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Aspheric Diffractive Versus Refractive Multifocal IOLs: Comparison of Visual Prognosis and Patient Satisfaction

Aspheric Diffractive Versus Refractive Multifocal IOLs: Comparison of Visual Prognosis and Patient Satisfaction. Eltutar , Kadir; Akcetin , Tulay A .; Ozcelik , N. Demet. Istanbul Education and Research Hospital Department of Ophthalmology.

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Aspheric Diffractive Versus Refractive Multifocal IOLs: Comparison of Visual Prognosis and Patient Satisfaction

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  1. Aspheric Diffractive Versus Refractive Multifocal IOLs: Comparison of Visual Prognosis and Patient Satisfaction Eltutar, Kadir; Akcetin, Tulay A.; Ozcelik, N. Demet IstanbulEducationandResearchHospitalDepartment of Ophthalmology Theauthorsstatethattheyhave no proprietaryinterestandtheyhave not receivedanygrantsorfunds in support of thestudy.

  2. Purpose: • Toevaluate the optical and visual performance after bilateral implantation of refractive and aspheric diffractive multifocal intraocular lenses.

  3. Methods: • Theprimaryobjective of thestudywastodeterminetheuncorrected distance, intermediate and near visual acuitiesafter uncomplicatedcataractsurgery, andbilateral MIOL implantation. • 10 patients who had bilateral implantation of the aspheric diffractive MIOL (n=20; + 4.00 D add), and 10 patients who had bilateral implantation of the refractive MIOL (n=20, + 3.50 add) wereenrolled. • Spectacleindependency, patientsatisfactionandphoticphenomenawereevaluated. • Thestudywascarriedoutprospectivelywith a follow-upperiodlastingforsixmonthspostoperatively.

  4. Methods: • Patients had tofollowtheexaminationdates on postoperativedays 1, 30 and 180. • Immersion A-scanbiometrywasusedforaxiallengthmeasurementswithtargetedemmetropiausing SRK-T formula. • Distancevisualacuitieswereachievedby ETDRS chart at 4,0 meters, intermediate (60.0 cm) andnear (40.0 cm) visualacuitieswereevaluatedwithJaegercards.

  5. Results: • Meanfollowup time was 25,30 ± 2,32 (24-30) weeks. • Meanage of thepatientswas 63,08 ± 4,20 (48-75 years). • Thesepatients had Grade 1-4 bilateralcataract (LOCS III) on baselineexamination. • No intraoperativecomplicationsoccurred in any of thecases. • PreoperativeandpostoperativeLogMAR UCVA findingsshowedstatisticallysignificantdifference in theasphericdiffractiveandtherefractivegroups (p < 0,05) • Consideringuncorrecteddistancevisualacuities , thedifferencebetweentherefractiveandtheasphericdiffractivegroupswas not statisticallysignificant (p>0.05) on postoperativefirstday, firstmonth, andsixthmonthexaminations.

  6. UCVA fordistancevision in bothgroups at certainvisits

  7. Uncorrectednearvisualacuities on postoperativefirstday, firstmonthandsixthmonth

  8. Uncorrectedintermediatevisualacuities at postoperativefirstday, firstmonthandsixthmonth

  9. SpectacleIndependency • Sixmonthspostoperatively, in asphericdiffractivegroupspectacleindependencyrateswere, 93,6 % fordistance, % 94,2 % fornear, and 88,4 % forintermediatevision. • Inrefractivegroupspectacleindependencyrateswere, 94,2 % fordistance, % 90,8 % fornear, and 92,8 % forintermediatevision. • Thedifferencewas not statisticallysignificant (p> 0,05).

  10. Complications related to phacoemulsification and MIOL implantation CME: Cystoid Macular Edema PCO: Posterior Capsular Opacification

  11. Conclusions: • Ourresultsshowthat; bilateralimplantation of MIOLswiththesameopticdesignsprovidesefficientdistancevision. There is no superioritybetweenthetwogroupsconsideringuncorrecteddistancevisualacuities. • The mean uncorrected near visual acuity was better in the aspheric diffractive group. • Themeanuncorrectedintermediatevisualacuitywasbetter in therefractivegroup. • Photicphenomenawastolerable in bothgroups. Though not statisticallysignificant, photicphenomenarelateddisturbanceswererelativelylessdetected in theasphericdiffractivegroup at allvisits.

  12. Conclusions: • ForrefractiveMIOLs, ifpoorlytoleratedbythepatient, photicphenomenamayevenleadtotheextraction of MIOLs. Especially in dimlightconditionssomepatientsmayneedpresbyopiccorrectionbyspectacles, andpatientsmust be warnedabout not drivingforlonghours at night. • ForasphericdiffractiveMIOLswith + 4.00 D add, nearvisionwashighlysatisfactory in bothbrightanddimlightconditions. Somepatientsmayneedspectaclesforintermediatevision, whichmightalso be resolvedbypreoperativetargetedmyopiabybiometry, orpreferringdiffractivemiolswithlower presbyopicaddition.

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