Alcon cachet lens 2013

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There was no significant difference between the two groups in terms of postoperative RMS of the total HOAs Figure 2 , coma Figure 3 , or spherical Figure 4 aberrations. Only the effective blur Figure 5 was significantly lower in the ICL group patients compared to the Cachet group Table 2. Abbreviations: ICL, implantable contact lens; post, postoperative; pre, preoperative. Abbreviations: ICL, implantable contact lens; post, postoperative; pre, preoperative; SA, spherical aberrations.

B Coma aberrations. C Spherical aberrations. The goal of refractive surgery is to safely and predictably create a stable and desired refractive state without causing new optical problems. In order to correct myopia the refractive power of the eye must be decreased, either by corneal refractive surgery, flattening the curvature of the anterior corneal surface, or by lenticular refractive surgery, through insertion of a PIOL of appropriate power 2 or by refractive lens exchange.

It has also been shown that PIOLs provide better visual quality, faster visual recovery, excellent refractive accuracy and stability, improved visual acuity, preservation of accommodation, and reversibility when compared to corneal surgery. Over the past few years, the concern with the ocular aberrations, especially HOAs, in any refractive surgical procedure is increasing. The most prevalent HOAs in studies of the normal population were from 3rd order horizontal trefoil, vertical coma, horizontal coma, and oblique trefoil and 4th order horizontal and oblique tetrafoil, horizontal and vertical secondary astigmatism, and spherical Zernike terms.

The contribution of each HOA progressively decreased with order except the 4th order spherical aberration. Despite the variability between studies addressing this subject, the anterior corneal 4th order spherical aberration had positive values.

This should negate most of the corneal positive spherical aberrations or even exceed it. In this study, we evaluated the total and not internal HOA for two reasons; first to study the end effect of the lens after interacting with both internal and corneal HOAs especially spherical aberrations and second to include the changes that can occur in the corneal HOA due to the surgery itself, especially the incision 11 , 18 , 19 even though its small size should not have much impact on the outcome of the procedure.

In our patient sample, the postoperative change in spherical aberrations RMS from positive to negative in each group separately and in the total study population was statistically significant due to the negative spherical aberrations induced by the PIOLs, while the total and coma aberration RMS change was not statistically significant Figure 1 and Table 1.

Even in other studies that considered the patient satisfaction in terms of visual acuity, quality of vision or halos and glare, PIOL implantation proved to be better when the Cachet, 10 , 28 ICL 17 , 29 or both 26 , 30 were evaluated.

Regarding the other parameters evaluated, there was a statistically significant improvement in postoperative spherical equivalent refraction in each group separately as well as in the total study population.

This is expected as the PIOL corrected the pre-existing refractive error. Safety and efficacy of both PIOLs have been previously studied. This was not the case among the ICL group in whom the three toric ICLs were implanted, which significantly improved the pre- existing astigmatic error Table 1. When both PIOLs were compared Table 2 , no statistically significant difference existed between all preoperative parameters except for the spherical equivalent.

Postoperatively, again both PIOLs showed similar behavior, with no statistically significant difference between all parameters including the induction of aberrations, except for the postoperative cylinder and the effective blur which were significantly better in the ICL group.

The reduction in the cylindrical refraction in the ICL groups could be explained by the use of the three toric implants in this group, which resulted in a significantly lower postoperative cylindrical error compared to the Cachet group in whom no toric implants were used.

The reduction in the postoperative cylindrical error in the ICL group, together with the ICL being implanted behind the iris the shutter of the ocular optical system could explain the effective blur being significantly lower in the ICL group compared to the Cachet PIOL which is implanted in the anterior chamber, in front of the iris with an unchanged astigmatic error.

Though each of the PIOLs studied in our work was evaluated separately in multiple previous studies, 10 , 11 , 17 , 19 , 26 — 30 to our knowledge, this is the first study to compare both PIOLs with respect to the induction of total HOAs, coma, and spherical aberrations.

We found a similar behavior between both PIOLs in almost all parameters. Both PIOLs had no significant effect on the induction of total HOAs and coma aberrations, but significantly reduced the spherical aberrations in a similar manner.

Evaluating both PIOLs on a larger population, with a longer follow up might yield more accurate and reliable results. Also, considering the toric models of both PIOLs in further, more comprehensive studies might add to our knowledge regarding the aberrometric performance of these implants. Clin Ophthalmol. Published online Jul Author information Copyright and License information Disclaimer. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

Results Preoperatively, there were no significant differences in any studied parameters, except for preoperative spherical equivalent. Keywords: high myopia, higher order aberrations, refractive procedures, phakic implants. Introduction Phakic intraocular lenses PIOL for the treatment of myopia, approved by the US Food and Drug Administration FDA in September , 1 work by diverging light rays so that the image of a viewed object is brought into focus onto the retina rather than in front of the retina.

Patients and methods Our study was performed on 38 eyes from 29 patients with an age range of 23—32 years. Results Our study was performed on 38 eyes from 29 patients with an age range of 23—32 years, divided into two groups.

Open in a separate window. Figure 1. HOA analysis. Table 1 Patient data in the study population. Figure 2. Total HOAs in both groups. Notes: A Cachet. B Visian ICL. Figure 3. Coma aberrations in both groups. Figure 4. Spherical aberrations in both groups. Figure 5.

Postoperative effective blur in both groups. Abbreviations: Eff, effective; ICL, implantable contact lens. Table 2 Comparison of the outcome between the two groups. Figure 6. Discussion The goal of refractive surgery is to safely and predictably create a stable and desired refractive state without causing new optical problems.

Footnotes Disclosure The authors report no conflicts of interest in this work. References 1. Phakic intraocular lenses. Curr Opin Ophthalmol. Barsam A, Allan BD. Excimer laser refractive surgery versus phakic intraocular lenses for the correction of moderate to high myopia [review] Cochrane Database Syst Rev.

Sanders DR. J Refract Surg. Randomized prospective comparison of visian toric implantable collamer lens and conventional photorefractive keratectomy for moderate to high myopic astigmatism. Surv Ophthalmol. Management of myopic astigmatism with phakic intraocular lens implantation. J Cataract Refract Surg. Phakic intraocular lenses part 1: historical overview, current models, selection criteria, and surgical techniques.

Intraindividual comparison of visual performance after posterior chamber phakic intraocular lens with and without a central hole implantation for moderate to high myopia. Am J Ophthalmol. Early clinical outcomes of implantation of posterior chamber phakic intraocular lens with a central hole Hole ICL for moderate to high myopia. All recorded data from images were used in the analysis.

A higher value for density represents a healthier cornea. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. We're building a better ClinicalTrials. Check it out and tell us what you think! Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information.

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Federal Government. Read our disclaimer for details. Results First Posted : June 26, Last Update Posted : July 2, View this study on Beta. Study Description. Detailed Description:. Subjects previously enrolled in protocols C NCT , C NCT , C NCT , and C NCT who received an L-series lens either in the first eye or second eye including those who were explanted were enrolled in this open-label, non-randomized, non-controlled, extension study in which they attended postoperative visits for up to 10 years following the date of implantation.

Subjects could enroll in the study at any time, thus the Entrance Visit may have coincided with any visit Year 4 to Year FDA Resources. Arms and Interventions. Intraocular lens for the treatment of moderate to high myopia. Outcome Measures.

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