• Journal of Korean Medical Science
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• v.33 no.44
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• pp.275.1-275.15
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• 2018

Background: We compared the efficacy between trifocal and bifocal diffractive intraocular lens (IOL) implantation. Methods: Through PubMed, MEDLINE, EMBASE, and CENTRAL, we searched potentially relevant articles published from 1990 to 2018. Defocus curves, visual acuities (VAs) were measured as primary outcomes. Spectacle dependence, postoperative refraction, contrast sensitivity (CS), glare, and higher-order aberrations (HOAs) were measured as secondary outcomes. Effects were pooled using random-effects method. Results: We included 11 clinical trials, with a total of 787 eyes (395 subjects). The trifocal IOL group showed better binocular distance VA corrected with defocus levels of -0.5, -1.0, -1.5, and -2.5 diopter than the bifocal IOL group (All $P{\leq}0.004$). The trifocal IOL group showed better monocular uncorrected distance and intermediate VAs (mean difference [MD], -0.04 logarithm of the minimum angle of resolution [logMAR]; 95% confidence interval [CI], -0.07, -0.01; P = 0.006 and MD, -0.07 logMAR; 95% CI, -0.13, -0.01; P = 0.03, respectively). Postoperative refraction, glare, CS, and HOAs were not significantly different from each other. Conclusion: The overall findings indicate that trifocal diffractive IOL implantation is better than the bifocal diffractive IOL in intermediate VA, and provides similar or better in distance and near VAs without any major deterioration in the visual quality.

• Journal of Korean Biological Nursing Science
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• v.21 no.1
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• pp.12-21
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• 2019

Purpose: The purpose of this study was to review previous literature with an aim to explore the sleep disturbance level after a patient undergoes cataract surgery using an integrative review. Methods: We used the key words, 'cataract surgery', 'sleep', and 'intraocular lens' to find peer-reviewed publications in seven databases. Among 450 searched articles, eight articles were selected after exclusion of articles that did not meet the criteria. Results: Five of the articles submitted that subjective sleep quality of the patients with blue-filtering intraocular lens (BF-IOL) implant improved as compared to that before surgery. The change of saliva melatonin concentration after BF-IOL implant did not coincide in two of the articles. Two of the articles reported an increased level of intrinsically photosensitive retinal ganglion cells response after BF-IOL implantation. Conclusion: The published studies stated that BF-IOL implant did not have any negative impact on quality of sleep among cataract patients suffering with poor sleep. Rregardless of intraocular lens type, cataract surgery may increase photoreception of intrinsically photosensitive retinal ganglion cells one year after surgery although the mechanism was not clear. It is necessary to identify various factors influencing the quality of sleep such as gender and activities among cataract patients with BF-IOL implant in the future.

• Medical Lasers
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• v.9 no.1
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• pp.44-50
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• 2020

Background and Objectives To evaluate the rotational stability of AcrySof toric intraocular lenses (IOL) by considering lapse of postoperative time and influence of capsulorhexis contraction. Materials and Methods A prospective, masked, single center study was conducted on 19 patients who had undergone microcoaxial cataract surgery and AcrySof toric IOL implantation. Slit-lamp retroillumination photographs of anterior segments were obtained from all patients after 1 week, 1 month and 3 months post-surgery. The degree of alteration of the postoperative IOL axis alignment and the amount of anterior capsular shrinkage were analyzed using Adobe Photoshop software. Results The mean degree of toric IOL axis misalignment was 2.18 (±20.2) degrees at 3 months follow-up. Quadrant analysis of the capsulorhexis aperture area at 1 week and 1 month post-operative, showed counterclockwise IOL rotation when the capsule contraction was dominant in the haptic part as well as clockwise rotation when dominant in the non-haptic part (p = 0.015). Conclusion The direction and degree of AcrySof toric IOL rotation differed throughout the follow-up period. Since most misalignments were found on the first post-operative day, physicians should try to minimize peri-operative risk factors that influence IOL rotation. There was also a correlation between the part of anterior capsule contraction and the direction of IOL rotation.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2010.11a
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• pp.103-104
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• 2010

• Macromolecular Research
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• v.16 no.7
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• pp.614-619
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• 2008

Copolymers of phenyl alkyl acrylates/methacrylates are used clinically as soft materials for the foldable intraocular lens (IOL) to treat cataracts. In this study, copolymers of 2-phenylethyl acrylate (PEA) and 2-phenylethyl methacrylate (PEMA) of various compositions were prepared using free radical polymerization in solution. The composition of the copolymers was determined by $^1H$-NMR analysis. The reactivity ratios of the monomers were calculated using the conventional Fineman-Ross or Kelen-Tudos method. The reactivity ratio of PEA ($r_1$) and PEMA ($r_2$) were estimated to be 0.280 and 2.085 using the Kelen-Tudos method, respectively. These values suggest that PEMA is more reactive in copolymerization than PEA, and the copolymers will have a higher content of PEMA units. The glass transition temperature ($T_g$) of the copolymers increased with increasing PEMA content. The molecular weight and polydispersity indices ($M_w/M_n$) of the polymers were determined by GPC. Overall, these results are expected to be quite useful in applications to foldable soft IOL materials.

• Journal of Preventive Medicine and Public Health
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• v.27 no.4 s.48
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• pp.807-814
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• 1994

This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6.86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 Won in 1992 to 444,000 Won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. Charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate In order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.

• Journal of the Korean Chemical Society
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• v.62 no.1
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• pp.30-35
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• 2018

The purpose of this study was to decrease the protein adsorption and improve the function of the hydrophobic acrylic Intraocular lens(IOL). Hydrophobic acrylic intraocular lenses were prepared by using ethyleneglycol phenyletheracrylate (EGPEA), styrene and 2-hydroxyethyl methacrylate (HEMA). Polyvinyl pyrrolidone (PVP) and 2-methacryloyloxyethyl phosphorylcholine (MPC) were used as additives. Water contents, wettability, light transmittance and protein adsorption amount were measured to evaluate the physical properties of the intraocular lens. The water content and wettability of all samples containing additives were increased and the amount of protein adsorption decreased. In particular, samples containing MPC showed a further decrease in protein adsorption. The hydrophobic acrylic intraocular lens with PVP and MPC was found to improve the function of the intraocular lens by reducing the protein adsorption while having basic physical properties.

• Korean Journal of Ophthalmology
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• v.32 no.6
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• pp.497-505
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• 2018

Purpose: To evaluate and compare published methods of calculating intraocular lens (IOL) power following myopic laser refractive surgery. Methods: We performed a retrospective review of the medical records of 69 patients (69 eyes) who had undergone myopic laser refractive surgery previously and subsequently underwent cataract surgery at Samsung Medical Center in Seoul, South Korea from January 2010 to June 2016. None of the patients had pre-refractive surgery biometric data available. The Haigis-L, Shammas, Barrett True-K (no history), Wang-Koch-Maloney, Scheimpflug total corneal refractive power (TCRP) 3 and 4 mm (SRK-T and Haigis), Scheimpflug true net power, and Scheimpflug true refractive power (TRP) 3 mm, 4 mm, and 5 mm (SRK-T and Haigis) methods were employed. IOL power required for target refraction was back-calculated using stable post-cataract surgery manifest refraction, and implanted IOL power and formula accuracy were subsequently compared among calculation methods. Results: Haigis-L, Shammas, Barrett True-K (no history), Wang-Koch-Maloney, Scheimpflug TCRP 4 mm (Haigis), Scheimpflug true net power 4 mm (Haigis), and Scheimpflug TRP 4 mm (Haigis) formulae showed high predictability, with mean arithmetic prediction errors and standard deviations of $-0.25{\pm}0.59$, $-0.05{\pm}1.19$, $0.00{\pm}0.88$, $-0.26{\pm}1.17$, $0.00{\pm}1.09$, $-0.71{\pm}1.20$, and $0.03{\pm}1.25$ diopters, respectively. Conclusions: Visual outcomes within 1.0 diopter of target refraction were achieved in 85% of eyes using the calculation methods listed above. Haigis-L, Barrett True-K (no history), and Scheimpflug TCRP 4 mm (Haigis) and TRP 4 mm (Haigis) methods showed comparably low prediction errors, despite the absence of historical patient information.

• Journal of The Korean Ophthalmological Society
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• v.60 no.2
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• pp.126-134
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• 2019

Purpose: To assess the accuracy of toric intraocular lens (IOL) implantation by the location and size of the corneal incision. Methods: We retrospectively reviewed the medical records of 98 patients (98 eyes) who underwent phacoemulsification with toric IOL implantation from January 2014 to March 2017. The patients were divided into two groups: group 1 got an incision of the superior side of the cornea (n = 54) and group 2 received an incision on the temporal side of the eye (n = 44). For both groups, incisions were made at their steep corneal astigmatism axises. Each group was further divided into subgroups for whom different sized blades were employed (2.75 vs. 2.2 mm widths). We measured the refractive index and autokeratometric parameters. We postoperatively assessed residual astigmatism and any reduction thereof. Results: In both groups, uncorrected and best-corrected visual acuity, refraction cylinder astigmatism, and autokeratometric astigmatism improved statistically. Between two groups, corneal astigmatism decrease was not significant. Residual astigmatism also showed no significant differences between the two. Patients in both groups treated using 2.75 mm wide blades exhibited greater increases in corneal astigmatism. Conclusions: During cataract surgery, precise correction of astigmatism via toric IOL implantation is possible when surgically induced astigmatism is minimized by careful choice of the location and size of the corneal incision.

• Journal of the Optical Society of Korea
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• v.18 no.2
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• pp.110-117
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• 2014

In this study, we objectively determined whether the ReSTOR as a multifocal IOL (intraocular lens) has a multifocal function compared to the IQ as a monofocal IOL in vivo by OQAS (Optical Quality Analysis System). Eighteen patients who had cataract surgery with implantation of ReSTOR (27 eyes) and 15 patients with IQ (21 eyes), were included inthis study. Uncorrected distance visual acuity (UCDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UCNVA)and distance corrected near visual acuity (DCNVA) were measured. After setting the artificial pupil size to 3 mm, we performed 'Optical quality'. We inputted defocus diopters of (objective spherical refraction)(far), (objective spherical refraction-1.25 D)(intermediate),(objective spherical refraction-2.5 D)(near), and (objective spherical refraction-3.5 D)(very near) into 'selected spherical refraction' simulating the optical quality at far, intermediate, and near distance. We changed the pupil size to 5 mm and repeated the same measurements. The UCDVA and CDVA did not show significant differences between the 2 groups. But, the UCNVA and DCNVA of the ReSTOR group were better than those of the IQ group (p=0.000, p=0.000). For 3 mm pupil, at far distance, modulation transfer function (MTF) cut off and point spread function (PSF) width at 50% of ReSTOR were worse than those of IQ (p=0.039, p=0.020). At intermediate distance, MTF cut off, Strehl ratio and PSF width at 50% of ReSTOR were worse than those of IQ (p=0.001, p=0.001, p=0.000). At near distance, MTF cut off of ReSTOR was worse than that of IQ (p=0.033). At very near distance, MTF cut off and Strehl ratio of ReSTOR were worse than those of IQ (p=0.002, p=0.002), but PSF width at 50% of ReSTOR was better than that of IQ. For 5 mm pupil, most parameters at each distance, there was no significant difference between the 2 groups. Only PSF width at 50% of ReSTOR were worse than those of IQ at intermediate distance (p=0.013). It was impossible to show the multifocal function of ReSTOR compared to the IQ byOQAS.