Purpose: To evaluate the visual acuity, defocus curve and visual quality of life following bilateral implantation of a new hybrid extended depth of focus (EDOF)-multifocal diffractive intraocular lens (IOL). Methods: Patients who underwent cataract surgery with bilateral implantation of Tecnis Synergy IOL were enrolled in this study. The main outcomes were defined as uncorrected distant, intermediate and near visual acuities (UDVA, UIVA and UNVA, respectively), defocus curve and VF-14 questionnaire aimed for visual performance. Results: The mean ± SD values for binocular UDVA, UIVA and UNVA were −0.01 ± 0.04, 0.05 ± 0.03 and 0.03 ± 0.05 logMAR, respectively. Defocus curve showed a continuous vision above 0.16 logMAR between +0.50 D and −2.50 D. Patients had good visual performance with mean VF-14 scores above 3 points. Driving at night (3.47 ± 0.64) was found to be the most difficult task to perform. Spectacle independence was 100% for both distant and near vision. Conclusion: Bilateral implantation of Tecnis Synergy IOL in cataract patients shows good visual acuity and performance, covering a good visual range without any need of spectacles.

Cataract is the most common cause of preventable blindness and vision loss where the only treatment is surgical replacement of the natural lens with an intraocular lens. Computer-generated holography (CGH) enables to control phase, size, and shape of the light beam entering through the eye-pupil. We developed a holographic vision simulator to assess visual acuity for patients to experience the postoperative corrected vision before going through surgery. A holographically shaped light beam is directed onto the retina using small non-cataractous regions of the lens with the help of a pupil tracker. A Snellen chart hologram is shown to subjects at desired depth with myopia and hyperopia correction. Tests with 13 patients demonstrated substantial improvements in visual acuity and the simulator results are consistent with the post-operative vision tests. Holographic simulator overperforms the existing vision simulators, which are limited to static pinhole exit pupils and incapable of correcting aberrations.

To compare visual acuity, defocus curve and visual quality of life performances of a new hybrid refractive-diffractive intraocular lens (IOL) and a trifocal diffractive IOL. Patients who underwent cataract surgery with bilateral implantation of ZFR00V or TFNT00 IOLs were enrolled in this study. The main outcomes were defined as uncorrected distant, intermediate and near visual acuities (UDVA, UIVA and UNVA, respectively), defocus curve and VF-14 questionnaire aimed for visual performance. Fifty patients, of whom 30 had bilateral ZFR00V implantation, were enrolled in the study. Patients with ZFR00V had significantly better UIVA than patients with TFNT00 (0.05 ± 0.03 vs. 0.07 ± 0.04 logMAR, P = 0.02). Defocus curve showed significantly higher visual acuity in intermediate range for ZFR00V IOL between −1.00 and −1.50 dioptres (all P < 0.05). All patients had good visual performance with mean VF-14 scores above 3 points with no significant difference between two IOL models. Spectacle independence was 100% for both distant and near vision in both group of patients. Bilateral implantation of ZFR00V in cataract patients shows better intermediate visual acuity scores and similar daily visual performance when compared with trifocal TFNT00 IOL.

Purpose: To investigate the corneal subbasal nerve plexus (SBP) and dendritic cell (DC) density changes in patients with thyroid-related ophthalmopathy (TAO) using in vivo confocal microscopy (IVCM). Methods: Thirty-three patients with inactive TAO and 36 healthy controls were included. All participants underwent comprehensive ophthalmologic examinations and IVCM. Corneal nerve fiber length (CNFL), density (CNFD), branch density (CNBD), total branch density (CTBD), fiber area (CNFA), fiber width (CNFW), fractal dimension (CNFrD) and DC density were analyzed using semi-automated and automated methods. Clinical features, ocular surface parameters, and correlations with IVCM findings were assessed. Results: TAO patients exhibited significant reductions in CNFL, CNFD, CNBD, CTBD, CNFA, CNFrD and increased DC density compared to controls ( p < 0.05). CNBD and CNFrD demonstrated the highest diagnostic sensitivity and specificity. Corneal nerve damage and increased DC density correlated with worsened ocular surface parameters, including reduced non-invasive average tear break-up time, The Schirmer test values and increased ocular surface disease index score. No significant association was found between IVCM parameters and systemic markers such as Clinical Activity Score, thyroid-stimulating hormone (TSH) and disease duration. Conclusion: TAO patients show corneal nerve degeneration and inflammation detectable by IVCM. These findings highlight immune-mediated mechanisms underlying corneal SBP damage and their association with ocular surface dysfunction, underscoring the potential of IVCM in clinical assessments and targeted therapeutic strategies.