Visual results in patients with asymmetric implants of intraocular lens, ReSTOR +2.50 in one eye and ReSTOR +3.00 in fellow eye

Session Details

Session Title: Multifocal Toric IOLs

Session Date/Time: Tuesday 16/09/2014 | 14:00-16:00

Paper Time: 14:54

Venue: Boulevard A

First Author: : J.Coloma SPAIN

Co Author(s): :    L. Santos   J. Beltran   J. Baviera        

Abstract Details

Purpose:

The purpose of this work is to evaluate binocular and monocular visual function of patients who underwent crystalline lens surgery with implantation of two AcrySof IQ ReSTOR lenses of similar optic characteristics, with different additions following eye dominance principles, as described on monovision in pseudophakia with monofocal lenses.

Setting:

Multiclinics, Clinica Baviera, Instituto Oftalmológico Europeo, Spain.

Methods:

158 medical histories of patients who had crystalline lens surgery and implant of ReSTOR + 2,50 multifocal intraocular lens in the dominant eye and ReSTOR + 3,00 in fellow eye between November 2012 and April 2013 were revised. Sensorial dominance was determinant in this study for implantation of intraocular lenses. Incomplete charts, patients with a final refractive equivalent spherical of over +/- 0.75, in either eye, patients who had BIOPTICS with Excimer laser and those with a history of intraoperative complications were excluded. Minimum follow-up time was 3 months. 54 eyes were analyzed in 27 patients. Visual acuities (VA) for statistical analyses were taken in near, intermediate, and distance in each group. Distance visual acuity was taken binocular and monocularly using Snellen tables at a distance of 6 m, obtained values are shown in its equivalent to the logMAR scale for further analysis. Near visual acuity (NVA) and intermediate visual acuity (IVA) were measured using the table of near vision designed by Paul Runge for near vision at 40 cm (Precision Vision, Las Salle II, USA). NVA was taken at 40 cm and IVA at 70 cm under photopic conditions. Post operatory visual satisfaction survey was given to patients.

Results:

The mean of distance visual acuity without correction in the ReSTOR + 2.50 group was 0.065 logMAR +/- 0.082 (SD) and 0.085 logMAR +/-0.10 (SD) in the ReSTOR +3.0 group, the difference being statistically insignificant (p=0.44). The group with a ReSTOR + 2.50 lens implant shows better intermediate visual acuity at 70 cm the mean being 0.41 logMAR +/-0.17 (SD), equivalent to J8 on the Jaeger scale, while IVA mean of the eye group with ReSTOR +3.0 was 0.43 logMAR +/-0.15 (SD), equivalent to J9 on the Jaeger scale. However, the difference for both groups is not significant statistically (p=0.67). With regards to near vision, the eye group with a ReSTOR + 2.50 lens implant had a visual acuity mean of 0.27 logMAR +/-0.21 (SD), equivalent to J5 on the Jaeger scale, while the eye group with a ReSTOR +3.00 lens implant had a near visual acuity mean of 0.9 logMAR +/-0.16 (SD), equivalent to J3 on the Jaeger scale; when doing the statistical analysis the difference is p=0.11. Patients’ satisfaction with binocular vision is high, comparable to the satisfaction surveys obtained from different studies with implants of multifocal lenses

Conclusions:

Our patients underwent a bilateral implant of diffractive aspheric lenses, implanting a ReSTOR lens model SV25TO with +2.50 in the dominant eye and a ReSTOR lens model SN6AD1 with +3.00 in the non-dominant eye. In this study, patients’ satisfaction with binocular vision is high, comparable to the satisfaction surveys obtained from different studies with implants of multifocal lenses , therefore, combined implantation of apodized diffractive multifocal lenses of different additions, implanting a lens with +2.50 in the dominant eye and another lens with +3.00 in the non-dominant eye, following sensorial dominance principles, is a useful tool to provide patients with a proper near, intermediate and distance vision after surgery and to decrease dependency from glasses in their daily life. We can conclude that the diffractive aspheric multifocal ReSTOR lens model SV250TO with +2.50 addition has a similar performance than the SN6AD1 lens with +3.00 addition, since no statistically significant difference was found when comparing near, intermediate and distance visions between the two lenses in this study. However, in clinical practice, a slight decrease of near vision was detected with lenses of lower addition.

Financial Interest:

NONE