Halo and glare classification of different multifocal IOL compared to monofocal IOL and phakic eyes

Session Details

Session Title: Special Cases
Session Date/Time: Friday 26/02/2016 | 08:30-10:00
Paper Time: 09:48
Venue: MC3 Room
First Author: : P.Hagen GERMANY
Co Author(s): :    D. Breyer   H. Kaymak   K. Klabe   F. Kretz   G. Auffarth  

Abstract Details

Purpose:

Surveys have shown that halo and glare is the dominant reason for MIOL explantation. This retrospective quality management investigation comprises results for phakic eyes and patients with bilateral IOL implantation with respect to the postoperative occurrence of photopsia.

Setting:

All IOL-implantations and follow-ups were performed at the Breyer-Kaymak-Klabe Eyesurgery in Duesseldorf, Germany, which is part of the International Vision Correcton Research Center (IVCRC.net).

Methods:

For patients with different bilateral implantation variants (emmetropic vision or blended vision) of refractive or diffractive IOL or MIOL, photopsia were assessed postoperatively at 3 months with an interactive graphical simulation software (Halo & Glare Simulator, CZM). Measured values for size and intensity were categorized as {“none”, ”mild”, “moderate”, “severe”}. The results of all groups (at least 10 patients per group) were compared to those of phakic eyes. Furthermore, a patient questionnaire (quality of vision) was evaluated.

Results:

Halo and glare were reported in all groups. Values for monofocal as well as refractive multifocal IOL were comparable to phakic eyes {'none”=24%, 'mild'=55%, 'moderate'=21%, 'severe'=0%}. Values for diffractive MIOL, however, were significantly higher {'none”=0%, 'mild'=28%, 'moderate'=62%, 'severe'=0%}. Blended vision implantation variants came with more halo & glare than emmetropic ones. Comparing rotationally symmetric with unsymmetric MIOL, unsymmetric “angel wing” type glare was rare and equally distributed in both groups (“none”=95%). The patient questionnaire revealed that satisfaction with the quality of vision can be high even if photopsia are perceived as strong in terms of size and intensity.

Conclusions:

Our analysis indicates that, generally speaking, refractive MIOL might cause less perception of photopsia. We suppose that the reason for this is that although neuroadaption plays a dominant role in the suppression of halo and glare, diffractive IOL physically often cause more light scattering due to the edges in their characteristic ring-type surface structure.

Financial Disclosure:

One or more of the authors receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, One or more of the authors travel has been funded, fully or partially, by a competing company, One or more of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, One or more of the authors receives consulting fees, retainer, or contract payments from a competing company