Refractive lens exchange for a multifocal intraocular lens with a surface-embedded near section in mild to moderate anisometropic amblyopic patients

J Cataract Refract Surg. 2012 Oct;38(10):1796-801. doi: 10.1016/j.jcrs.2012.06.046. Epub 2012 Aug 21.

Abstract

Purpose: To evaluate visual and refractive outcomes in amblyopic patients who had bilateral implantation of a multifocal intraocular lens (IOL) with a surface-embedded near section.

Setting: Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom.

Design: Comparative case series.

Methods: Anisometropic amblyopic patients having bilateral implantation of Lentis Mplus multifocal IOLs were examined for distance and near visual acuities, contrast sensitivity, defocus curves, extent of crowding, reading speed, stereoacuity, and Quality of Vision (QoV) questionnaire scores preoperatively and at 3-month intervals during 12 months. A +3.00 diopter (D) reading addition IOL was used in all eyes.

Results: Twenty-eight eyes (14 patients) (mean age 59.4 years) were included. In the nonamblyopic eye, the mean uncorrected distance visual acuity (UDVA) was 0.16 logMAR ± 0.17 (SD), the mean corrected distance visual acuity (CDVA) was 0.02 ± 0.07 logMAR, and the mean near acuity was M 0.5 (Jaeger [J] 2 = logRAD 0.1) or better. In the amblyopic eye, the means were 0.30 ± 0.14 logMAR, 0.21 ± 0.11 logMAR, and M 0.8 (J4 = logRAD 0.3) or better, respectively. Bilateral reading speeds (mean 137.73 ± 28.7 words per minute [wpm]) surpassed unilateral nonamblyopic eye speeds (mean 130.6 ± 29.4 wpm). The mean QoV scores improved from 7.78 ± 10.23 preoperatively to 1.92 ± 5.21 at 12 months. No glare or halos were reported; 1 patient had mild starburst symptoms at 1 year. Patients rated distance and near vision as excellent.

Conclusion: Anisometropic amblyopic patients may benefit from bilateral implantation of the multifocal IOL; no unwanted side effects were detected.

Publication types

  • Comparative Study

MeSH terms

  • Amblyopia / physiopathology
  • Amblyopia / surgery*
  • Anisometropia / physiopathology
  • Anisometropia / surgery*
  • Female
  • Humans
  • Hyperopia / physiopathology
  • Hyperopia / surgery
  • Lens Implantation, Intraocular*
  • Lenses, Intraocular*
  • Male
  • Middle Aged
  • Phacoemulsification*
  • Presbyopia / physiopathology
  • Presbyopia / surgery
  • Quality of Life
  • Reading
  • Refraction, Ocular / physiology*
  • Sickness Impact Profile
  • Surveys and Questionnaires
  • Visual Acuity / physiology*