Background: To compare the visual outcomes and optical quality of patients who underwent bilateral implantation of EDOF (AcrySof^® IQ Vivity IOL, DFT015) for mini-monovision, trifocal (AcrySof^® IQ PanOptix, TNFT00), or monofocal (AcrySof^® IQ IOL, SN60WF) IOL. Methods: The monocular-corrected and uncorrected distance visual acuities (CDVA and UDVA, respectively) were evaluated postoperatively at 1 and 3 months. The binocular visual acuity by distance, the binocular defocus curve, contrast sensitivity, and patient satisfaction were examined 3 months postoperatively. All patients were asked to complete questionnaires regarding their satisfaction, visual symptoms, and spectacle dependency. Results: This study included 178 eyes from 89 patients. The postoperative binocular UDVA did not differ significantly among the three groups. In the defocus curve, the Vivity group showed better visual acuity over a range of far and intermediate (60 cm) than the other two IOLs groups. In near-vision, the PanOptix group showed the best near-vision, and the Vivity group showed significantly better vision than the IQ group. The Vivity group showed contrast sensitivity and optical quality comparable to the IQ group. Conclusions: The bilateral implantation of AcrySof^® IQ Vivity IOL with the mini-monovision approach provided excellent distance and intermediate visual acuity with good near-vision, resulting in high satisfaction.

The Clareon PanOptix (CNWT) IOL is a newer trifocal IOL made from a glistening-free hydrophobic acrylic material incorporating hydroxyethyl methacrylate (HEMA). While its predecessor (TFNT) has established clinical outcomes, long-term data. This study aimed to evaluate the refractive and visual outcomes during a 1-year follow-up after CNWT implantation in one eye, with a different type of refractive multifocal or extended depth of focus IOL in the contralateral eye (mix- and match setting). This was a retrospective, single-arm case series conducted at the single eye clinic, Seoul, Republic of Korea. The study included patients who underwent cataract surgery with mix-and-match IOL implantations, receiving a CNWT in one eye. Data were collected from the eyes with a CNWT. Monocular uncorrected distance visual acuity (UCDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UCNVA), and manifest refraction were analyzed from measurements taken at 1, 3, 6, and 12 months postoperatively. Rates and causes of secondary surgical intervention, such as IOL exchange and toric IOL axis readjustment, were also investigated. Statistical analysis involved Kolmogorov-Smirnov tests for normality and t-tests for comparisons, with p <.05 considered significant. Data from 897 eyes (out of 1282 initially screened) with continuous measurements and no secondary interventional surgeries were included in the primary monocular visual acuity and refractive analysis. UCDVA of LogMAR 0.0 or better increased from 50.91% at 1 month to 85.95% at 12 months. CDVA of LogMAR 0.0 or better improved from 89.52% at 1 month to 98.1% at 12 months. At 12 months, 94.09% of eyes achieved UCNVA of LogMAR 0.1 or better. A slight mean hyperopic shift (+ 0.07D) was observed up to 12 months. Toric CNWT IOLs were used in 71.0% of these eyes, with 88.07% achieving manifest refractive astigmatism of ≤ -0.75D at 12 months. Overall, 85 out of 1282 eyes (6.63%) underwent secondary surgery: 4.45% for IOL exchange and 2.18% for toric IOL axis readjustment. Post-reoperation, UCDVA and UCNVA significantly improved. The new hydrophobic acrylic trifocal IOL (CNWT) with HEMA demonstrated significant improvements in visual acuity and stable refractive outcomes over one year in a mix-and-match setting. The use of toric CNWT IOLs effectively reduced astigmatism. These findings suggest that this IOL is a reliable option for enhancing visual quality and reducing spectacle dependency in this specific implantation context. Despite the low rate of reoperations, the results underscore the ongoing need for advancements in biometric measurements and IOL power calculation formulas to further minimize such interventions.

This study aimed to evaluate the spherical aberration (SA) in different corneal areas before and after femtosecond laser-assisted in situ keratomileusis (fLASIK) and transepithelial photorefractive keratectomy (tPRK), with the goal of identifying the limitations of and potential improvements in using SA within a 6 mm area. The study included 62 patients who underwent fLASIK and tPRK. Complete eye examinations including keratometry, corneal epithelial thickness, central corneal thickness, and topography were performed preoperatively and postoperatively. Anterior, posterior, and total corneal aberrations were measured preoperatively and three months postoperatively, with pupil diameters ranging from 2 to 8 mm. In the fLASIK group, compared to the preoperative SA, the anterior and total SA increased postoperatively in the 6 and 7 mm areas. In the tPRK group, meanwhile, the anterior and total SA of the 5 mm or larger areas increased postoperatively. An area of 6 mm or larger showed an increase in correlation with the changes in Q value and refractive correction. As the corneal SA and asphericity in the 6 mm zone cannot specifically demonstrate the status of areas smaller than 6 mm or changes in the optical zone after laser refractive surgery, comparison with normal values in various areas of the cornea is necessary.

Purpose: To evaluate the outcomes of wavefront-optimized (WFO) and topography-guided (TG) transepithelial photorefractive keratectomy (transPRK) in the treatment of myopia and myopic astigmatism.Methods: Patients who underwent transPRK using the WaveLight EX500 excimer laser for the correction of myopia and myopic astigmatism between January 2022 and March 2023 were divided into groups of WFO transPRK (77 eyes of 36 patients) or TG transPRK (63 eyes of 31 patients) in this retrospective, observational cohort study. The preoperative and postoperative 3-month refractive and visual outcomes of the two groups were analyzed.Results: In both groups, the uncorrected distance visual acuity was 0.0 logarithm of the minimum angle of resolution or better in 95% of eyes 3 months postoperatively, and the mean manifest refraction spherical equivalent was within ±1.0 diopter in 90% of eyes. No significant differences were observed between the groups in terms of the uncorrected distance visual acuity or astigmatism. A significant induction of higher order aberrations (HOAs) was observed in both groups. However, the induction of total corneal HOAs (p = 0.014) and spherical aberrations (p < 0.001) was significantly lower in the TG group than that in the WFO group.Conclusions: WFO and TG transPRK effectively improved the visual and refractive outcomes; however, the induction of total corneal HOAs and spherical aberration was lesser following the TG ablation.

This case report presents a unique approach to vision restoration following the implantation of an extended depth of focus (EDOF) intraocular lens (IOL) in an eye with negative corneal spherical aberration (SA) within a 4-mm area. Vision was successfully restored by modifying the corneal SA through topography-guided ablation (TGA). This novel combination of EDOF IOL implantation and TGA provides a potential solution for optimizing postoperative visual outcomes in patients with atypical asphericity induced by refractive surgeries. A patient who had undergone LASIK surgery underwent EDOF IOL implantation to treat cataracts. Although no significant issues were noted during a routine preoperative examination, he complained of blurry vision postoperatively. Furthermore, his best-corrected visual acuity was decreased compared with the preoperative level. A reevaluation of the preoperative examination results revealed that the anterior corneal SA within the 2–4-mm zone was negative, whereas the primary corneal SA (6-mm zone) and total higher-order aberration (4-mm zone) remained within the normal range, measuring 0.155 μm and 0.150 μm, respectively. To correct the negative SA, TGA was performed after lifting of the flap. Consequently, an uncorrected distance visual acuity of 0.0 (logMAR) was achieved at 1 month postoperative. Given that most presbyopia-correcting IOL are designed with a negative SA to compensate for a positive corneal SA, assessing the SA in the pupil area is crucial to the success of multifocal IOL implantation.

Background: We aimed to evaluate the feasibility, safety, and efficiency of Corneal Lenticule Extraction for Advanced Refractive Correction (CLEAR) enhancement performed after primary CLEAR. Methods: Six eyes from five patients underwent enhancement to correct residual myopic error. All procedures were carried out with the low-energy FEMTO LDV Z8 laser platform (Ziemer Ophthalmic Systems AG, Port, Switzerland) equipped with integrated optical coherence tomography enabling precise lenticule positioning. Results: The myopic residual refractive sphere was fully corrected in all cases, with refraction remaining stable over the follow-up period. All eyes showed improvement in uncorrected distance visual acuity after retreatment with CLEAR and achieved 20/20 vision or better at the final follow-up visit. Conclusions: Our results suggest that CLEAR enhancement is a safe and effective option for treating residual myopic refractive error after primary CLEAR, keeping the procedure flapless.