Visual Field Changes in Patients Undergoing TECNIS ZCB00 Monofocal vs. TECNIS Symfony Extended Depth of Focus Intraocular Lens Implantation
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 发起方
- 试验地点
- 2
- 主要终点
- Mean Deviation
研究概览
简要总结
Glaucoma is a leading cause of blindness worldwide. Damage to the optic nerve results in vision loss gradually. This vision loss can be detected by using visual field testing, and is a way of monitoring glaucoma progression. As this population ages, cataracts develop, and patients need to undergo cataract surgery to replace the cloudy crystalline lens with an artificial intraocular lens (IOL). The standard of treatment is implantation of a monofocal IOL, but this limits depth of focus and does not allow clear vision at both distance and near without glasses post-operatively. Multifocal and trifocal lenses split light into multiple distinct foci at near, intermediate and far distances without glasses correction. However, these lenses have been shown to reduce contrast sensitivity and impair visual field testing results, and are not recommended in patients with glaucoma. The TECNIS Symfony IOL has recently been approved by Health Canada and offers an extended range of vision with a single elongated focal point to allow patients to see at both distance and near. The lens is advertised to enhance contrast sensitivity, but it is currently unknown whether the TECNIS Symfony IOL impacts visual field testing. We will study the visual field changes in patients undergoing both TECNIS ZCB00 monofocal and TECNIS Symfony extended depth of focus IOL implantation during cataract surgery. The results of this study will impact the advice cataract surgeons give to patients with glaucoma, regarding whether this population of patients would benefit from a standard monofocal IOL implantation or an extended depth of focus TECNIS Symfony IOL implantation.
详细描述
Primary open angle glaucoma is a leading cause of blindness worldwide, and is the most common form of glaucoma. This condition involves progressive damage to the optic nerve over time and ultimately vision loss that can be detected using standard automated perimetry visual field testing. As this population ages, patients will eventually develop cataracts and require cataract surgery to replace the cloudy crystalline lens with an artificial intraocular lens. The standard of treatment is implantation of a monofocal intraocular lens (IOL), but this limits depth of focus and does not allow clear vision at both distance and near without spectacle correction post-operatively. To provide a refractive component to cataract surgery, multifocal and trifocal lenses were introduced and split light into multiple distinct foci at near, intermediate and far distances without correction. However, splitting of incoming light has the potential to decrease contrast sensitivity and increase photic phenomena. In addition, multifocal IOLs have been shown to reduce mean deviation on automated perimetry compared to monofocal IOLs and are not recommended in patients where visual field reduction may not be tolerated, such as in patients with glaucoma. The TECNIS Symfony IOL has been recently been approved by Health Canada and offers extended range of vision with a single elongated focal point, corrects for chromatic aberration and results in contrast enhancement. It is unknown whether this new IOL impacts visual field testing in glaucoma patients post cataract surgery.
The objective of this study is to compare visual field outcomes in patients choosing to undergo cataract surgery with either a TECNIS ZCB00 monofocal vs TECNIS Symfony extended depth of focus intraocular lens.
It is hypothesized that patients who undergo implantation of a TECNIS Symfony extended depth of focus intraocular lens will have impaired visual field testing (a decrease in mean deviation on Humphrey 24-2 standard automated perimetry) compared to those undergoing TECNIS ZCB00 monofocal intraocular lens implantation.
This will be a prospective cohort study.
Patients undergoing either TECNIS ZCB00 monofocal or TECNIS Symfony extended depth of focus ZXR intraocular lens insertion during cataract surgery will be recruited.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients who have chosen to undergo elective cataract surgery in one eye with 20/40 - 20/100 vision (best corrected) in the operated eye on initial pre-op surgical assessment and with greater than or equal to 20/25 vision (best corrected) in the operated eye at 1-month post-operatively.
- •Patients who have chosen to undergo TECNIS ZCB00 monofocal intraocular lens implantation.
- •Patients who have chosen to undergo implantation of a TECNIS Symfony extended depth of focus intraocular lens.
- •Patient must be able to reliably perform visual field testing.
- •No other eye disease other than cataract.
- •Patient must be older than 18 years of age.
- •Patient must be proficient in the English language.
排除标准
- •Patients who are unwilling or unable to undergo visual field testing.
- •Patients with glaucoma.
- •Patients who have history of laser refractive surgery.
- •Patients who experienced an intra-operative complication.
结局指标
主要结局
Mean Deviation
时间窗: 1 year
An overall value of the total amount of visual field loss
次要结局
- Pattern Standard Deviation(1 year)
研究者
Tony Lin
Principal Investigator
Western University, Canada