Optimization of Methods for the Selection of Multifocal Intraocular Correction in Eye-Lens Surgery

Abstract

Purpose : to develop a methodology for the selection of patients for multifocal intraocular correction with an individual definition of the IOL type based on the data obtained from a preoperative questionnaire and a trial selection of multifocal contact lenses. Patients and methods . The study is based on the data obtained from an analysis of 1000 medical case reports and questionnaires of patients who have been recently operated in the LLC «Eye Clinik “Lege Artis”» because of cataracts and refractive changes. All patients underwent ultrasonic phacoemulsification according to the standard procedure on the Centurion apparatus. Monofocal IOLs from leading global manufacturers, such as M-plus, Comfort (Oculentis), Restor (Alcon) and the trifocal IOL manufactured by PanOptix (Alcon) were offered to patients for the implantation. In order to achieve this objective, questionnaires were developed with questions allowing to determine the psychological type of the patient before the surgery, the nature of his/her visual load and the requirements he/she has in relation to his/her vision. In order to simulate the conditions of multifocal intraocular correction, there were multifocal contact lenses Acuvue Moist selected for patients with varying degrees of ADD power. To assess the degree of patient satisfaction with the results of treatment performed by individual selection of multifocal IOLs, there was an anonymous postoperative survey conducted after 2 weeks and 2 months. Results. The analysis showed that the proportion of implantations of multifocal IOLs among all ultrasound phacoemulsification surgeries was 17 %. Of these, in 55 % of cases patients have chosen IOLs with a low degree of ADD power (Lentis Comfort), in 32 % — PanOptix and in 13 % — Lentis M-plus or Restor. The degree of patient satisfaction with the surgery and the vision obtained in 2 weeks after the surgery was 90 %, and after 2 months — 95 %. Cases with incomplete patient satisfaction with the surgery made (5 %) were noted mainly in the group with the implantation of bifocal IOLs and are associated with typical complaints about the appearance of light phenomena, mostly at night