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Kenneth M.P. Yee, Justin Nguyen, Jeannie Nguyen-Cuu, J Sebag; Impact of Multifocal Intraocular Lenses on Contrast Sensitivity Function in Vision Degrading Vitreopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2199.
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© ARVO (1962-2015); The Authors (2016-present)
Multifocal intraocular lenses (IOLs) are known to reduce contrast sensitivity function (CSF). Patients with significant vitreous floaters are also known to have diminished CSF (Retina 34:1062-8, 2014; AJO 172:7-12, 2016), a condition called Vision Degrading Vitreopathy (VDV). This study evaluated whether there is an additive reduction of CSF in patients with multifocal IOL and VDV and whether vitrectomy improves CSF, even in patients with multifocal IOLs.
36 subjects (63 ± 7 years old) with clinically significant vitreous floaters (VDV) were age-matched into 3 groups: multifocal IOLs (n=12), monofocal IOLs (n=12), and phakic eyes (n=12). There was no difference in the prevalence of YAG posterior capsulotomy in the pseudophakic groups. VA (Snellen) and CSF (Freiburg Acuity Contrast Test, %W) were measured before and 1 month after 25-gauge limited vitrectomy.
There was no difference in VA between the 3 groups and no group had significant change in VA post-ppv. Multifocal IOL eyes had pre-op CSF = 5.64 ± 3.18 %W, 65% worse than monofocal IOL eyes (3.41 ± 0.36 %W; p < 0.025) and 74% worse than phakic eyes (3.25 ± 0.55 %W; p< 0.018) with vitreous floaters. All groups had significant improvement in CSF after limited vitrectomy (see table). Despite this improvement, multifocal IOL eyes (2.77 ± 1.24 %W) still had 46% worse CSF than monofocal IOL eyes (1.91 ± 0.41 %W; p < 0.043) and phakic eyes (1.90 ± 0.48 %W; p < 0.044).
Patients with Vision Degrading Vitreopathy and multifocal IOLs have greater reduction in contrast sensitivity function (CSF) than others. Although the contribution of vitreous to reduced CSF is eliminated following vitrectomy and CSF improves, eyes with multifocal IOLs still have worse CSF compared to phakic eyes and those with monofocal IOLs. The measure of CSF is thus useful for pre-operative evaluation and case selection as well as an outcome measure of post-operative improvement, even in the presence of multifocal pseudophakia.
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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