Comparative visual performance of corneal laser-blended vision vs refractive lens exchange using either a trifocal or extended-depth-of-focus IOL

Session Details

Session Title: Advanced Optic IOLs

Session Date/Time: Tuesday 17/09/2019 | 08:30-10:30

Paper Time: 09:28

Venue: Free Paper Forum: Podium 1

First Author: : A.Abdul Hamid UK

Co Author(s): :    S. Vaswani   I. Siso-Fuertes   J. Dermott   A. Hartwig   C. O'Donnell                 

Abstract Details

Purpose:

To report comparative LogMar binocular visual acuity at distance (BDVA), intermediate (BIVA) and near (BNVA), post-operative refraction, modulation transfer function (MTF) and patient reported outcomes (PROMS) data between three groups of patients. The first group underwent blended vision (BV) LASIK, the second group underwent refractive lens exchange (RLE) surgery with a trifocal IOL and the final group underwent RLE with an extended depth of focus (EDOF) IOL.

Setting:

Optegra Eye Hospital London, UK

Methods:

Surgeries were carried out in a private hospital and patients were divided in 3 groups: BV LASIK (group 1) or RLE with a Zeiss AT LISA tri 839MP IOL (group 2) or a Zeiss AT LARA 829MP IOL (both Carl Zeiss Meditec, Germany) (group 3). Intended sample size for each group will comprise of 40 eyes. In the RLE groups, all eyes were targeted for emmetropia and in the BV LASIK group, one eye was targeted for emmetropia and the contralateral eye between -1.00D to -1.50D. BDVA, BIVA, BNVA, post-operative refraction, MTF and PROMS data were evaluated.

Results:

Mean post-operative BDVA, BIVA and BNVA values were -0.11, 0.07 and 0.06; -0.01, 0.08, 0.05; 0.03, 0.02, 0.32 for groups 1, 2 and 3 respectively. Group 3 showed a statistically significant difference (p = 0.001) when comparing BNVA pre and post-operatively. All patients would have surgery again and 93% of the total were independent from glasses. Moderate halos at night were reported by 0%, 67% and 40% in groups 1, 2 and 3, respectively. In mesopic conditions, MTF curves for patients with identical pupil sizes across groups suggest that increased optical quality is achieved with the EDOF IOL.

Conclusions:

The three reported approaches provide excellent and comparable visual outcomes at distance and intermediate. However, near vision was noted to be significantly better in patients undergoing BV LASIK or RLE with a trifocal IOL, compared with those implanted with an EDOF IOL. These results lead to a high patient satisfaction and spectacle independence

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented