Yeni Nesil Odak Derinliği Arttırılmış Göz İçi Mercekleri
Özet
Katarakt ve refraktif cerrahide kullanılan göz içi mercekleri (GİM), hastaların uzak görüşün yanı sıra gözlüksüz yakın ve orta mesafe görüş taleplerini karşılamak üzere sürekli gelişmektedir. Geleneksel monofokal ve multifokal merceklerin yarattığı parlama, halo ve kontrast kaybı gibi dezavantajları gidermek amacıyla, son yıllarda odak derinliği arttırılmış (ODA) yeni mercek tasarımları geliştirilmiştir. ODA-GİM’ler, ışığı tek bir uzatılmış fokal noktaya odaklayarak uzak, orta ve yakın mesafelerde sürekli ve kaliteli bir görüş alanı sağlamayı ve disfotopsiyi en aza indirmeyi hedefler. Bu mercekler; sferik aberasyon veya pinhole etkisi kullanan "saf ODA-GİM'ler" ile difraktif veya refraktif bileşenleri birleştiren "hibrit MF-ODA-GİM'ler" olmak üzere iki temel gruba ayrılır. Laboratuvar ortamında başarılı sonuçlar veren bazı modeller klinikte stabilite sorunları yaşatabilirken, Amerikan Oftalmoloji Akademisi standartlarını tam karşılayan çalışmalar henüz sınırlıdır. Yakın mesafe görüş başarısı tartışmalı olsa da bu teknoloji hastaların yaşam tarzına uygun tedavi seçenekleri sunmaktadır.
Intraocular lenses (IOLs) used in cataract and refractive surgery are continuously evolving to meet patients' demands for spectacle-independent near and intermediate vision alongside sharp distance vision. To address drawbacks like glare, halos, and reduced contrast sensitivity caused by traditional monofocal and multifocal lenses, new designs with extended depth of focus (EDOF) have been developed in recent years. EDOF-IOLs aim to provide a continuous, high-quality visual range across distant, intermediate, and near points with minimized dysphotopsia by focusing light into a single elongated focal point. These lenses are categorized into two primary groups: "pure EDOF-IOLs," which utilize spherical aberration or the pinhole effect, and "hybrid MF-EDOF-IOLs," which integrate diffractive or refractive components. While certain models yielding successful laboratory outcomes face stability issues in clinical settings, studies fully satisfying the American Academy of Ophthalmology criteria remain limited. Although efficacy regarding near vision is still debated, this technology offers critical alternative treatment pathways tailored to patients' unique lifestyles.
Referanslar
Grzybowski A KP. Recent Developments in Cataract Surgery. Vol 124 Cham: (Grzybowski A, ed.). Springer International; 2020.
Talley-Rostov A. Patient-centered care and refractive cataract surgery. Current Opinion in Ophthalmology. 2008;19(1). doi:10.1097/ICU.0b013e3282f2d7a3.
Finkelman YM, Ng JQ, Barrett GD. Patient satisfaction and visual function after pseudophakic monovision. Journal of Cataract and Refractive Surgery. 2009;35(6). doi:10.1016/j.jcrs.2009.01.035.
Labiris G, Toli A, Perente A, Ntonti P, Kozobolis VP. A systematic review of pseudophakic monovision for presbyopia correction. International Journal of Ophthalmology. 2017;10(6). doi:10.18240/ijo.2017.06.24.
Sieburth R, Chen M. Intraocular lens correction of presbyopia. Taiwan Journal of Ophthalmology. 2019;9(1). doi:10.4103/tjo.tjo_136_18.
Kohnen T, Nuijts R, Levy P, Haefliger E, Alfonso JF. Visual function after bilateral implantation of apodized diffractive aspheric multifocal intraocular lenses with a +3.0 D addition. Journal of Cataract and Refractive Surgery. 2009;35(12). doi:10.1016/j.jcrs.2009.08.013.
Steinert RF, Aker BL, Trentacost DJ, Smith PJ, Tarantino N. A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens. Ophthalmology. 1999;106(7). doi:10.1016/S0161-6420(99)00704-6.
de Silva SR, Evans JR, Kirthi V, Ziaei M, Leyland M. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database of Systematic Reviews. 2016;2016(12). doi:10.1002/14651858.CD003169.pub4.
Bellucci R, Cargnoni M, Bellucci C. Clinical and aberrometric evaluation of a new extended depth-of-focus intraocular lens based on spherical aberration. Journal of Cataract and Refractive Surgery. 2019;45(7). doi:10.1016/j.jcrs.2019.02.023.
Cochener B. Clinical outcomes of a new extended range of vision intraocular lens: International Multicenter Concerto Study. Journal of Cataract and Refractive Surgery. 2016;42(9). doi:10.1016/j.jcrs.2016.06.033.
Alio JL, Plaza-Puche AB, Férnandez-Buenaga R, Pikkel J, Maldonado M. Multifocal intraocular lenses: An overview. Survey of Ophthalmology. 2017;62(5). doi:10.1016/j.survophthal.2017.03.005.
Kanclerz P, Toto F, Grzybowski A, Alio JL. Extended depth-of-field intraocular lenses: An update. Asia-Pacific Journal of Ophthalmology. 2020;9(3). doi:10.1097/APO.0000000000000296.
Domínguez-Vicent A, Esteve-Taboada JJ, del Águila-Carrasco AJ, Ferrer-Blasco T, Montés-Micó R. In vitro optical quality comparison between the Mini WELL Ready progressive multifocal and the TECNIS Symfony. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2016;254(7). doi:10.1007/s00417-015-3240-7.
Domínguez-Vicent A, Esteve-Taboada JJ, del Águila-Carrasco AJ, Monsálvez-Romin D, Montés-Micó R. In vitro optical quality comparison of 2 trifocal intraocular lenses and 1 progressive multifocal intraocular lens. Journal of Cataract and Refractive Surgery. 2016;42(1). doi:10.1016/j.jcrs.2015.06.040.
Gallego AA, Bará S, Jaroszewicz Z, Kolodziejczyk A. Visual strehl performance of IOL designs with extended depth of focus. Optometry and Vision Science. 2012;89(12). doi:10.1097/OPX.0b013e3182775e1a.
Böhm M, Petermann K, Hemkeppler E, Kohnen T. Defocus curves of 4 presbyopia-correcting IOL designs: Diffractive panfocal, diffractive trifocal, segmental refractive, and extended-depth-of-focus. Journal of Cataract and Refractive Surgery. 2019;45(11). doi:10.1016/j.jcrs.2019.07.014.
Alio JL. Presbyopic lenses: Evidence, masquerade news, and fake news. Asia-Pacific Journal of Ophthalmology. 2019;8(4). doi:10.1097/01.APO.0000577792.28242.2d.
Nakazawa M, Ohtsuki K. Apparent accommodation in pseudophakic eyes after implantation of posterior chamber intraocular lenses: Optical analysis. Investigative Ophthalmology and Visual Science. 1984;25(12).
Savini G, Schiano-Lomoriello D, Balducci N, Barboni P. Visual performance of a new extended depth-of-focus intraocular lens compared to a distance-dominant diffractive multifocal intraocular lens. Journal of Refractive Surgery. 2018;34(4). doi:10.3928/1081597X-20180125-01.
Savini G, Balducci N, Carbonara C, et al. Functional assessment of a new extended depth-of-focus intraocular lens. Eye (Basingstoke). 2019;33(3). doi:10.1038/s41433-018-0221-1.
Lai YJ, Yeh SI, Cheng HC. Distribution of corneal and ocular spherical aberrations in eyes with cataract in the Taiwanese population. Taiwan Journal of Ophthalmology. 2015;5(2). doi:10.1016/j.tjo.2015.03.003.
Cheng H, Barnett JK, Vilupuru AS, et al. A population study on changes in wave aberrations with accomodation. Journal of Vision. 2004;4(4). doi:10.1167/4.4.3.
Campbell FW. The Depth of Field of the Human Eye. Optica Acta: International Journal of Optics. 1957;4(4). doi:10.1080/713826091.
Narang P, Agarwal A, Ashok Kumar D, Agarwal A. Pinhole pupilloplasty: Small-aperture optics for higher-order corneal aberrations. Journal of Cataract and Refractive Surgery. 2019;45(5). doi:10.1016/j.jcrs.2018.12.007.
Breyer DRH, Kaymak H, Ax T, Kretz FTA, Auffarth GU, Hagen PR. Multifocal intraocular lenses and extended depth of focus intraocular lenses. Asia-Pacific Journal of Ophthalmology. 2017;6(4). doi:10.22608/APO.2017186.
SIFI Medtech. Supplement -Mini Well – EuroTimes. Available from: https://www.eurotimes.org/sifi-medtech-supplement-mini-well/. (Accessed 16th June 2022).
Giers BC, Khoramnia R, Varadi D, et al. Functional results and photic phenomena with new extended-depth-of-focus intraocular Lens. BMC Ophthalmology. 2019;19(1). doi:10.1186/s12886-019-1201-3.
WIOL-CF. WIOL-CF Cilnical Results. Available from: http://www.wiols.com/data/files/ files/dokumenty-lekar/WIOL-CF_Clinical_Results_EN_201310_pages.pdf. (Accessed 16th June 2022).
Kim YC, Kang KT, Yeo Y, Kim KS, Siringo FS. Consistent pattern in positional instability of polyfocal full-optics accommodative IOL. International Ophthalmology. 2017;37(6). doi:10.1007/s10792-016-0398-x.
Lee Y, Kim Y. In-the-bag dislocation of polyfocal full-optics accommodative intraocular lens: A case report. Indian Journal of Ophthalmology. 2019;67(7). doi:10.4103/ijo.IJO_1552_18.
Kang KT, Kim YC. Dislocation of polyfocal full-optics accommodative intraocular lens after neodymium-doped yttrium aluminum garnet capsulotomy in vitrectomized eye. Indian Journal of Ophthalmology. 2013;61(11). doi:10.4103/0301-4738.119335.
Studeny P, Krizova D, Urminsky J. Clinical experience with the WIOL-CF accommodative bioanalogic intraocular lens: Czech national observational registry. European Journal of Ophthalmology. 2016;26(3). doi:10.5301/ejo.5000653.
Siatiri H, Mohammadpour M, Gholami A, Ashrafi E, Siatiri N, Mirshahi R. Optical aberrations, accommodation, and visual acuity with a bioanalogic continuous focus intraocular lens after cataract surgery. Journal of Current Ophthalmology. 2017;29(4). doi:10.1016/j.joco.2017.06.007.
Pallikaris IG, Portaliou DM, Kymionis GD, Panagopoulou SI, Kounis GA. Outcomes after accommodative bioanalogic Intraocular Lens implantation. Journal of Refractive Surgery. 2014;30(6). doi:10.3928/1081597X-20140520-01.
The Ophthalmologist. The New TECNIS Eyhance Monofocal IOL Available from: https://theophthalmologist.com/subspecialties/delivering-intermediate-vision-the-new-tecnis-eyhance-monofocal-iol. (Accessed 16th June 2022).
Burkhard Dick H, Elling M, Schultz T. Binocular and monocular implantation of small-aperture intraocular lenses in cataract surgery. Journal of Refractive Surgery. 2018;34(9). doi:10.3928/1081597X-20180716-02.
Dick HB, Piovella M, Vukich J, et al. Prospective multicenter trial of a small-aperture intraocular lens in cataract surgery. Journal of Cataract and Refractive Surgery. 2017;43(7). doi:10.1016/j.jcrs.2017.04.038.
Hooshmand J, Allen P, Huynh T, et al. Small aperture IC-8 intraocular lens in cataract patients: achieving extended depth of focus through small aperture optics. Eye (Basingstoke). 2019;33(7). doi:10.1038/s41433-019-0363-9.
Ang RE. Visual performance of a small-aperture intraocular lens: First comparison of results after contralateral and bilateral implantation. Journal of Refractive Surgery. 2020;36(1). doi:10.3928/1081597X-20191114-01.
Grabner G, Ang RE, Vilupuru S. The Small-Aperture IC-8 Intraocular Lens: A New Concept for Added Depth of Focus in Cataract Patients. American Journal of Ophthalmology. 2015;160(6). doi:10.1016/j.ajo.2015.08.017.
Agarwal P, Navon SE, Subudhi P, Mithal N. Persistently poor vision in dim illumination after implantation of XtraFocus small-aperture IOL (Morcher). BMJ Case Reports. 2019;12(11). doi:10.1136/bcr-2019-232473.
Power B, Murphy R, Leccisotti A, Moore T, Power W, O’Brien P. Maximising Refractive Outcomes with an Extended Depth of Focus IOL. The Open Ophthalmology Journal. 2018;12(1). doi:10.2174/1874364101812010273.
Kohnen T, Böhm M, Hemkeppler E, et al. Visual performance of an extended depth of focus intraocular lens for treatment selection. Eye (Basingstoke). 2019;33(10). doi:10.1038/s41433-019-0443-x.
Pedrotti E, Bruni E, Bonacci E, Badalamenti R, Mastropasqua R, Marchini G. Comparative analysis of the clinical outcomes with a monofocal and an extended range of vision intraocular lens. Journal of Refractive Surgery. 2016;32(7). doi:10.3928/1081597X-20160428-06.
Bozukova D, Pagnoulle C, Jérôme C. Biomechanical and optical properties of 2 new hydrophobic platforms for intraocular lenses. Journal of Cataract and Refractive Surgery. 2013;39(9). doi:10.1016/j.jcrs.2013.01.050.
Asqelio Product. Asqelio Premium Intraocular Lenses. Available from: https://www.astp.com/new-page. (Accessed 14th July 2022).
Akondi V, Pérez-Merino P, Martinez-Enriquez E, et al. Evaluation of the true wavefront aberrations in eyes implanted with a rotationally asymmetric multifocal intraocular lens. Journal of Refractive Surgery. 2017;33(4). doi:10.3928/1081597X-20161206-03.
Gillmann K, Mermoud A. Visual Performance, Subjective Satisfaction and Quality of Life Effect of a New Refractive Intraocular Lens with Central Extended Depth of Focus. Klinische Monatsblatter fur Augenheilkunde. 2019;236(4). doi:10.1055/a-0799-9700.
Nivean M, Nivean PD, Reddy JK, et al. Performance of a new-generation extended depth of focus intraocular lens-a prospective comparative study. Asia-Pacific Journal of Ophthalmology. 2019;8(4). doi:10.1097/APO.0000000000000245.
Swiss Advanced Vision. InFo Swiss Made EDOF IOL Premium Hybrid Design. Available from: https://sav-iol.com/technology/. (Accessed 14th July 2022)
Swiss Advanced Vision. EDEN Avaliable from: https://sav-iol.com/product-eden/eden/. (Accessed 14th July 2022)
Swiss Advanced Vision. HARMONIS. Avaliable from: https://sav-iol.com/product-harmonis/harmonis/. (Accessed 14th July 2022)
MacRae S, Holladay JT, Glasser A, et al. Special Report: American Academy of Ophthalmology Task Force Consensus Statement for Extended Depth of Focus Intraocular Lenses. Ophthalmology. 2017;124(1). doi:10.1016/j.ophtha.2016.09.039.
Kohnen T, Suryakumar R. Extended depth-of-focus technology in intraocular lenses. Journal of Cataract and Refractive Surgery. 2020;46(2). doi:10.1097/j.jcrs.0000000000000109.
Titiyal JS, Kaur M, Bharti N, Singhal D, Saxena R, Sharma N. Optimal near and distance stereoacuity after binocular implantation of extended range of vision intraocular lenses. Journal of Cataract and Refractive Surgery. 2019;45(6). doi:10.1016/j.jcrs.2018.12.024.
Alio´ JL PJ. Multifocal Intraocular Lenses: Neuroadaptation.. . 2nd Ed. (Alio´ JL PJ, ed.). Cham, Switzerland: Springer International Publishing; 2019.
