ABSTRACT
PURPOSE: To evaluate visual outcomes at different distances (near, intermediate, and far), depth of focus, optical quality, quantitative dysphotopsia, and patient satisfaction in two groups. METHODS: The extended depth of focus (EDOF) only group (n = 40 eyes) was implanted bilaterally with an EDOF intraocular lens (IOL) and the mixed group (n = 40 eyes) was implanted with the same EDOF IOL in the dominant eye and a trifocal IOL in the fellow eye. At the 3-month postoperative visit, refractive outcomes and monocular and binocular uncorrected (UDVA) and corrected (CDVA) distance visual acuities for far UDVA, CDVA, distance-corrected intermediate visual acuity (DCIVA) at 80 cm, uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA) at 40 cm, and binocular defocus curve were evaluated. RESULTS: The mean spherical equivalent (SE) 3 months postoperatively was -0.16 ± 0.41 diopters (D) in the EDOF only group and -0.39 ± 0.63 D in the mixed group. In the EDOF only group, binocular visual acuities were: UDVA = -0.04 ± 0.07 logMAR (20/18); CDVA = -0.04 ± 0.06 logMAR (20/18); DCIVA (80 cm) = 0.07 ± 0.19 logMAR (20/23); DCNVA (40 cm) = 0.32 ± 0.15 logMAR (20/42); and UNVA (40 cm) = 0.24 ± 0.17 logMAR (20/35). In the mixed group, binocular visual acuities were: UDVA = 0.03 ± 0.09 logMAR (20/21) (P = .08); CDVA = -0.01 ± 0.07 logMAR (20/20) (P = .25); DCIVA (80 cm) = 0.24 ± 0.23 logMAR (20/35) (P = .08); DCNVA (40 cm) = 0.19 ± 0.07 logMAR (20/31) (P = .03); and UNVA (40 cm) = 0.18 ± 0.10 logMAR (20/30) (P = .37). CONCLUSIONS: Effective restoration of visual acuity was demonstrated in both groups, with high levels of visual quality and patient satisfaction. Better results in near visual acuity were demonstrated in the mixed group. [J Refract Surg. 2019;35(7):408-416.].
Subject(s)
Depth Perception/physiology , Lens Implantation, Intraocular , Multifocal Intraocular Lenses , Patient Satisfaction/statistics & numerical data , Visual Acuity/physiology , Adult , Aged , Cataract/complications , Female , Humans , Male , Middle Aged , Phacoemulsification , Prospective Studies , Prosthesis Design , Pseudophakia/physiopathology , Refraction, Ocular , Vision, Binocular/physiologyABSTRACT
BACKGROUND: Modern intraocular lens surgery has made great progress over the last few years towards creating independency of spectacles in daily life. Especially in the areas of distant and near visual acuity, optimisation has been possible. Nevertheless, with new media and requirements in professional life, there is an increasing need for optimisation of the intermediate range. In a prospective, non-randomised clinical study, the functional and refractive results after implantation of a novel intraocular lens with enhanced depth of focus were analysed. PATIENTS/MATERIAL AND METHODS: We have evaluated eleven patients after binocular implantation of the AT LARA 829MP (Carl Zeiss Meditec AG, Germany) 3 months after surgery. We examined refraction, corrected and uncorrected monocular and binocular distant visual acuity (CDVA, UDVA) as well as distance-corrected monocular and binocular visual acuity at different intermediate distances (with DCIVA 90, 80 and 60 cm) and 40 cm (DCNVA). We also performed defocus curve analysis. RESULTS: We found a mean increase of monocular CDVA from 0.35 to - 0.01 logMAR. Binocular DCIVA at 90, 80 and 60 cm was - 0.07, 0.04 and 0.07 logMAR, respectively. Even with a principle focus on intermediate distances, we found a functional DCNVA of 0.33 logMAR. Defocus curve analysis showed a visual acuity of 0.3 logMAR in a range of - 2.5 D to + 1.0 D. CONCLUSION: Binocular implantation of the AT LARA 829MP targeting emmetropia gives stable visual acuity from the distant to the near intermediate range, still with functional vision at the near distance of 40 cm.
