JCRS highlights chosen by Professor Thomas Kohnen, European editor, JCRS

Thomas Kohnen

Posted: Tuesday, November 1, 2016



Innovative intraocular lenses (IOLs) designed to provide an extended range of vision do indeed appear to provide successful restoration of vision at all distances, concludes a prospective study conducted at 40 clinical sites throughout Europe. The prospective case series included 411 patients who had bilateral implantation of the extended-range-of-vision IOL (TECNIS Symfony), with intended micro-monovision in one group and intended emmetropia in the other group. By four to six months after cataract surgery, the mean decimal uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities were 0.95, 0.81, and 0.69, respectively. Patients in the monovision group had significantly better intermediate vision. A majority of patients (85%) were able to achieve spectacle independence. Photic complaints were rare, reported by only 10% of patients. Patient satisfaction scores were very high, with more than 91% of patients reporting that they would recommend the same procedure to their friends and family.
B Cochener et al, JCRS, “Clinical outcomes of a new extended range of vision intraocular lens: International Multicenter Concerto Study”, Volume 42, Issue 9, 1268-1275.

Computer and experimental visual simulations show that rotationally asymmetric IOL designs tend to provide better visual quality than concentric IOL designs. Spanish researchers evaluated visual and perceptual performance for different orientations of a rotationally asymmetric bifocal IOL (Mplus), simulated optically using a simultaneous vision simulator. The prospective observational study included 20 people ranging from 21 to 62 years old. Horizontal orientation (near segment at 0 or 180 degrees ±45 [SD]) was preferred by 14 people and by 13 at far and near distances, respectively. Eight showed strong orientation preferences. The mean difference in preferred orientation between far and near was 27±22 degrees. No significant differences in high-contrast visual acuity (HCVA) were observed. Optical predictions correlated strongly and significantly with measurements (p< .0001). The mean difference between measurement and simulation in the preferred orientation was 28±29 degrees at far and 36±28 degrees at near. The researchers note that implanting a rotationally asymmetric IOL along the identified preferred orientation can optimise perceptual quality and visual performance. The preferred orientation was influenced by ocular optics and ocular and corneal aberrations, which can be used to predict the orientations in which the IOL should be implanted. A Radhakrishnan et al, JCRS, “Differences in visual quality with orientation of a rotationally asymmetric bifocal intraocular lens design”, Volume 42, Issue 9, 1276-1287.