Comparison of depth-of-focus and mesopic contrast sensitivity in small-aperture corneal inlay, accommodating IOL, and multifocal IOL patients

Session Details

Session Title: Presbyopic Corrections

Session Date/Time: Monday 15/09/2014 | 16:30-18:30

Paper Time: 16:30

Venue: Boulevard F (Level 1)

First Author: : J.Pepose USA

Co Author(s): :                  

Abstract Details

Purpose:

To compare monocular defocus curves and binocular mesopic contrast sensitivity with a small-aperture intracorneal inlay to three premium IOLs.

Setting:

Multicentered study

Methods:

A retrospective comparison of 6-month data from a prospective three-arm study on the Crystalens AO (Bausch + Lomb, Aliso Viejo, CA) Acrysof Restor 3.0 (Alcon, Ft. Worth, TX) and Tecnis Multifocal (Abbott Medical Optics, Santa Ana, CA) to 6-month data from a prospective clinical trial on the KAMRA inlay (AcuFocus, Irvine, CA). Monocular defocus curves were measured from +5.0D to -5.0D in 0.50D steps for the inlay and +4.0D to -4.0D in 0.50D steps for the IOLs. For all patient groups, binocular mesopic contrast sensitivity was measured with and without glare for 1.5, 3, 6, and 12 cycles/degree using the OPTEC 6500 contrast sensitivity tester (Stereo Optical Co., Chicago, IL).

Results:

Crystalens AO (n=25) and KAMRA inlay (n=327) patients had continuous functional vision of 20/40 or better over 3.0D and 4.0D, respectively. ReSTOR 3.0 (n=25) and Tecnis Multifocal (n=22) IOLs had non-continuous functional vision over a dioptric range of 4.5D each. Inlay patients showed better functional vision at intermediate dioptric ranges when compared to all three IOLs. When compared to the three IOLs, the inlay patients showed significantly better contrast sensitivity at all tested spatial frequencies (p < 0.05) for the binocular mesopic no glare condition. Crystalens AO and Restor 3.0 patients showed significantly better contrast sensitivity than Tecnis Multifocal (p <0.05) at 1.5 and 3 cycles/degree, while there was no significant differences between Crystalens and Restor . There were no significant differences between the three IOL’s at 6 and 12 cycles/degree. For the binocular mesopic glare condition, the inlay patients again showed significantly better contrast sensitivity at all spatial frequencies (p < 0.0001) versus the three IOLs. Crystalens AO was significantly better than Tecnis Multifocal at 3 cycles/degree (p=0.011) and at 6 cycles/degree (p=0.0094). There was no significant difference between Restor 3.0 and Tecnis Multifocal at any spatial frequency.

Conclusions:

Patients implanted monocularly with a small aperture corneal inlay achieved a broader continuous range of vision and better mesopic contrast sensitivity, with and without glare, than patients implanted with either accommodating or multifocal IOLs with correction.

Financial Interest:

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... receives consulting fees, retainer, or contract payments from a competing company