Clinical Outcomes after Mix-and-Match Implantation of Extended Depth of Focus and Diffractive Multifocal Intraocular Lenses.

Jae Hyuck Lee,Ho Seok Chung,Jae Yong Kim,So Young Park,Su Young Moon,Hungwon Tchah,Hun Lee,Carlo Cagini

doi:10.1155/2021/8881794

Abstract

Purpose To evaluate the clinical outcomes after bilateral mix-and-match cataract surgery using extended depth of focus (EDOF) and diffractive multifocal (DMF) intraocular lenses (IOLs). Setting. Asan Medical Center, Seoul, South Korea. Design Prospective clinical study. Methods Thirty-seven patients underwent TECNIS Symfony EDOF IOL (ZXR00) implantation in the dominant eye, and TECNIS +3.25 DMF IOL (ZLB00) implantation in the nondominant eye. Patients were followed up for 3 months; uncorrected and corrected distance visual acuity (UDVA and CDVA), uncorrected intermediate and near visual acuity (UIVA and UNVA), contrast sensitivity, defocus curves, stereopsis, and patient satisfaction were assessed. Results At 3 months, the mean logarithm of the minimum angle of resolution (logMAR) of UDVA was 0.07 ± 0.09 in EDOF IOL eyes, 0.12 ± 0.11 in DMF IOL eyes, and 0.02 ± 0.05 in both eyes. UIVA was 0.11 ± 0.11 in EDOF IOL eyes, 0.16 ± 0.12 in DMF IOL eyes, and 0.04 ± 0.07 in both eyes. UNVA was 0.25 ± 0.15 in EDOF IOL eyes, 0.22 ± 0.16 in DMF IOL eyes, and 0.13 ± 0.13 in both eyes. Thirty patients (81.1%) were more than satisfied with near vision, and 8 patients (21.6%) complained of severe glare and halo. Spectacle independence for near vision was achieved in 34 patients (91.9%), and 31 patients (83.8%) had better than a 50-second arc of stereopsis. Conclusion Mix-and-match cataract surgery with EDOF and DMF IOL implantation provided good visual outcomes for all distances. Additionally, excellent patient satisfaction was achieved with a high level of spectacle independence and acceptable photic phenomena.

Highlights

Until 20 years ago, cataract surgery using monofocal intraocular lenses (IOLs) could restore only uncorrected distance visual acuity (UDVA)
Binocular multifocal IOL surgery was proposed for cataract patients with presbyopia
All patients provided written informed consent prior to enrollment. e study followed the principles of the Declaration of Helsinki, was approved by the Asan Medical Center Review Board (20170713), and registered as a clinical trial (KCT0004111). is study basically shared similar platform with the study regarding mix-and-match implantation of diffractive multifocal IOLs with different diopter add powers performed by our institute [7]

Summary

Introduction

Until 20 years ago, cataract surgery using monofocal intraocular lenses (IOLs) could restore only uncorrected distance visual acuity (UDVA). Javitt et al [2] found that only 9.8% of subjects studied who had undergone binocular monofocal IOLs surgery did not require reading glasses for viewing near targets and 80.4% needed reading spectacles for more than half of the time. Binocular multifocal IOL surgery was proposed for cataract patients with presbyopia. Diverse types of multifocal IOLs have been made for cataract patients requiring presbyopia treatment. Such IOLs achieved fine clinical results especially with proper patient selection [3, 4]. The most widely preferred multifocal IOLs in the market are diffractive and refractive lenses

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Results

Conclusion