July 2018
Volume 59, Issue 9
ARVO Annual Meeting Abstract  |   July 2018
Evaluating Visual Outcomes in Small-Aperture IOL, Accommodating IOL, and Multifocal IOL Patients
Author Affiliations & Notes
  • Ling Lin
    AcuFocus Inc, Irvine, California, United States
  • Jay Stuart Pepose
    Pepose Vision Institute, St. Louis, Missouri, United States
    Washington University School of Medicine, St. Louis, Missouri, United States
  • Srividhya Vilupuru
    AcuFocus Inc, Irvine, California, United States
  • Footnotes
    Commercial Relationships   Ling Lin, AcuFocus Inc (E); Jay Pepose, AcuFocus Inc (C), Allergan (C), Bausch & Lomb (C), Envisia Therapeutics (C), Johnson & Johnson Vision Care (C), TearLab (C); Srividhya Vilupuru, AcuFocus Inc (E)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2198. doi:
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      Ling Lin, Jay Stuart Pepose, Srividhya Vilupuru; Evaluating Visual Outcomes in Small-Aperture IOL, Accommodating IOL, and Multifocal IOL Patients. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2198.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Small-aperture technology has been applied to presbyopia correction in patients after cataract removal. A retrospective, comparative evaluation was performed on visual outcomes including visual acuities (VA), defocus curves and mesopic contrast sensitivity between small-aperture vs. accommodating and multifocal intraocular lenses (IOL) in cataract patients at 6 months.

Methods : A prospective three-arm study (conducted from 2010 to 2012) on bilateral implantation of Crystalens AO (N=26, Bausch + Lomb), Acrysof ReSTOR +3.0D (N=25, Alcon) and Tecnis +4D Multifocal (MF) IOL (N=22, J&J Vision) and a recent prospective study (conducted from 2015 to 2016) on contralateral implantation of IC-8 IOL with an aspheric monofocal IOL (N=105, AcuFocus) were analyzed and compared. Monocular and binocular uncorrected and high-contrast distance-corrected distance (4 m for IC-8, 6 m for others), intermediate (67 cm for IC-8, 80 cm for others) and near (all 40 cm) visual acuities were tested with logMAR charts. Defocus curves (binocular for IC-8, monocular for others) were measured with an ETDRS chart at 4 m with manifest refraction. Binocular mesopic contrast sensitivity (CS) was measured with and without glare at 1.5, 3, 6, and 12 cycles/degree (cpd) using Optec 6500 Vision tester at 6 months post-op. VAs were converted to logMAR. Statistical tests were done using t-test with a control using Dunnett's Method.

Results : IC-8, Crystalens, ReSTOR, and Tecnis MF IOL groups had similar mean UDVA (0.02 - 0.11). IC-8 and Crystalens had mean UIVA of 0.08 and 0.07, nearly two lines better than ReSTOR and Tecnis MF (both 0.24, p<.0001). Mean UNVA for IC-8 and Tecnis MF was 0.18 and 0.19; ReSTOR had better UNVA at -0.01 and Crystalens had worse UNVA at 0.26 (p<.01). Snellen 20/40 vision range was continuous across 4.5 D for IC-8 and 2.5 D for Crystalens, non-continuous across 4.5 D for ReSTOR, 4.0 D for Tecnis MF. For CS with and without glare, IC-8 and ReSTOR groups were similar across all spatial frequencies. IC-8 group was worse than Crystalens at 6 cpd and better than Tecnis MF at 3 cpd with no glare (p<.05).

Conclusions : The small-aperture IOL improved vision across all distances and showed a wide range of continuous functional vision demonstrating extended depth of focus. IC-8 patients showed superior intermediate VA and comparable binocular mesopic contrast sensitivity compared to accommodating and multifocal IOLs.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.


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