Accommodating intraocular lenses for patients with cataract a review

Should a single PRO measure that encompasses all types of IOLs be developed?

Finally, can a collaborative mechanism be built that would allow stakeholders to share the development costs of a PRO instrument? Participants agreed that the concepts of subjective quality of vision and visual function are both important—and that they exist independently of a specific IOL technology.

(Although there is considerable controversy in the ophthalmic community about the term , this article uses the nomenclature from the workshop.) The FDA has received an increasing number of requests for review of additional entries, but the process for review is a cumbersome one. Chang, MD, at the University of California, San Francisco.

accommodating intraocular lenses for patients with cataract a review-76

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

The systematic review found that, using the best available data, second-eye cataract surgery was associated with clinically meaningful improvement in stereopsis but did not affect other clinical measures of vision or of health-related quality of life, apart from improvements in a mental health measure in one trial.

For instance, EDOF optics could be added to toric optics to provide extended depth of focus for toric IOLs—or added to accommodative optics to boost near performance.

Clinicians and patients want a broader array of IOL options.

During the workshop, participants discussed a number of issues to consider beyond the traditional statistical measures of precision, reproducibility, validity, and responsiveness.

For instance, how best can the words patients use to describe visual phenomena (such as starbursts, comets, and halos) be parsed?

In outcomes studies, PROs are often used to measure the effect of an intervention on such factors as symptom impact, disability, treatment tolerability, treatment satisfaction, and health-related quality of life.

PROs are “really among the most important factors we should be considering,” said William H. “It is no coincidence that we’re focusing here on PROs because of the large subjective component to these devices.” If ophthalmologists focus only on functions such as visual acuity and contrast sensitivity, they may overlook patients’ thoughts, beliefs, and attitudes about their vision, several speakers pointed out.

As a result, we evaluate many submissions on a case-by-case basis,” said Malvina B. “Both the FDA and sponsors spend significant resources on repeat submissions, and there’s a delayed or limited benefit to other devices with similar characteristics.” Existing roadblocks. “Because this should improve uncorrected intermediate distance without the optical trade-offs of a diffractive multifocal, this is a technology that would appeal to many cataract patients,” Dr. The goal of the EDOF IOL is to provide improved near and intermediate visual performance without compromising distance vision.

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