Comparative clinical outcomes of binocular defocus customisation using monofocal and EDOF IOLs in patients undergoing refractive cataract or lens exchange surgery

Session Details

Session Title: Premium IOLs: Multifocal, EDOF & Toric

Session Date/Time: Tuesday 25/09/2018 | 16:30-18:00

Paper Time: 17:32

Venue: Room A4

First Author: : M.Pande UK

Co Author(s): :    E. Proudfoot                    

Abstract Details

Purpose:

Binocular defocus customisation is a common strategy to enlarge the binocular focal range in patients undergoing lens surgery to correct presbyopia. Monofocal IOLs have a limited depth of field and require a higher degree (between 1.25 to 2.00 dioptres) defocus difference between eyes as used in conventional monovision systems. EDOF IOLs however have a larger depth of field and hence the defocus difference between eyes can be limited to physiological values of less than 1.0 D. EDOF IOLs however are associated with dyspotposias not associated with monofocal IOLs. We present a comparative clinical evaluation of these two presbyopia correcting options.

Setting:

Vision Surgery & Research Centre North Ferriby. HU14 3LD UK

Methods:

Two continuous cohorts of 35 patients each who had undergone lens exchange surgery were identified. Cohort A had defocus customisation using monofocal IOLs while Cohort B had defocus customisation using EDOF IOLs. Defocus difference in Cohort A and B ranged from 1.25 to 2 Dioptres and 0.25 to 1 Dioptres respectively. 4-8 weeks after surgery all patients underwent a subjective refraction, a functional visual assessment using the PANFOCAL VA system, an objective task performance assessment and answered a questionnaire. The visual target was to achieve uncorrected binocular visual acuities of 6/9 or better from 40 cm to 6m.

Results:

Binocular defocus customisation was successfully achieved in all patients and no patients needed a secondary refractive enhancement. All patients in both cohorts achieved uncorrected Binocular vision of 6/9 or better. There were no significant differences between cohorts in intermediate vision but the near photopic and mesonic visual acuities were significantly worse in Cohort A compared to cohort B. Distance vision in dim lights was reported to be a concern by more patients in cohort B. Patient satisfaction was very high in both cohorts.

Conclusions:

Binocular defocus customisation is a valid strategy to maximise binocular focal range. The amount of defocus difference needed to achieve the full range of unaided vision is within physiological limits if EDOF IOLs are used. Unaided near vision is better with EDOF defocus customisation.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented