2 minute read
JCRS Highlights
THOMAS KOHNEN European Editor of JCRS
STANDARDISATION NECESSARY FOR TRIALS OF ADVANCED TECHNOLOGY IOLS
Studies assessing and comparing outcomes for enhanced monofocal, EDOF, and multifocal IOLs require an unambiguous standardisation of the measurements for refraction visual acuity and contrast sensitivity, according to updated recommendations. The authors note better harmonization of study design will give meta-analyses greater statistical power.
Among the recommendations, clinicians should 1) adjust manifest refraction to infinity rather than six metres, for example, by adding 0.25 D to the obtained refraction with a four-metre chart distance; 2) avoid using non-standardised charts or scales at intermediate and near distances and instead use ETDRS test and logMAR values; 3) clearly state and define the distances and luminance levels at which they measure visual acuities; 4) include the distances at which they measure contrast sensitivity; 5) predictability reports should contain the IOL calculation formula, the IOL constant, and the biometer used; and, 6) standardise patient satisfaction questionnaires to encompass questions regarding spectacle-dependence and visual symptoms. J Fernández et al., “Standard for collecting and reporting outcomes of IOL-based refractive surgery: update for enhanced monofocal, EDOF, and multifocal IOLs”, 48(11): 1235–1241.
Cataract patients without comorbidities almost always have better uncorrected distance visual acuity (UDVA) than their preoperative distance-corrected visual acuity (CDVA) by their first postoperative week following immediate sequential bilateral cataract surgery (ISBCS), according to a new chart review study. In the series of 116 patients who underwent ISBCS in 2019, postoperative UDVA was stable or improved compared with preoperative CDVA in 48% on the day of the procedure, 79% postoperative day one, and 90% postoperative week one. Furthermore, 92% of eyes had a UDVA of 20/40 or better on postoperative week one. Five of the remaining 18 eyes had limited visual potential due to comorbidities. K Kwedar et al., “Visual recovery after immediate sequential bilateral cataract surgery at a veterans’ hospital”, 48(11): 1260–1263.
NEW MULTIFOCAL PROVIDES BROAD RANGE OF VISION
The new Tecnis Synergy multifocal (ZFR00V) IOL can provide cataract patients with an extensive range of vision, particularly through near distances, and better mesopic performance than the AcrySof PanOptix Trifocal IOL (model TFNT00), according to a new study. Among 95 patients with Tecnis IOLs and 52 patients with AcrySof IOLs, most achieved 20/25 or better binocular CDVA (100% vs. 96.2%) and distance-corrected near visual acuity (DCNVA) measured 40 cm (88.4% vs. 75.0%) and 33 cm (78.9% vs. 51.9%) at three months follow-up. Mean binocular DCNVA at 40 cm was better by 0.5 Snellen lines in the Tecnis group than the AcrySof group. The mean binocular photopic and mesopic DCNVA at 33 cm was better by 0.8 Snellen lines in eyes with the Tecnis lens than the AcrySof lens and better by 0.5 lines in photopic high-contrast and low-contrast CDVA. Patientreported ocular symptoms and safety were generally similar in the two IOL groups. HB Dick et al., “Comparison of 3-month visual outcomes of a new multifocal intraocular lens vs a trifocal intraocular lens”, 48(11): 1270–1276.
