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      Clinical Results of a Trifocal Toric Intraocular Lens Using the Holladay Total Surgically Induced Astigmatism Formula for Correcting Low Corneal Astigmatism in Japanese Patients

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          Abstract

          Purpose

          To evaluate the effectiveness and safety of the AcrySof IQ PanOptix toric intraocular lens (IOL) with cylinder power of 1.0 D (TFNT20) in a Japanese population with low corneal astigmatism and compare with historical control data for nontoric IOLs.

          Setting

          Tokyo Dental College Suidobashi Hospital, Tokyo, Japan.

          Design

          Prospective, single-center study.

          Methods

          Patients ≥20 years old received TFNT20 IOL in at least 1 eye based on Alcon Toric calculator (Holladay Total surgically induced astigmatism). Effectiveness endpoints included the percentage of eyes with refractive cylinder ≤0.25 D at 30–60 days after surgery, which was compared with a historical control threshold rate of 29.2% for nontoric IOLs and refractive cylinder ≤0.50 D. Monocular uncorrected distance visual acuity (UDVA; 5 m), uncorrected intermediate visual acuity (UIVA; 60 cm), uncorrected near visual acuity (UNVA; 40 cm), and adverse events were evaluated.

          Results

          Of 41 eyes implanted with TFNT20 IOLs, 37 eyes (90%) achieved refractive cylinder ≤0.25 D at 30–60 days after surgery, demonstrating the superiority of TFNT20 compared with historical data ( P<0.0001). Refractive cylinder of ≤0.50 D was achieved by 41 eyes (100%). At 30–60 days, mean ± SD monocular CDVA was −0.15 ± 0.07 logMAR, UDVA was −0.09 ± 0.09 logMAR, UIVA was −0.00 ± 0.07 logMAR, and UNVA was 0.03 ± 0.07 logMAR. Six eyes (15%) had elevated postoperative intraocular pressure, which returned to normal and was not device-related.

          Conclusion

          TFNT20 IOLs successfully reduced postoperative refractive cylinder and provided good distance, intermediate, and near uncorrected VAs in Japanese patients with low corneal astigmatism.

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          Most cited references28

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          Global and regional estimates of prevalence of refractive errors: Systematic review and meta-analysis

          Hassan Hashemi, Akbar Fotouhi, AbbasAli YEKTA … (2017)
          Purpose The aim of the study was a systematic review of refractive errors across the world according to the WHO regions. Methods To extract articles on the prevalence of refractive errors for this meta-analysis, international databases were searched from 1990 to 2016. The results of the retrieved studies were merged using a random effect model and reported as estimated pool prevalence (EPP) with 95% confidence interval (CI). Results In children, the EPP of myopia, hyperopia, and astigmatism was 11.7% (95% CI: 10.5–13.0), 4.6% (95% CI: 3.9–5.2), and 14.9% (95% CI: 12.7–17.1), respectively. The EPP of myopia ranged from 4.9% (95% CI: 1.6–8.1) in South–East Asia to 18.2% (95% CI: 10.9–25.5) in the Western Pacific region, the EPP of hyperopia ranged from 2.2% (95% CI: 1.2–3.3) in South-East Asia to 14.3% (95% CI: 13.4–15.2) in the Americas, and the EPP of astigmatism ranged from 9.8% in South-East Asia to 27.2% in the Americas. In adults, the EPP of myopia, hyperopia, and astigmatism was 26.5% (95% CI: 23.4–29.6), 30.9% (95% CI: 26.2–35.6), and 40.4% (95% CI: 34.3–46.6), respectively. The EPP of myopia ranged from 16.2% (95% CI: 15.6–16.8) in the Americas to 32.9% (95% CI: 25.1–40.7) in South-East Asia, the EPP of hyperopia ranged from 23.1% (95% CI: 6.1%–40.2%) in Europe to 38.6% (95% CI: 22.4–54.8) in Africa and 37.2% (95% CI: 25.3–49) in the Americas, and the EPP of astigmatism ranged from 11.4% (95% CI: 2.1–20.7) in Africa to 45.6% (95% CI: 44.1–47.1) in the Americas and 44.8% (95% CI: 36.6–53.1) in South-East Asia. The results of meta-regression showed that the prevalence of myopia increased from 1993 (10.4%) to 2016 (34.2%) (P = 0.097). Conclusion This report showed that astigmatism was the most common refractive errors in children and adults followed by hyperopia and myopia. The highest prevalence of myopia and astigmatism was seen in South-East Asian adults. The highest prevalence of hyperopia in children and adults was seen in the Americas.
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            Refractive errors in an elderly Japanese population: the Tajimi study.

            Aiko Iwase, Tetsuya Yamamoto, Makoto Araie … (2008)
            To evaluate the prevalence of refractive errors associated with age, gender, and central corneal thickness and to evaluate astigmatism in the refraction and keratometry in a randomly sampled elderly Japanese population. Population-based epidemiologic survey. A random sampling of residents of Tajimi, Japan, aged 40 years or older. A total of 3021 residents (participation rate, 78.1%) participated. Each subject underwent screening examinations including autokeratorefractometry, subjective refraction, best-corrected visual acuity, central corneal thickness measurement, intraocular pressure measurement, slit-lamp examination, fundus photography, and visual field testing. The prevalence of myopia (spherical equivalent [SE], 0.5 D), refractive astigmatism (cylinder, >0.5 D), and anisometropia (difference in SE between eyes, >1.0 D), and the correlation of refractive errors with age, gender, and central corneal thickness. Astigmatism in the refraction and keratometry was analyzed using polar value analysis and the vector calculation method. The crude prevalence of myopia, high myopia, hyperopia, refractive astigmatism in the refraction, and anisometropia was 41.8% (95% confidence interval [CI], 40.0%-43.6%), 8.2% (95% CI, 7.2%-9.2%), 27.9% (95% CI, 26.3%-29.6%), 54.0% (95% CI, 52.1%-55.8%), and 15.1% (95% CI, 13.7%-16.4%), respectively. The prevalence of myopia decreased with age up to 70 to 79 years but increased slightly in patients 80 years and older; the prevalence of hyperopia showed the opposite trend. The prevalence of astigmatism and anisometropia was higher in the older age groups. No significant gender difference was found associated with the refractive status except for keratometric readings. Polar value analysis and the vector calculation method showed a trend toward against-the-rule astigmatism with increasing age in both refractive and keratometric astigmatism, with a discrepancy between the two. The overall prevalence of myopia (SE, <-0.5 diopters) was 41.8% in the study population, which is higher than that in population-based studies previously reported.
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              Multifocal versus monofocal intraocular lenses after cataract extraction.

              Samantha R de Silva, Jennifer Evans, Varo Kirthi … (2016)
              Good unaided distance visual acuity (VA) is now a realistic expectation following cataract surgery and intraocular lens (IOL) implantation. Near vision, however, still requires additional refractive power, usually in the form of reading glasses. Multiple optic (multifocal) IOLs are available which claim to allow good vision at a range of distances. It is unclear whether this benefit outweighs the optical compromises inherent in multifocal IOLs.
              Article 0 comments Cited 87 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Ophthalmol
                Journal ID (iso-abbrev): Clin Ophthalmol
                Journal ID (publisher-id): opth
                Title: Clinical Ophthalmology (Auckland, N.Z.)
                Publisher: Dove
                ISSN (Print): 1177-5467
                ISSN (Electronic): 1177-5483
                Publication date (Electronic): 08 March 2024
                Publication date Collection: 2024
                Volume: 18
                Pages: 755-763
                Affiliations
                [1 ]Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital , Tokyo, Japan
                [2 ]Alcon Japan Ltd , Tokyo, Japan
                Author notes
                Correspondence: Hiroko Bissen-Miyajima, Department of Ophthalmology, Tokyo Dental College, Suidobashi Hospital , Kandamisaki‑cho 2‑9‑18, Chiyoda‑ku, Tokyo, 101‑0061, Japan, Tel +81-3-5275-1856, Email bissen@tdc.ac.jp
                Author information
                http://orcid.org/0000-0003-0417-2363
                Article
                Publisher ID: 448427
                DOI: 10.2147/OPTH.S448427
                PMC ID: 10929566
                PubMed ID: 38476355
                SO-VID: 9c65a86f-db01-4942-89fd-f42252168eed
                Copyright © © 2024 Bissen-Miyajima et al.
                License:

                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
                Date received : 09 November 2023
                Date accepted : 13 February 2024
                Page count
                Figures: 4, Tables: 1, References: 28, Pages: 9
                Funding
                Funded by: Alcon Vision LLC;
                This study was funded by Alcon Vision LLC. Alcon assisted with the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, and approval of the manuscript.
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: trifocal iol,toric iol,low corneal astigmatism,toric calculator,visual acuity
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: trifocal iol, toric iol, low corneal astigmatism, toric calculator, visual acuity

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