A new “low-add” rotationally asymmetric multifocal intraocular lens: clinical experience with the Lentis LS-313 MF20

Session Details

Session Title: Pseudophakic IOLs/ Multifocals II

Session Date/Time: Tuesday 16/09/2014 | 08:00-10:30

Paper Time: 09:50

Venue: Boulevard A

First Author: : J.Reiter GERMANY

Co Author(s): :                  

Abstract Details

Purpose:

Clinical evaluation of this new “low-add” MIOL with progressive near-add of +2.00 dpt in the inferior IOL-segment, performing a prospective study in the context of planed cataract surgery. Focus of investigation was post op visual acuity for far, intermediate and near, depth of focus, contrast sensitivity, halo and glare-assessment especially for night driving and overall patient satisfaction.

Setting:

Eye-Clinic Landshut, Bavaria

Methods:

In a prospective study 40 eyes of 20 patients (bilateral) received the IOL Lentis LS 313 MF20. This sister-IOL to the Mplus with a reduced near-add of 2.00 dpt at IOL plane was implanted in the context of planed cataract surgery. All eyes were otherwise healthy, with the exception of mild AMD and/or glaucoma. The clinically expected post op visual acuity was 0.63 or more. Standard coaxial phacoemulsification with an incision of 2.4 mm was performed in peribulbar anesthesia, starting with the non-dominant eye. At 1, 3 and 6 months post op eyes were examined by an ophthalmologist and technician for data-collection and statistical analysis. Visual acuity testing was performed using EDTRS-charts for 4 m, 80 cm and 40 cm under daylight conditions. Depth of focus was determined on the basis of best distance correction adding +/- spheres in 0.5 dpt steps to the oculus test frame and recording distance visual acuity under daylight conditions. Contrast sensitivity was tested under photopic (85 cd/m²) and mesopic (3 cd/m²) conditions using the contrast sensitivity tester by Ophtec 6500. Halo and glare assessment for day and night was performed using test pictures and subjective quantification. A questionnaire determines overall satisfaction in daily life.

Results:

As expected there was a significant improvement of UCVA from pre op 0.25 to post op 0.80 and BSCVA from pre op 0.45 to post op 0.95 (mean, monocular). Refraction changed from pre op +1.33 dpt SEQ to post op -0.30 dpt SEQ. Cylinder remained unchanged (0.26 dpt vs 0.25 dpt). Monocular UIVA was 0.74 and DCIVA 0.73, UNVA was 0.57 and DCNVA 0.54. Binocular results were as follows: UCVA 0.95, DCVA 1.06, UIVA 0.85, DCIVA 0.80, UNVA 0.65, DCNVA 0.58 and CNVA 0.92. Contrast sensitivity results were comparable to monofocal IOLs. Defocus curves show a broad shoulder from +0.50 to -1.50 dpt. 5 of 20 patients reported mild halos during night driving during 3 months. No subject reported an intractable glare or haloing. 4 of 20 patients use additional readers for newspaper, none for intermediate distance.

Conclusions:

The above results show significant improvement of UCVA und BSCVA up to 0.80 and 0.95 (decimal). Intermediate visual acuity was almost at the level of distance visual acuity, binocular 0.80. Binocular UNVA was 0.65 and DCNVA was 0.58, well above newspaper print (0.40). Defocus curves show a broad shoulder from +0.50 to -1.50 dpt of 0.80 (decimal). Only 5 of 20 patients report mild halos during night driving. Only 4 of 20 patients use additional readers for small print. No patient reported of intractable glare and halo or dysphotopsia. In summary this new “low add” segment MIOL has the potential to become a patient- and surgeon-friendly multifocal IOL for cataract surgery and presbyopic lens exchange for its low profile of optic side effects. The worst complication so far seems to be additional readers for small print in otherwise happy patients for far and intermediate distance.

Financial Interest:

NONE