Influence of extended depth of focus intraocular lenses on visual field sensitivity.

Makiko Takahashi,Kazuhiro Kimura,Takuya Yoshimoto,Katsuyoshi Suzuki,Chiemi Yamashiro,Masaaki Kobayashi,Makoto Hatano,Tomohiko Nagai,Shinichiro Teranishi,Yuka Kobayashi,Fumiaki Higashijima,Ryu Takabatake,Manami Ohta,I-Jong Wang

doi:10.1371/journal.pone.0237728

Abstract

PurposeTo investigate the influence of EDOF IOLs, TECNIS Symfony® (Johnson & Johnson Surgical Vision, Inc.), on visual field sensitivity and to compare the IOLs with other kinds of IOLs.MethodsThe subjects included the normal fellow eyes of patients who underwent the Humphrey Field Analyzer (HFA) 30–2 with Swedish Interactive Threshold Algorithm Fast within 6 months after cataract due to glaucoma or suspected glaucoma. Each parameter of HFA was compared among eyes implanted with TENIS Symfony® (EDOF group), diffractive bifocal IOLs (bifocal group), and monofocal IOLs (monofocal group).ResultsThe total of 76 eyes, including 24 eyes in the EDOF group, 26 eyes in the bifocal group, and 26 eyes in the monofocal group, were included in this study. Mean deviation (MD) of HFA was -0.24±0.58 dB in the EDOF group, -1.38±0.58 dB in the bifocal group, and 0.02±0.44 dB in the monofocal group. Foveal threshold (FT) of HFA was 35.8±1.6 dB in the EDOF group, 33.6±1.7 dB in the bifocal group, and 36.6±1.4 dB in the monofocal group. In both MD and FT, there was significant difference between the bifocal group and the others (p<0.001). There was no difference between the EDOF group and the monofocal group. Moreover, there was no significant difference between the three groups about pattern standard deviation (PSD) of HFA.ConclusionTECNIS Symfony® may have little influence on visual field sensitivity, whereas diffractive bifocal IOLs decrease visual field sensitivity.

Highlights

Multifocal intraocular lenses (IOLs) can yield a better quality of life (QOL) and higher satisfaction of patients due to decreasing spectacle dependence rate
There was no significant difference between the three groups about pattern standard deviation (PSD) of Humphrey Field Analyzer (HFA)
Eyes implanted with diffractive bifocal IOLs did reduce the Foveal threshold (FT) value by 3.0 dB in HFA and the mean deviation (MD) value by 1.4 dB, compared to eyes implanted with monofocal IOLs

Summary

Introduction

Multifocal intraocular lenses (IOLs) can yield a better quality of life (QOL) and higher satisfaction of patients due to decreasing spectacle dependence rate. The IOLs broaden the range of clear vision due to expanding the range of depth, which provides natural appearance for patients without a decline at middle-distance. TECNIS SymfonyR (produced from Johnson & Johnson Surgical Vision, Inc.) is one of the EDOF IOLs using a unique technology that enhances the correction of chromatic aberration and that maintains good contrast sensitivity as well as monofocal IOLs [5,6,7]. It is possible that EDOF IOLs become indicated for patients who have not been a candidate for diffractive bifocal IOLs. Several studies have recently addressed that multifocal IOLs decrease mean deviation (MD) of VF test using (Humphrey field analyzer, Carl Zeiss Meditec, Inc.) compared to diffractive bifocal IOLs, monofocal IOLs, or phakic eyes [8, 9]. This study investigated the influence of TECNIS SymfonyR, one of the EDOF IOLs, on VF sensitivity

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Results

Conclusion