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Jongchul Han, Chihoon Kim, Eui-Sang chung, Tae-Young Chung; Factors Associated With Good Near Vision After Monofocal Intraocular Lens Implantation. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6218.
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To analyze factors contributing to uncorrected near visual acuity of at least J4 after monofocal intraocular lens (IOL) implantation.
This was a prospective study comprising 84 eyes of 59 patients who had undergone phacoemulsification with monofocal IOL implantation. All the patients were aimed for postop emmetropia and had postop UCVA of at least 0.70 and postop SE within ±0.5D. Patients were divided into two groups, good (uncorrected near visual acuity of at least J4) and bad near visual acuity group. Factors analyzed included age, sex, preoperative UCVA, preoperative manifested refraction, axial IOL movement, axial length, pupil size, corneal multifocality, types of IOL, and higher-order aberrations. Axial IOL movement was measured using IOL master as a difference in anterior chamber depth (ACD) after instillation of cyclopentolate 1% and subsequently pilocarpine 2% at two separate visits. Binary logistic regression and odds ratio with 95% confidence intervals were determined
Mean age of 84 cases (29 men, 55 women) was 65.7±9.9 years (range 31 to 83 years) in this study. Thirty-four eyes were in good near visual acuity group and 50 eyes were in bad near visual acuity group. Potential risk factor data in the good near vision and bad near vision groups are as follows : age (63.8±10.0 years vs 67±9.9 years), preoperative distant UCVA (0.47±0.22 vs 0.40±0.25), mean IOL movement (0.52±0.46 mm vs 0.46±0.45 mm), axial length (23.32±1.05 mm vs 0.95±0.10 mm), pupil size (3.24±0.58 mm vs 3.60±0.65 mm), corneal multifocality (2.30±1.03D vs 2.14±0.76D), total RMS (0.82±0.55 um vs 0.79±0.44 um), higher-order RMS (0.31±0.12 um vs 0.36±0.22 um), spherical aberration (-0.27±0.25 um vs -0.21±0.34 um), respectively. There were no statistically significant differences between the two groups other than small pupil size (P=0.04) and short axial length (P=0.03). These two factors were found to be inversely related to good near vision. The pupil size smaller than 2.6 mm and axial length less than 23.0 mm showed good near vision.
Among various factors, small pupil size and short axial length were associated with good near vision after phacoemulsification and monofocal IOL implantation
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