Comparison of the Clinical Outcomes between Echelette Extended Range of Vision and Diffractive Bifocal Intraocular Lenses.

Xin Liu,Peiqing Chen,Xiaohui Song,Danni Lyu,Xingchao Shentu,Ke Yao,Yanan Zhu,Wei Wang,Yibo Yu

doi:10.1155/2019/5815040

Abstract

Purpose To compare the clinical outcomes of echelette extended range of vision (ERV) and diffractive bifocal intraocular lenses (IOLs). Methods This is a prospective, consecutive, nonrandomized clinical trial. Seventy-three eligible patients (109 eyes) received the implantation of echelette ERV IOL (Tecnis Symfony ZXR00) or diffractive bifocal IOL (Tecnis ZMB00). 1 week, 1 month, and 3 months after surgery, visual acuities at different distances were examined. At 3 months, defocus curves, contrast sensitivities (CSs) with and without glare, optic path difference (OPD) scans, and questionnaires were evaluated. Regression analyses were applied to discover influence factors on postoperative vision. Results ZXR00 showed better distance (P < 0.05) and intermediate (P < 0.001) visual acuities, while ZMB00 was better at distance-corrected near visual acuity (P < 0.001). Multivariate analyses indicated that worse intermediate (P < 0.001) and near vision (P=0.013) of ZMB00 might occur in patients with longer axial length. ZXR00 demonstrated smoother defocus curve and higher CSs. Superior modulation transfer function (MTF) and higher Strehl ratio (P < 0.05) were shown in ZXR00. In questionnaire evaluation, ZXR00 received better outcomes in self-reported vision, Visual Function-14 (VF-14) questionnaire, Quality of Vision (QoV) questionnaire, satisfaction, and recommendation grades. Spectacle dependence did not differ between ZXR00 and ZMB00 statistically. Conclusion ZXR00 proved to be remarkable in distance and intermediate vision, defocus curve smoothness, CSs, and visual comfort, while ZMB00 achieved better near vision. ZXR00 may attain better near vision if postoperative SE remains slightly negative. Patients with relatively longer axial length might receive less favorable intermediate and near vision after ZMB00 implantation. This trial is registered with ChiCTR-ONC-17011119.

Highlights

Intraocular lens (IOL) implantation has become a common practice for the increasingly large population of cataract patients; it compromised ocular accommodating ability, leading to postoperative presbyopia and a high spectacle dependence rate up to 80% [1]
Instead of adding certain focus, extended range of vision (ERV) IOLs extended the depth of focus. e effects of ERV IOLs were achieved based on the principles of echelette diffractive ring (Tecnis Symfony ZXR00), spherical aberration induction (SIFI MiniWell), or pinhole effect (Acu-Focus IC-8) [3]
Patients who had definite requirement on intermediate vision were implanted with ZXR00, while those who required definite near vision were implanted with ZMB00. e investigators of postoperation examinations and patients themselves were masked to the type of IOLs implanted

Summary

Introduction

Intraocular lens (IOL) implantation has become a common practice for the increasingly large population of cataract patients; it compromised ocular accommodating ability, leading to postoperative presbyopia and a high spectacle dependence rate up to 80% [1]. Like the monovision of the 1950s, the bifocal IOLs of the 1980s, and the accommodating IOLs, trifocal IOLs, and extended range of vision (ERV) IOLs of the 21st century, were developed to tackle the problem. Compared to monofocal IOLs, multifocal intraocular lenses (MIOLs) like bifocal and trifocal ones are able to provide clear images at each focus and alleviate the problem of presbyopia. E effects of ERV IOLs were achieved based on the principles of echelette diffractive ring (Tecnis Symfony ZXR00), spherical aberration induction (SIFI MiniWell), or pinhole effect (Acu-Focus IC-8) [3].

Methods

Results

Conclusion