Visual Outcomes After Implantation of a Segmental Refractive Multifocal Intraocular Lens Following Cataract Surgery

Am J Ophthalmol. 2018 Jul:191:156-165. doi: 10.1016/j.ajo.2018.04.011. Epub 2018 Apr 21.

Abstract

Purpose: To evaluate visual outcomes, with particular attention to intermediate visual acuity (VA), of a segmental refractive multifocal intraocular lens (IOL) with optimized depth of focus (DoF).

Design: Prospective, nonrandomized, noncomparative case series.

Methods: Setting: Department of Ophthalmology, Goethe University, Frankfurt/Germany. Patient or Study Population: Fifty eyes (25 patients) were included. Inclusion criteria were bilateral cataract, age > 45 years, corneal astigmatism ≤ 0.75 diopter (D) postoperatively, pupil size 3-6 mm (mesopic), and center shift < 1 mm (Pentacam). Exclusion criteria were ocular surgeries, amblyopia, or potential postoperative distance-corrected VA (DCVA) > 0.3 logMAR. Intervention or Observation: Uncorrected (UCVA) and DCVA in 4 m, 80 cm, 40 cm; contrast sensitivity (CS); reading skills; defocus curve; and questionnaire on optical quality (OQ) and spectacle independence were assessed after 3 months.

Main outcome measures: UCVA and DCVA in 4 m, 80 cm, 40 cm; defocus curve.

Results: UCVA was 0.05 ± 0.122 logMAR at 4 m, 0.18 ± 0.164 logMAR at 80 cm, and 0.16 ± 0.140 logMAR at 40 cm. Defocus curve testing showed, respectively, a flat monocular and binocular VA range from 0.00 to -2.00 D (-0.03 to 0.11 logMAR, -0.05 to 0.05 logMAR). Median CS under photopic and mesopic conditions without and with glare was 1.81 logCS, 1.65 logCS, 1.52 logCS, and 1.14 logCS, respectively. Reading speed at 40 cm showed a reading acuity of 0.100 logRAD with 94 words/minute.

Conclusion: This segmental multifocal IOL provides good VA at all distances (<0.20 logMAR), particularly providing good intermediate visual acuity and DoF. It showed good reading skills, OQ, and CS and high spectacle independence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Lens Implantation, Intraocular / methods*
  • Male
  • Middle Aged
  • Phacoemulsification*
  • Phakic Intraocular Lenses*
  • Prospective Studies
  • Prosthesis Design
  • Pseudophakia / physiopathology*
  • Refraction, Ocular / physiology*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vision, Binocular / physiology*
  • Visual Acuity*