Comparative outcome of four multifocal intraocular lenses

Session Details

Session Title: Pseudophakic IOLs/ Multifocals I

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

Paper Time: 17:16

Venue: Boulevard A

First Author: : M.Assouline FRANCE

Co Author(s): :    L. Bessede   T. Guedj           

Abstract Details

Purpose:

To compare refractive outcome, best corrected and uncorrected visual acuity, as well as subjective defocusing curves of 4 different multifocal lens designs.

Setting:

Centre Iena Vision & Clinique de la Vision – Paris – France

Methods:

Retrospective study of consecutive cases comparing 3 recent multifocal intraocular lenses (Medicontur Bi Flex 677M diffractive and refractive design, n=33, OcuLentis-Mplus aspheric refractive design, n=223, and Physiol Finevision trifocal diffractive design n=161) to a standard bifocal diffractive lens design (ATLisa-Zeiss, n=193).

Results:

Mean postoperative residual sphere was more hyperopic in the Bi-Flex group (+0.50+/- 0.55 D) as compared to the Mplus (+0 .11 +/-0.46, p=0.0001) and the Finevision (+0.25+/-0.40, p=0.002). Adjustment of A constant was since implemented by the company. There was no significant difference for best corrected acuity, or residual cylinder between groups. Monocular uncorrected visual acuity (MUVA) was both 20/20 at 5 m and Jaegger 1 at 35 cm (indicating an outstanding functional outcome) in 40.0%, 49.2%, 49.3% of Bi-Flex, Mplus and Finevision cases respectively as compared to 39.2% of the ATLisa implanted eyes. Intermediate distance MUVA at 65 cm was J5 or better in 94.7 %, 75.6% and 76.8% versus 45.5% of cases respectively, and was J4 in 56.2%, 24.7% and 18.3% versus 6.1% of cases respectively. Subjective defocusing curves suggested a better defocusing performance for the Bi-Flex lens in the distance vision range, and of Bi-Flex, MPlus and Finevision lenses in the intermediate vision range, as compared to the ATLisa Bifocal lens. Analysis of “mix & match” cases suggested that a combination of MPlus in the dominant eye with either Finevision or Biflex in the non dominant eye is optimal to improve binocular defocusing curves and pseudo-accommodation.

Conclusions:

Advanced multifocal intraocular lens designs provide an excellent refractive and visual outcome for distance and near tasks, and have improved significantly the functional efficacy of uncorrected intermediate vision, as compared to standard bifocal diffractive designs. Intermediate vision ability appears essential to an improved quality of vision and quality of life, considering increasing professional, relational and occupational activities, which involve digital interfaces.

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... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented