Diffractive multifocal intraocular lens implantation in eyes with a small-diameter pupil

Masayuki Ouchi,Takuya Shiba

doi:10.1038/s41598-018-30141-1

Masayuki Ouchi, Takuya Shiba

Open Access

https://doi.org/10.1038/s41598-018-30141-1

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Abstract

Postoperative outcome of diffractive multifocal intraocular lens (MIOL) implantation in eyes with a small-diameter pupil was evaluated. This non randomized case series involved 23 eyes of 23 patients who underwent diffractive MIOL implantation and whose preoperative photopic pupil diameter was ≤3.0 mm [small-diameter pupil (SDP) group], and 79 eyes of 79 patients implanted with the same MIOL whose pupil diameter was >3.0 mm as controls (LDP group). Contrast sensitivity of high spatial frequency (12, and 18 cycle per degree) and both 12.5% and 6% low-contrast visual acuity (VA) were significantly worse in the SDP group than in the LDP group (P = 0.04, 0.05, 0.05, 0.03). However, no significant difference was found between eyes in the SDP group with a postoperative pupil diameter greater than 3.0 mm and LDP group eyes. No significant differences were found in uncorrected and corrected distance VA (UDVA, CDVA), uncorrected and corrected near VA (UNVA, CNVA), contrast sensitivity with low spatial frequency, and defocus curve between the two groups. In conclusion, in eyes implanted with a diffractive MIOL, a pupil diameter of ≤3.0 mm deteriorates contrast sensitivity. This effect was eliminated postoperatively when pupil size was enlarged to >3.0 mm during surgery.

Highlights

Multifocal intraocular lens (MIOL) implantation is widely applied for the treatment of cataracts
We evaluated the postoperative outcome of full-optic diffractive multifocal intraocular lens (MIOL) implantation in eyes with a preoperative small pupil, as well as the correlation between postoperative pupil size and visual function
The mean postoperative pupil diameter was 2.98 ± 1.22 mm (2.04–3.81 mm) in the small-diameter pupil (SDP) group, while 10 of 23 eyes measured larger than 3.00 mm, and 4.01 ± 1.56 mm (3.23–5.04 mm) in the LDP group

Summary

Introduction

Multifocal intraocular lens (MIOL) implantation is widely applied for the treatment of cataracts. Clinical studies report that in patients with a small pupil, refractive MIOL implantation may result in poor postoperative near-field visual function[1,2,3]. Fujimoto et al.[4] reported a case series of laser pupilloplasty for eyes with decreased near visual acuity (VA) due to age-related narrowing of the pupil in patients implanted with a refractive MIOL. Alfonso et al.[6] reported that pupil size is related to contrast sensitivity in eyes implanted with an apodized diffractive-refractive IOL, but to the best of our knowledge there are no published clinical case series studies of eyes with a small pupil implanted with a full-optic diffractive IOL. We evaluated the postoperative outcome of full-optic diffractive MIOL implantation in eyes with a preoperative small pupil, as well as the correlation between postoperative pupil size and visual function

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