The Influence of Angle Alpha, Angle Kappa, and Optical Aberrations on Visual Outcomes after the Implantation of a High-Addition Trifocal IOL.

Guadalupe Cervantes-Coste,Rafael Valdez,Claudia Corredor-Ortega,André Tapia,Martha Massaro,Mariana Osorio,Roberto Gonzalez-Salinas,Cecilio Velasco-Barona

doi:10.3390/jcm11030896

Guadalupe Cervantes-Coste, Rafael Valdez + Show 6 more

Open Access

https://doi.org/10.3390/jcm11030896

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Abstract

The aim of our investigation was to examine the possible correlations between optical aberrations, angle kappa, angle alpha, and visual outcomes following cataract surgery. In total, 56 eyes of 28 patients were implanted with the Liberty 677MY trifocal intraocular lens (IOL). Pre- and postoperative higher-order aberrations, coma, astigmatism, angle alpha, and angle kappa were registered, along with uncorrected and corrected visual acuities at multiple distances. Visual acuity and contrast sensitivity defocus curves were plotted, and the areas under the curve were calculated 1 and 3 months postoperatively. Excellent visual outcomes were found at all distances. Patients reported low levels of dysphotopsia, and 96.4% of patients achieved complete spectacle independence. While angle kappa significantly decreased during cataract surgery (p = 0.0007), angle alpha remained unchanged (p = 0.5158). Angle alpha correlated with postoperative HOAs and had a negative impact on near vision (p = 0.0543). Preoperative corneal HOA and coma had a strong adverse effect on future intermediate and near vision. Residual astigmatism significantly affected postoperative intermediate vision (p = 0.0091). Our results suggest that angle kappa is not an optimal predictive factor for future visual outcomes, while angle alpha and the preoperative screening of optical aberrations might help patient selection prior to multifocal IOL implantation.

Highlights

With the growth of people’s demand for high living standards, the interest in achieving long-term visual comfort and spectacle independence has increased [1]
The rapid development in cataract and refractive surgery has brought the ever-growing popularity of multifocal intraocular lens (IOL) (MIOLs), which successfully respond to these needs, providing functional vision at multiple distances [2,3]
We investigated the possible correlations between pre- and postoperative optical aberrations and visual outcomes following the binocular implantation of a high-addition MIOL

Summary

Introduction

With the growth of people’s demand for high living standards, the interest in achieving long-term visual comfort and spectacle independence has increased [1]. The rapid development in cataract and refractive surgery has brought the ever-growing popularity of multifocal IOLs (MIOLs), which successfully respond to these needs, providing functional vision at multiple distances [2,3]. Spectacle-free vision after surgery has become achievable, postoperative visual outcomes do not always meet the preoperative expectations [2,4]. Aside from conventional biometric parameters such as axial length, keratometry values, and anterior chamber depth, additional anatomic variables should be probably considered for inclusion in preoperative assessment and surgical planning [2,7,9]

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Discussion

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