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To detemine the subjective and objective quality of vision following implantation of a diffractive multifocal lens in one eye and secondary implantation of a piggyback sulcus refractive multifocal lens in the contralateral eye

Session Details

Session Title: Quality of vision evaluation techniques

Session Date/Time: Tuesday 08/10/2013 | 14:00-16:00

Paper Time: 15:48

Venue: Elicium 2 (First Floor)

First Author: : S.Das INDIA

Co Author(s): :    V. Prabhu   S. Nagappa   M. Kurian   S. Hegde   M. Paryani   B.

Abstract Details

Purpose:

A patient underwent a planned phacoemulsitication with implantation of a diffractive multifocal intraocular lens (ReSTOR) in one eye. As he had already had an aspheric monofocal IOL implanted in the other eye, he had a secondary sulcus refractive multifocal IOL (Sulcoflex) implanted in that eye. We measured the uncorrected & best corrected visual acuity (UCVA & BCVA). The subjective indicators of visual quality such as contrast sensitivity on FACT & stray light scatter on cQuant were done. In addition objective indicators of quality of vison were checked on the OQAS (Optical Quality Analysis System) and higher order aberrations of both the eye on OPD-3 and iTrace. The patient satisfaction score was also measured

Setting:

Narayana Nethralaya, Bangalore, a tertiary eye care center and postgraduate institute of ophthalmology

Methods:

A patient underwent a planned phacoemulsitication with implantation of a diffractive multifocal intraocular lens (ReSTOR) in one eye. As he had already had an aspheric monofocal IOL implanted in the other eye, he had a secondary sulcus refractive multifocal IOL (Sulcoflex) implanted in that eye. We measured the uncorrected & best corrected visual acuity (UCVA & BCVA). The subjective indicators of visual quality such as contrast sensitivity on FACT & stray light scatter on cQuant were done. In addition objective indicators of quality of vison were checked on the OQAS (Optical Quality Analysis System) and higher order aberrations of both the eye on OPD-3 and iTrace. The patient satisfaction score was also measured

Results:

The UCVA & BCVA were comparable in the two eyes.The stray light scatter on the cQuant was similar in the two eyes. The OQAS showed a significantly higher Objective Scatter Index, lower Modulation Transfer Function and lower MTF in the eye with the sulcoflex IOL compared to the eye with the ReSTOR. The contrast sensitivity on the FACT was also lower in the eye with the Sulcoflex. The higher order aberrations increased significantly in the same eye after the secondary sulcus implantation of the Sulcoflex IOL. It was also significantly more than the contralateral eye which had a primary ReSTOR implantation.

Conclusions:

The relatively poor objective indicators of visual quality in the eye with the secondary piggyback multifocal IOL is due to the additional IOL aqueous interfaces present in this case. This indicates the need for intensive patient education before undertaking implantion of these IOLs. The acceptable subjective indicators imply that these lenses are a good option for patients who have had surgery with monofocal intraocular lenses and want spectacle freedom for distance and near. As these lenses are very easy to use with low morbidity, there is scope for further research into development of similar piggyback IOLs which do away with the limitations of the present ones.

Financial Interest:

NONE