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      Refractive Lens Exchange in Hyperopic Presbyopes with the Acrysof IQ Panoptix Intraocular Lens: One-Year Results and Analysis of the Literature

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          Abstract

          Purpose

          To assess the functional and refractive outcomes in hyperopia and presbyopia correction by clear lens exchange with the intraocular trifocal artificial lens (IOL) Acrysof IQ Panoptix implant at 1 year.

          Materials and Methods

          A number of 128 eyes (64 patients) underwent clear lens exchange with placement of the trifocal IOL Acrysof IQ Panoptix implant for hyperopia and presbyopia. Prior to the surgery the patients had a complete ocular examination. In all cases the artificial lens was implanted in the bag without any intraoperative complications. Visual acuity (VA) at distance, intermediate and near and ocular refraction were evaluated at 4 weeks, 6 and 12 months postoperatively.

          Results

          The mean age was 53.49 ±7.377 years old (range 40–73 years). As high as 51.57% of the patients were males and 48.43% were females. The mean achieved refraction was 0.26 ± 0.73D. Almost 60.93% of patients were within ±0.25D of the target refraction, with 82.03% eyes within ±0.50D of the planned correction. At 1 year after surgery, 96.45% of eyes had a stable refraction (p >0.05). At 1 year, a total of 92.25%, 89.92% and 91.47% achieved a monocular uncorrected distance, intermediate and near visual acuity of 0.2 logarithm of the minimum angle of resolution or better, respectively. At the same time point, a total of 95.35%, 91.47% and 93.80% achieved a binocular uncorrected distance, intermediate and near visual acuity of 0.2 logarithm of the minimum angle of resolution or better, respectively. There was no statistically significant difference (p>0.05) between the postoperative uncorrected and best corrected VA (distance, intermediate, near) at 6 months and postoperative uncorrected and best corrected VA (distance, intermediate, near) at 12 months. None of our patients had any intraoperative complications. Two cases (1.56%) developed posterior capsule opacification. Twelve patients (18.75%) complained about photic phenomena such as glare and haloes, but this symptom disappeared after 6 months postoperatively. As high as93.56% of patients had a high satisfaction with the outcomes of the surgery. Spectacle independence was obtained in 97.65% eyes.

          Conclusion

          The Acrysof Panoptix trifocal artificial lens offers a good vision at distance, intermediate and near, with a good quality of vision and refraction.

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          Most cited references 34

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          Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis.

          Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment.
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            A Comparative Evaluation of a New Generation of Diffractive Trifocal and Extended Depth of Focus Intraocular Lenses

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              Efficacy and safety of multifocal intraocular lenses following cataract and refractive lens exchange: Metaanalysis of peer-reviewed publications.

              We performed a metaanaysis of peer-reviewed studies involving implantation of a multifocal intraocular lens (IOL) in presbyopic patients with cataract or having refractive lens exchange (RLE). Previous reviews have considered the use of multifocal IOLs after cataract surgery but not after RLE, whereas greater insight might be gained from examining the full range of studies. Selected studies were examined to collate outcomes with monocular and binocular uncorrected distance, intermediate, and near visual acuity; spectacle independence; contrast sensitivity; visual symptoms; adverse events; and patient satisfaction. In 8797 eyes, the mean postoperative monocular uncorrected distance visual acuity (UDVA) was 0.05 logMAR ± 0.006 (SD) (Snellen equivalent 20/20(-3)). In 6334 patients, the mean binocular UDVA was 0.04 ± 0.00 logMAR (Snellen equivalent 20/20(-2)), with a mean spectacle independence of 80.1%. Monocular mean UDVA did not differ significantly between those who had a cataract procedure and those who had an RLE procedure. Neural adaptation to multifocality may vary among patients.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Ther Clin Risk Manag
                tcrm
                tcriskman
                Therapeutics and Clinical Risk Management
                Dove
                1176-6336
                1178-203X
                19 November 2020
                2020
                : 16
                : 1125-1137
                Affiliations
                [1 ]Department of Ophthalmology, Medicine and Pharmacy University “Iuliu Hațieganu” , Cluj Napoca, Romania
                [2 ]Oculens Clinic , Cluj-Napoca, Romania
                [3 ]Department of Ophthalmology, Eye County Hospital , Cluj-Napoca, Romania
                [4 ]Department of Pathophysiology, Medicine and Pharmacy University “Iuliu Hațieganu” , Cluj Napoca, Romania
                [5 ]Department of Neurology, Medicine and Pharmacy University “Iuliu Hațieganu” , Cluj Napoca, Romania
                Author notes
                Correspondence: Cristina Ariadna Nicula Department of Ophthalmology, Medicine and Pharmacy University “Iuliu Hațieganu” , Cluj Napoca, RomaniaTel +40-722849575 Email niculacristina65@yahoo.com
                Article
                279065
                10.2147/TCRM.S279065
                7682609
                © 2020 Nicula 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).

                Page count
                Figures: 4, Tables: 8, References: 34, Pages: 13
                Categories
                Original Research

                Medicine

                clear lens exchange, trifocal artificial lens, presbyopia, hyperopia

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