objective vs subjective outcomes in the latest trifcoal iol physiol (finevision)

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Correlation of subjective and objective outcomes in a diffractive trifocal IOL, a case series. Dr. Ivo Ferreira Ríos Dra. Karla Zuñiga Posselt Dr. Eduardo Chávez Mondragón

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Page 1: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Correlation of subjective and objective outcomes in a diffractive trifocal IOL, a case series.

Dr. Ivo Ferreira RíosDra. Karla Zuñiga Posselt

Dr. Eduardo Chávez Mondragón

Page 2: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Disclosure

• No conflict of interest.

Page 3: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Collaborators

• Dra. Karla Zuñiga• Dra. Aida Corona• Dr. Eduardo Chávez Mondragón• Dr. Yonathan Garfias

Page 4: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

The key to success• Subjective outcomes

Page 5: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

It’s coming…

Page 6: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

It’s coming…

Page 7: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

It’s here…

Page 8: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

It’s here…

Page 9: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

It’s here…

Page 10: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

It’s here…!!!

Page 11: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

It’s here…!!!

• Patient Reported Outcomes Measures (PROMs)

• Subjective outcomes it’s what matters the most in these days….

Page 12: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Our idea..If the subjective outcomes are so

important…

DO THEY CORRELATE?

With the objective outcomes we have

control during cataract surgery and patient

selection?

Page 13: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Purpose

• To evaluate the results and the relationship between Subjective and Objective outcomes of the latest trifocal Intraocular Lens (IOL) Physiol Finevision.

Page 14: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Objective outcomes

• VA, Aberrometry (RMS, PSF, MTF)

Page 15: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Subjective outcomes

• VFQ-25 & CATQUEST-9SF

Page 16: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Design

• Prospective non-interventional study.

Page 17: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Methods• 24 eyes of 12 patients

• Bilateral cataract surgery with implantation of Physiol trifocal IOL.

We analysed: UDVA UNVA VA 70, 60, 50, 40

1, 3 and 6 months

Page 18: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Methods• With a OPD Scan III Software we

performed:

Aberrometry measurements of:

• Higher-order root mean-square (RMS) • Point Spread Function (PSF) with the Strehl

Ratio.

Page 19: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

MethodsWith a OPD Scan III Software we performed:

• Bilateral contrast sensitivity was obtained with Modulation Transfer Function (MTF).

Page 20: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

MethodsThe subjective outcomes were obtained:

• National Eye Institute VFQ-25 questionnaire

• Catquest-9SF

Page 21: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Methods• Descriptive analysis of our data

• Kolmogorov-Smirnov analysis that presented: normal distribution of UNVA far, near and intermediate

abnormal distribution of questionnaries results.

• Pearson correlation to between our objective and subjective variables.

Page 22: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

ResultsPearson correlation to between our objective and subjective variables.

Page 23: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Results• Intermediate VA in Logmar

Page 24: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Results

Mean Monocular UNVA LogMar 0.06 +/- 0.07

Spherical Equivalent (3months)

0.52 =/- 0.47

Mean RMS 0.07

PSF Strehl Ratio 0.38

Page 25: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Results• Score for the VFQ- 25 was global of

91.03 over 100.

• The results of catquest-SF9 the questionnaire was evaluated with rasch analysis for obtaining the final score.

Page 26: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Results

• UDVA (r = 0.89) • UNVA (r=0.71),

and • VA at 70, 60, 50

and 40 cm • Strehl ratio

Good score in both

questionnaires.

Good correlation between

Page 27: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Conclusion• We found a strong correlation in our objective and

subjective outcomes in the variables we described.

• If do a good selection and perform an excellent surgery technique (objective variables) we can predict to have excellent subjective outcomes in our patients.

Page 28: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Bibliography

• 1) Zhang F, Sugar A, Jacobsen G, Collins M. Visual function and spectacle independence after cataract surgery: bilateral diffractive multifocal intraocular lenses versus monovision pseudophakia. J Cataract Refract Surg. 2011; 37:853-8.

• 2) Vryghem JC, Heireman S. Visual performance after the implantation of a new trifocal intraocular lens. Clin Ophthalmol. 2013;7:1957-65.

• 3) Gatinel D, Pagnoulle C, Houbrechts Y, Gobin L. Design and qualification of a diffractive trifocal optical profile for intraocular lenses. J Cataract Refract Surg. 2011;37(11):2060-7.

• 4) Cochener B, Vryghem J, Rozot P, Lesieur G, Heireman S, Blanckaert JA, et al. Visual and refractive outcomes after implantation of a fully diffractive trifocal lens. Clin Ophthalmol. 2012;6:1421-7.

• 5) Sheppard AL, Shah S, Bhatt U, Bhogal G, Wolffsohn JS. Visual outcomes and subjective experience after bilateral implantation of a new diffractive trifocal intraocular lens. J Cataract Refract Surg. 2013;39(3):343-9.

• 6) Lesieur G. Outcomes after implantation of a trifocal diffractive IOL. J Fr Ophtalmol. 2012;35(5):338-42.

• 7) Carson D, Hill WE, Hong X, Karakelle M. Optical bench performance of AcrySof(®) IQ ReSTOR(®), AT LISA(®) tri, and FineVision(®) intraocular lenses. Clin Ophthalmol. 2014;8:2105-13.

• 8) Jonker SM, Bauer NJ, Makhotkina NY, Berendschot TT, van den Biggelaar FJ, Nuijts RM. Comparison of a trifocal intraocular lens with a +3.0 D bifocal IOL: results of a prospective randomized clinical trial. J Cataract Refract Surg. 2015;41(8):1631-40.

Page 29: Objective vs subjective outcomes in the latest trifcoal iol Physiol (Finevision)

Thank you

Correo: [email protected] [email protected]

LinkedIn: Dr. Ivo Ferreira RíosTwitter: Ivo Ferreira Ríos MD