

• MeSH
• aberometrie MeSH
• astigmatismus diagnóza   chirurgie   MeSH
• dospělí MeSH
• fakoemulzifikace * MeSH
• implantace nitrooční čočky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• nitrooční čočky * MeSH
• prospektivní studie MeSH
• protézy - design MeSH
• pseudofakie patofyziologie   MeSH
• refrakce oka fyziologie   MeSH
• rohovková topografie MeSH
• rohovkové aberace diagnóza   chirurgie   MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: To analyze and compare the clinical outcomes obtained after cataract surgery with the implantation of a new multifocal toric intraocular lens (IOL) using two different types of corneal incision. METHODS: Retrospective study including 64 eyes of 35 patients who underwent surgery with implantation of the AT LISA 909M multifocal toric IOL (Carl Zeiss Meditec) in 2 different ophthalmologic centers using different criteria for corneal incision size: sub-1.8 mm (micro-incision surgery [MICS] group) and 2.2 mm (mini-incision group). Visual, refractive, and corneal topographic outcomes were evaluated during 6-month follow-up. Additionally, refractive astigmatic changes were analyzed using the Alpins vectorial method. RESULTS: Significant reductions of refractive sphere and cylinder were observed postoperatively (P<.03), with associated visual improvements for near and distance (P<.01) in both groups. Mean postoperative magnitudes of difference vector, torque, and magnitude of error in the overall sample were 0.52±0.36 diopters (D), 0.36 ± 0.36 D, and 0.08 ± 0.38 D, respectively. A mean overcorrection of 4% in refractive astigmatism was found. Mean angle of error was 0.37± 5.50° and -4.51±13.16° for the MICS and mini-incision groups, respectively (P=.09). Significant positive correlations were found between the magnitudes of torque and difference vector (r=0.78, P<.01) as well as between the magnitude of torque and absolute angle of error (r=0.76, P<.01). CONCLUSIONS: Implantation of the AT LISA toric IOL using corneal incisions <2.2 mm provides excellent predictability for astigmatic correction.

• MeSH
• astigmatismus patofyziologie   MeSH
• dospělí MeSH
• fakoemulzifikace metody   MeSH
• implantace nitrooční čočky MeSH
• lidé středního věku MeSH
• lidé MeSH
• mikrochirurgie metody   MeSH
• mladý dospělý MeSH
• následné studie MeSH
• nitrooční čočky MeSH
• protézy - design MeSH
• refrakce oka fyziologie   MeSH
• retrospektivní studie MeSH
• rohovka chirurgie   MeSH
• rohovková topografie MeSH
• výsledek terapie MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH