Angle alpha as predictor for improving patient satisfaction with multifocal intraocular lenses?

The core target of multifocal IOLs implantation is to provide advanced visual quality at different distances without spectacle or contact lenses that can be valuable when monofocal IOLs are implanted. Patients with monofocal IOLs need spectacles or contact lenses for the near and intermediate distance's vision. Multifocal intraocular lenses due to the optical part construction provide spectacle independence for patients in the postoperative period. The aim of this review was to analyze the modern approach to the several aspects of multifocal intraocular correction: spectacle independence, dysphotopsia, patient satisfaction. Patients’ questionnaire after surgery provides the data for evaluation of the quality of life, vision satisfaction at all range of distances on different levels of illumination, and patient activities of daily living. During the long period, a photic phenomenon (dysphotopsia) had been discussed in the literature as the principal reason for decrease of patients satisfaction with the treatment and lens explantation. Recently, high grade of spectacle independence and low risk of photic phenomena after modern multifocal IOLs implantation determine high-level patient satisfaction after cataract surgery. Multifocal intraocular correction is the effective technology for restoring passive accommodation that the wide range of the clinical studies proved. This review analyzes 33 studies (32 clinical studies and 1 metaanalisis) published in international peer-reviewed targeted titles.

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One-year clinical evaluation of rotationally asymmetric multifocal intraocular lens with +1.5 diopters near addition

Scientific Reports ◽

10.1038/s41598-019-49524-z ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 3

Author(s):

Tetsuro Oshika ◽

Hiroyuki Arai ◽

Yoshifumi Fujita ◽

Mikio Inamura ◽

Yasushi Inoue ◽

...

Keyword(s):

Visual Acuity ◽

Patient Satisfaction ◽

Contrast Sensitivity ◽

Intraocular Lenses ◽

Phase Iii ◽

Multifocal Intraocular Lenses ◽

Defocus Curve ◽

Near Visual Acuity ◽

One Year ◽

High Level

Abstract We conducted a one-year prospective, multicenter study to assess clinical outcomes after implantation of segmented, rotationally asymmetric multifocal intraocular lenses (IOLs) with +1.5 diopters (D) near addition. In this phase III clinical trial, 120 eyes of 65 patients undergoing phacoemulsification and implantation of Lentis Comfort LS-313 MF15 (Oculentis GmbH) were included. The ophthalmological examinations were performed before and 1 day, 1 week, 1, 3, 6, 9, and 12 months after surgery. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuity at 70 cm, and uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity at 30 cm were measured. A defocus curve was obtained and patients were asked about the severity of photic phenomena. Postoperative distance and intermediate visual acuity was excellent, with UDVA, CDVA, UIVA, and DCIVA of approximately 20/20, 20/16, 20/25, 20/25 were attained, respectively. The level of near visual acuity was lower; UNVA and DCNVA remained at around 20/60 and 20/70, respectively. The defocus curve indicated that postoperative uncorrected visual acuity of 20/25 and 20/40 was obtained at as close as 67 cm and 50 cm, respectively. Contrast sensitivity was within the normal range, with a minimal level of subjective symptoms and high patient satisfaction. The rotationally asymmetric multifocal IOLs with +1.5 D near addition provided excellent distance and intermediate vision, but near vision was not enough for reading small prints. Contrast sensitivity was high, with very low incidences of photic phenomena and a high level of patient satisfaction.

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