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      Comparison of Primary Duet Lens Procedures: In-The-Bag Monofocal with Sulcus Multifocal, and Standard Single Multifocal Lens for Cataract Surgery

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          Abstract

          Purpose

          To assess the safety and efficacy of primary duet intraocular lens (IOL) procedure using an in-The-bag monofocal IOL and a sulcus-based multifocal reversible platform for cataract surgery. The visual outcomes were compared with a single in-The-bag multifocal IOL.

          Patients and Methods

          Retrospective cohort study. Consecutive patients who underwent primary duet IOL procedures were compared with consecutive patients who underwent single multifocal IOL surgery. Primary outcomes were uncorrected distance and near visual acuities (UDVA and UNVA), refraction and spherical equivalent data. Secondary outcomes included surgical complications.

          Results

          The study group consisted of 32 eyes (22 toric IOLs) whilst the control group had 57 eyes (29 toric IOLs). There were no statistically significant differences between the two groups on post-operative 1-month and 1-year UDVA ( p=0.1522 and 0.4926, respectively) and UNVA ( p=0.1248 and 0.2738, respectively). There were no statistically significant differences in the postoperative 1-month spherical equivalent within ± 0.5 diopter ( p=0.1891). Postoperative intraocular pressure spikes were observed on day-1 in both groups, with most returned to their baseline at 1-month and all were normal at 1-year post surgery. There were no statistically significant differences in intraocular pressure between the two groups on day-1, 1-month and 1-year after surgery ( p=0.6421). There were no statistically significant differences in the IOL axis deviation from the intended axis in the toric subgroup analysis ( p=0.5843).

          Conclusion

          Primary duet IOL procedure is equally effective and safe in correcting distance and near vision when compared with single multifocal IOL in the capsular bag.

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          Most cited references29

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          Formula choice: Hoffer Q, Holladay 1, or SRK/T and refractive outcomes in 8108 eyes after cataract surgery with biometry by partial coherence interferometry.

          To assess how intraocular lens (IOL) formula choice affects refractive outcomes after cataract surgery using IOLMaster biometry. Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom. Database study. Hypothetical prediction errors were retrospectively calculated on prospectively collected data from electronic medical records using optimized Hoffer Q, Holladay 1, and SRK/T formulas (Sofport AO and Akreos Fit IOLs) across a range of 0.5 mm or 1.0 mm axial length (AL) subgroups. In short eyes, the Hoffer Q had the lowest mean absolute error (MAE) for ALs from 20.00 to 20.99 mm. The Hoffer Q and Holladay 1 had a lower MAE than the SRK/T for ALs from 21.00 to 21.49 mm. There were no statistically significant differences in MAE for ALs from 21.50 to 21.99 mm. In medium eyes, there were no statistically significant differences in MAE for any IOL formula for ALs from 22.00 to 23.49 mm. For ALs from 23.50 to 25.99 mm, there was a trend toward lower MAEs for the Holladay 1, with statistically significant differences in 2 subgroups. In long eyes, the SRK/T had the lowest MAE, with statistically significant differences for ALs of 27.00 mm or longer. The Hoffer Q performed best for ALs from 20.00 to 20.99 mm, the Hoffer Q and Holladay 1 for ALs from 21.00 to 21.49 mm, and the SRK/T for ALs of 27.00 mm or longer. Using optimized constants, refractive outcomes of 40%, 75%, and 95% within ±0.25 diopter (D), ±0.50 D, and ±1.00 D, respectively, were achievable. No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
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            Aiming for emmetropia after cataract surgery: Swedish National Cataract Register study.

            To assess and analyze refractive outcome after cataract surgery in Sweden from 2008 through 2010.
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              • Article: not found

              Comparison of a new refractive multifocal intraocular lens with an inferior segmental near add and a diffractive multifocal intraocular lens.

              To compare the visual acuity outcomes and ocular optical performance of eyes implanted with a multifocal refractive intraocular lens (IOL) with an inferior segmental near add or a diffractive multifocal IOL. Prospective, comparative, nonrandomized, consecutive case series. Eighty-three consecutive eyes of 45 patients (age range, 36-82 years) with cataract were divided into 2 groups: group A, 45 eyes implanted with Lentis Mplus LS-312 (Oculentis GmbH, Berlin, Germany); group B, 38 eyes implanted with diffractive IOL Acri.Lisa 366D (Zeiss, Oberkochen, Germany). All patients underwent phacoemulsification followed by IOL implantation in the capsular bag. Distance corrected, intermediate, and near with the distance correction visual acuity outcomes and contrast sensitivity, intraocular aberrations, and defocus curve were evaluated postoperatively during a 3-month follow-up. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), corrected distance near and intermediate visual acuity (CDNVA), contrast sensitivity, intraocular aberrations, and defocus curve. A significant improvement in UDVA, CDVA, and UNVA was observed in both groups after surgery (P ≤ 0.04). Significantly better values of UNVA (P<0.01) and CDNVA (P<0.04) were found in group B. In the defocus curve, significantly better visual acuities were present in eyes in group A for intermediate vision levels of defocus (P ≤ 0.04). Significantly higher amounts of postoperative intraocular primary coma and spherical aberrations were found in group A (P<0.01). In addition, significantly better values were observed in photopic contrast sensitivity for high spatial frequencies in group A (P ≤ 0.04). The Lentis Mplus LS-312 and Acri.Lisa 366D IOLs are able to successfully restore visual function after cataract surgery. The Lentis Mplus LS-312 provided better intermediate vision and contrast sensitivity outcomes than the Acri.Lisa 366D. However, the Acri.Lisa design provided better distance and near visual outcomes and intraocular optical performance parameters. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Clin Ophthalmol
                Clin Ophthalmol
                opth
                Clinical Ophthalmology (Auckland, N.Z.)
                Dove
                1177-5467
                1177-5483
                19 January 2023
                2023
                : 17
                : 273-282
                Affiliations
                [1 ]Department of Ophthalmology, Royal Prince Alfred Hospital , Camperdown, New South Wales, Australia
                [2 ]Department of Anesthetics, Royal Prince Alfred Hospital , Camperdown, New South Wales, Australia
                [3 ]Department of Anaesthesia and Pain Medicine, Nepean Hospital , Kingswood, New South Wales, Australia
                Author notes
                Correspondence: Brian P Harrisberg, Centre Sydney Eye Surgeons, RPAH Medical Centre , G8/100 Carillon Avenue, Newtown, New South Wales, 2042, Australia, Tel +61 418 201 647, Fax +61 2 9519 3882, Email brian.harrisberg@sydney.edu.au
                [*]

                These authors contributed equally to this work

                Author information
                http://orcid.org/0000-0003-2273-0752
                http://orcid.org/0000-0003-3695-2620
                Article
                396472
                10.2147/OPTH.S396472
                9869909
                6918800c-3bf4-40e1-9d54-4eed3d32590a
                © 2023 Harrisberg et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 13 November 2022
                : 09 January 2023
                Page count
                Figures: 5, References: 30, Pages: 10
                Categories
                Original Research

                Ophthalmology & Optometry
                cataract surgery,duet procedure,spectacle independence,1stq addon
                Ophthalmology & Optometry
                cataract surgery, duet procedure, spectacle independence, 1stq addon

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