A pilot study of +3.5 D aspheric diffractive multifocal intraocular lens implantation using a real-time intraoperative navigation system

Abstract

Objective To evaluate visual performance after implantation of a +3.5 diopter (D) aspheric diffractive multifocal intraocular lens (IOL) under a real-time intraoperative navigation system. Methods In this prospective clinical study, 8 patients (12 eyes) underwent implantation of a +3.5 D aspheric, diffractive, multifocal IOL Diffractiva-aA using a real-time intraoperative navigation system. Distance and near visual acuity, defocus curve, capsulorhexis circularity, IOL centration, and patient satisfaction questionnaire were monitored at 3 days, 1 month, and 1 year postoperatively. Data were analyzed by paired t-test or rank sum test and repeated measured ANOVA. Results Patients achieved significantly better uncorrected distance and near visual acuity after surgery (P 0.05). The defocus curves were bimodally distributed with peaks at spherical equivalents of 0 D (0 to +0.5 D) and -2.0 D (-2.4 to -2.0 D), which represented emmtropia at a distance and at the near and median operating distances of 40-55 cm. One month postoperatively, capsulorhexis circularity was 0.81±0.02, and the values of the eccentricity and inclination of the IOLs were 0.21±0.12 mm and 1.11°±0.36°, respectively. The visual quality score of the questionnaire showed that 7 patients did not use spectacles after surgery, and there was no report of severe visual problems. Only 3 patients were affected by a slight halo at night. All patients were satisfied with the results of the surgery. Conclusion A +3.5 D aspheric, diffractive, multifocal IOL can provide good visual acuity at near-intermediate and far distances for those who are used to close work. With the guidance of the latest ophthalmic surgical navigation system, the benefits of a multifocal IOL will be maximized and help patients to achieve better visual quality. Key words: Multifocal intraocular lenses; Real-time intraoperative navigation system; Defocus curves; Visual quality