Moderator
Abhay R. Vasavada, MS, FRCS
Panelists
Huck A. Holz, MD
Kendrick M Wang, MD
Viewing Papers
Expand a paper title to the right to view the paper abstract and authors. Use the video link to jump to that poster in the session.
Presenting Author
Robert Edward T. Ang, MD
Purpose
This observational, single-site study aimed to assess visual outcomes in patients with prior corneal refractive surgery (either corneal inlay or laser refractive surgery) treated with contralateral implantation of a small-aperture IC-8 intraocular lens (IOL) (NCT05377515).
Methods
Eligible patients had received prior cataract surgery and had been implanted with an IC-8 IOL for ?3 months prior to study initiation. Twenty-nine patients were recruited, 16 of which had a history of keratorefractive surgery (post-refractive group [RG]), and 13 were previously treated with a corneal inlay (post-inlay group [IG]). Both groups had been treated in one eye with an IC-8 IOL, with a refractive target of ?0.75D. Outcome measures were monocular and binocular uncorrected (UC), distance (D), intermediate (I), and near (N) visual acuity (VA) ?0.3 logMAR, depth of focus, and visual symptoms at 12 months.
Results
For the RG, mean logMAR � SD monocular UCDVA, UCIVA, and UCNVA in IC-8 eyes at 12 months were 0.05�0.06 (20/22), 0.04�0.14 (20/22), and 0.09�0.13 (20/25), respectively. Binocular values were 0.02�0.05 (20/21), 0.02�0.11 (20/21), and 0.08�0.12 (20/24), respectively. For the IG, mean logMAR � SD monocular UCDVA, UCIVA, and UCNVA in IC-8 eyes at 12 months were 0.10�0.09 (20/25), 0.05�0.08 (20/22), and 0.05�0.09 (20/22), respectively. Binocular values were 0.06�0.09 (20/23), 0.05�0.08 (20/22), and 0.05�0.09 (20/22), respectively. Defocus curve testing yielded 2.32D and 2.33D depth of focus in the RG and IG, respectively. Mean visual symptom severity was very mild�mild in both groups.
Conclusion
These results demonstrated that the IC-8 IOL provides good DVA, IVA, and NVA for cataract patients, with mild to very mild visual symptoms in patients with either prior keratorefractive surgery or corneal inlay.
Presenting Author
Damien Gatinel, MD, PhD
Purpose
This study aims to analyze the impact of the number of spirals (N) and the winding parameter (n) on the optical performance of spiral refractive multifocal lenses. We specifically focused on their effects on Through-Focus Point Spread Function (PSF), Modulation Transfer Function (MTF), and image quality as assessed by a convolved letter image.
Methods
We employed Zemax OpticStudio software (Ansys) for ray tracing simulations, using the Arizona eye model to evaluate the optical performance of spiral diopter IOLs. The IOLs modeled in this study had a dioptric base power of 20D. Various configurations were tested by varying the number of spirals (N) and the winding parameter (n). Through-Focus MTF and PSF were analyzed across different defocus levels to assess the optical quality and the impact of these design parameters.
Results
We found that the number of spiral branches (N) has a significant influence on the optical performance of the lenses. Configurations with an odd number of spirals exhibited substantial prismatic effects, which could lead to potential image distortion. The winding parameter (n), however, showed a less pronounced effect on the overall optical quality. Through-focus MTF analysis generally revealed three distinct peaks, with the median peak consistently being the highest across all configurations. The best configuraton (number of spiral branches) was N=4. The results suggest that specific combinations of N and n may lead to variations in phase transfer, potentially affecting defocused images.
Conclusion
This study shows that the number of spiral branches (N) is crucial for optical quality, with odd numbers causing prismatic effects, while 4 or multiples of 4 provide the best optical performance. The winding parameter (n) has a lesser but still relevant impact. These findings can guide the design of multifocal IOLs to improve visual outcomes.
Presenting Author
Dineshkumar N. Maru, MBBS, MS
Purpose
To compare visual outcomes and patient satisfaction following the Implantation of Autofocus Pro ringless polyfocal Progressive trifocal IOL and diffractive trifocal IOL.
Methods
The Prospective non-randomised comparative study was conducted at Aastha Hospital, India between June 22 to Sept 23. The study included 14 eyes of 7 patients receiving bilateral Autofocus Pro ringless polyfocal Progressive trifocal IOL(Autofocus) and 14 receiving AT LISA tri 839 MP trifocal IOL(AT LISA). Post-operative examination at one month included uncorrected visual acuity(UCVA) at 3?m, uncorrected intermediate visual acuity(UIVA) at 80?cm, UIVA at 60?cm, and uncorrected near visual acuity(UNVA) at 40?cm, Contrast sensitivity under photopic conditions, defocus curve and a questionnaire on subjective quality of vision, optical phenomena and spectacle independence.
Results
The standard visual acuity testing of Autofocus IOL and AT LISA trifocal IOL is UCVA at 3M: 0.05?�?0.08 logMAR vs. 0.01?�?0.04 logMAR, p?=?0.10; UIVA at 60 cms: 0.01?�?0.10 logMAR vs. -0.01?�?0.06 logMAR, p?=?0.30, UIVA 80 cms: 0.01?�?0.09 logMAR vs. -0.01?�?0.06 logMAR, p?=?0.46 and UNVA 40 cms: 0.14?�?0.13 logMAR vs. 0.14?�?0.09 logMAR, p?=?0.33 respectively. In addition,Contrast sensitivity results were better in the Autofocus group than in the AT LISA trifocal group. The defocus curve, night vision and spectacle freedom shows better results of the Autofocus IOL than the AT LISA trifocal IOL.
Conclusion
: Patients who received Autofocus Pro ringless polyfocal Progressive trifocal IOL had comparable visual outcomes for distance, intermediate and near with higher contrast sensitivity under various conditions. It also allowed spectacle-independence, glare and halo-free vision with good patient satisfaction.
Presenting Author
John P. Berdahl, MD
Co-Authors
Zaiwei Xu MS, Wei Lu PhD, Deanna Moschitta MS, William Xu PhD
Purpose
This study aims to evaluate the image quality provided by an enhanced version of the PanOptix optical design.
Methods
The Modulation Transfer Function (MTF) of next generation Clareon PanOptix vs. Clareon PanOptix was measured on an optical bench under both photopic and mesopic conditions. Monocular and binocular Vision Acuity (VA) were predicted from MTF area under the curve metric. Additionally, halo and starburst were assessed using a halo bench.
Results
The total light utilization of Clareon PanOptix Pro reaches 94%, which is a 6% increase from the 88% light utilization of Clareon PanOptix. Two-dimensional PSF shows that 50% of the light that was scattered before is distributed between the Distance and Intermediate foci, aimed to enhance visual performance in that range. White-light MTF was measured across Distance, Intermediate and Near foci, as well as -1D defocus where Clareon PanOptix Pro achieves a 16% higher MTF (averaged over 0 to 70 lp/mm) compared to Clareon PanOptix. Through-Focus binocular VA, derived from area under the MTF curve, predicts the continuous range of vision provided by Clareon PanOptix Pro.
Conclusion
Clareon PanOptix Pro, the next generation of Clareon PanOptix, exhibits enhanced total light utilization and improved image quality between Distance and Intermediate foci providing a continuous range of vision.
Presenting Author
Andrea Janekova, MD
Purpose
To compare from 18 to 48-months outcomes of visual performance, posterior capsule opacification (PCO) rate and Nd:YAG capsulotomy treatments in three types of different optic design hydrophilic intraocular lenses.
Methods
Patients who underwent bilateral cataract surgery with implantation of one of the 3 type intraocular lens: monofocal (Softec HD, Lenstec), asymmetric refractive (ClearView 3, Lenstec) or trifocal diffractive (AT LISA TRI, Zeiss) in both eyes were included. Patients were evaluated at follow-up visit in period 18 to 48 months after the surgery. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA), were compared between groups postoperatively. Incidence of required Nd:YAG capsulotomies was recorded and compared between groups.
Results
There were 120 eyes of 60 patients in each group included with follow up period 38 months (median 39 months). The rate of Nd:YAG capsulotomy treatment was 59% in monofocal group, 60% in refractive IOL group and 53% in trifocal group. CDVA before and after Nd:YAG capsulotomy treatment significantly improved in all groups. Number of eyes requiring capsulotomy in first 18 months was 3, 10 and 14 eyes in monofocal, refractive and trifocal group respectively. Number of needed capsulotomies in first 12 months was 3, 10 and 14 in monofocal, refractive and trifocal group respectively with significantly higher rate in refractive and trifocal group than monofocal group (p < 0.05).
Conclusion
Earlier clinically significant PCO requiring Nd:yag capsulotomy was observed in patients with multifocal types of lenses in comparison to monofocal lens. No significant difference in visual acuities was found between the two tested multifocal groups.
Presenting Author
Neel R. Desai, MD, ABO
Co-Authors
Subhashini Chandrasekaran MD, Bryan Adams DO, Chad Hummel MD, Robert Weinstock MD, Thiago Moulin MD
Purpose
Purpose is to evaluate long-term visual outcomes, low light reading, patient satisfaction, and level of spectacle freedom achieved with implantation of six types of intraocular lenses (IOLs): Panoptix trifocal, Vivity extended range of vision, Odyssey multifocal, Clearview segmented bifocal, Envista monofocal, and Tecnis Eyhance monofocal-plus.
Methods
Data of 30 patients per cohort, who underwent refractive cataract surgery with one of the above IOLs bilaterally, will be assessed for uncorrected distance/intermediate/near visual acuity, low light(50 lux) reading and residual refractive error. Secondary analysis will be conducted using a validated patient-reported survey to assess satisfaction, spectacle independence, low light reading and dysphotopsias. Exclusion criteria include patients with a history of glaucoma, retinal comorbidities, LASIK/PRK/RK, surface disease requiring intervention or postoperative complications. Monofocal IOL groups were included as controls as they are largely free of dysphotopsias and aim for distance vision.
Results
TBD
Conclusion
TBD
Presenting Author
Joaquin O De Rojas, MD, ABO
Co-Authors
Helga Sandoval MD, MSc, Richard Potvin OD, William Soscia MD, Priya Mathews MPH, MD, Kerry Solomon MD
Purpose
To evaluate the visual outcomes of two extended depth of focus (EDOF) intraocular lenses (IOLs) under mesopic lighting conditions in patients undergoing uneventful routine laser assisted cataract surgery with a plano target refraction in both eyes (OU).
Methods
Prospective, randomized, double-masked study that includes 64 patients who underwent bilateral cataract surgery with implantation of an EDOF OU. Patients were randomized into one of 2 groups: Symfony with OptiBlue or Vivity. At postoperative month 3 and under mesopic conditions (3 � 5 cd/m2), binocular uncorrected (UCVA) and distance corrected visual acuity (DCVA) were assessed at 4m, 66 and 40 cm, along with a defocus curve and low contrast VA (10% and 25%) at 4m. Statistical analyses with a P-value < 0.05 will be used to compare both groups.
Results
Sixty-two subjects (31 in each group) completed the study. The mean refraction spherical equivalent and residual refractive cylinder were not statistically significantly different between groups, with 90% of eyes within 0.5D of plano. Mean mesopic binocular DCVAs at 4 m were 0.06 �0.07 and 0.09 �0.07; at 66 cm, 0.27 �0.17 and 0.32 �0.11; and at 40 cm 0.54 �0.15 and 0.52 �0.12 for the Symfony and Vivity groups, respectively. There was no statistically significant difference in VA between groups at any test distance either distance corrected or uncorrected. There were no statistically significant differences in the defocus curve, or the low contrast VA at 10% or 25%.
Conclusion
Both EDOF IOLs showed good refractive predictability. Subjects in both groups demonstrated equivalent binocular visual performance in mesopic conditions, as measured by VA at various test distances, low-contrast distance VA, and the defocus curve.
Presenting Author
Shafiq U Rehman, FRCOphth
Co-Authors
Clare O'Donnell PhD, Nabila Jones PhD, Amir Hamid FRCOphth
Purpose
To compare the clinical outcomes of refractive lensectomy involving a multifocal IOL (MFIOL) and a novel extended depth of field (EDOF) IOL design.
Methods
Retrospective analysis of electronic medical records, reviewing consecutive eyes of refractive lens exchange or cataract surgery involving an AT LISA trifocal IOL (MFIOL) and a TECNIS PureSee extended depth of field (EDOF) design between November 2023 to August 2024. Operative, post operative complications, post-op unaided distance (UDVA) and near visual acuities (UNVA), and spherical equivalent (SER) refractive outcomes were analysed. Eyes with less than one week follow-up and those with co-pathology were excluded from the analysis. Patient Reported Outcome Measures (PROMs) where eyes had three or more months follow-up were included.
Results
587 eyes (319 patients) in the MFIOL group and 250 eyes (147 patients) in the EDOF group were included. Preoperative SER ranged from -18.5D to +7.00D for MFIOLs and -15.75D to +8.50D for EDOF. Binocular UDVA was similar (p=0.08) between groups, with mean�SD logMAR for MFIOL -0.04�0.09 vs.-0.01�0.09 for EDOF. Mean UNVA was significantly better (p<0.05), for="" the="" mfiol="" cohort="" (0.21�0.12="" vs.="" 0.36�0.14="" logmar).="" refractive="" predictability="" was="" superior="" in="" the="" mfiol="" group="" (85%="" vs.="" 75%="" within="" �0.50="" d="" of="" target="" ser).="" emerging="" proms="" data="" show="" satisfaction="" was="" generally="" high,="" with="" fewer="" reports="" of="" glare="" and="" halos="" (44%="" vs="" 65%)="" in="" the="" edof="">
Conclusion
With low complication rates, excellent binocular vision outcomes and high patient satisfaction our data shows IOL innovations are providing presbyopic patients seeking surgical solutions for refractive error with a range of efficacious solutions.
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