{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:02:04Z","timestamp":1787022124583,"version":"build-2736575974"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T00:00:00Z","timestamp":1680739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\n Purpose<\/jats:title>\n To study the influence of angle kappa (\u03ba) on visual acuity after implantation of a multifocal intraocular lens (MIOL) and consecutive \u201ctouch-up\u201d corneal refractive surgery with Laser-in-situ-Keratomileusis (LASIK).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective multicenter study included patients who underwent MIOL surgery and consecutive LASIK (= Bioptics) in the period from 2016 to 2020 at Care Vision Refractive Centers in Germany. Our study was approved by the local ethics committee at the University in Duesseldorf (approval date: 23.04.2021) and conducted according to the tenets of the Declaration of Helsinki and Good Clinical Practices Guidelines. The pre- and post-operative \u03ba of 548 eyes were measured using a Scheimpflug-based imaging system. Corrected distance visual acuity (CDVA) and the safety index (SI) were analyzed in relation with \u03ba. For a more detailed analysis, the cohort was divided into pre-operative hyperopic and myopic patients to show group-specific differences.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There was a significant decrease (p<0.001) in the magnitude of \u03ba after MIOL implantation and Bioptics. However, there was almost no significant correlation of \u03ba on CDVA and SI, pre- and postoperatively.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n A large \u03ba is not a significant risk factor for poor visual acuity. Therefore, it is not a suitable clinical predictor of postoperative outcomes after a Bioptic procedure.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0283578","type":"journal-article","created":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T13:43:09Z","timestamp":1680788589000},"page":"e0283578","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Pre- and postoperative angle kappa in MIOL patients after touch-up LASIK"],"prefix":"10.1371","volume":"18","author":[{"given":"Amr","family":"Saad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8977-4261","authenticated-orcid":true,"given":"Andreas","family":"Frings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasyl","family":"Druchkiv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toam","family":"Katz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,4,6]]},"reference":[{"issue":"2","key":"pone.0283578.ref001","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/ceo.13136","article-title":"Applications of corneal topography and tomography: a review.","volume":"46","author":"R Fan","year":"2018","journal-title":"Clinical & Experimental Ophthalmology."},{"key":"pone.0283578.ref002","author":"NM Scoville","year":"2020","journal-title":"Optical Axes and Angle Kappa. eyewikiaaoorg"},{"key":"pone.0283578.ref003","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.2147\/OPTH.S251998","article-title":"Scheimpflug vs Scanning-Slit Corneal Tomography: Comparison of Corneal and Anterior Chamber Tomography Indices for Repeatability and Agreement in Healthy Eyes.","volume":"14","author":"AJ Kanellopoulos","year":"2020","journal-title":"Clinical Ophthalmology"},{"issue":"4","key":"pone.0283578.ref004","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1097\/APO.0000000000000253","article-title":"AcrySof IQ PanOptix Intraocular Lens Versus Extended Depth of Focus Intraocular Lens and Trifocal Intraocular Lens: A Clinical Overview.","volume":"8","author":"RR Sudhir","year":"2019","journal-title":"The Asia-Pacific Journal of Ophthalmology"},{"issue":"6","key":"pone.0283578.ref005","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.jcrs.2009.01.031","article-title":"Dissatisfaction after multifocal intraocular lens implantation","volume":"35","author":"MA Woodward","year":"2009","journal-title":"Journal of Cataract and Refractive Surgery"},{"issue":"2","key":"pone.0283578.ref006","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0886-3350(00)00540-X","article-title":"Subjective photic phenomena with refractive multifocal and monofocal intraocular lenses: Results of a multicenter questionnaire.","volume":"27","author":"G H\u00e4ring","year":"2001","journal-title":"Journal of Cataract & Refractive Surgery."},{"key":"pone.0283578.ref007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/458296","article-title":"Visual Outcomes and Patient Satisfaction after Refractive Lens Exchange with a Single-Piece Diffractive Multifocal Intraocular Lens","volume":"2014","author":"JSM Chang","year":"2014","journal-title":"Journal of Ophthalmology"},{"issue":"9","key":"pone.0283578.ref008","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1038\/eye.2011.150","article-title":"Predictive factor and kappa angle analysis for visual satisfactions in patients with multifocal IOL implantation.","volume":"25","author":"G Prakash","year":"2011","journal-title":"Eye"},{"issue":"8","key":"pone.0283578.ref009","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.jcrs.2018.05.026","article-title":"Role of angle \u03ba in visual quality in patients with a trifocal diffractive intraocular lens. 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