Abstract
Purpose :
Implantation of multifocal intraocular lenses (mIOL) is constantly rising. However, mIOL have a complex optic and it is unclear how visual outcome will be in patients with mIOL after retinal detachement (RD) surgery. Purpose of this study was to evaluate this.
Methods :
The study consited of a retro and a prospective part. In a retrospective manner, with a follow up period of more than 6 weeks with RD surgery in mIOL pseudophacic RD were evaluated in regards to best CDVA, duration of symptoms, and macula-status, reattachment-rate and other. These patients were compared to a matched group of monofocal pseudophacic RD (matching criteria: macular status, age and duration of symptoms).
In prospective manner a total of 18 eyes of 17 patients were evaluated with a follow up period of minimum12 month, evaluationg following parameters: corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), uncorrected intermediate acuity (UIVA), uncorrected near visual avuity (UNVA), defocus curve, subjectiv patient outcome, macula-status, duration of symptoms.
Results :
In the retrospective cohort we evaluated 42 eyes (21 with multifocal lenses, 21 with monofocal lenses). Postoperative CDVA of the mIOL groupt 6 weeks after surgery was worse (0.3 logMAR) compared to the monofocal IOL group (0.17 logMAR) (p = 0,021). This was valid for both groups, macula-off and macula-on status.
The prospective study cohort revealed high VA in all measured distances (0,1 logMAR CDVA; 0.13 logMAR; UDVA; 0,1 logMAR UIVA; 0,11 logMAR UNVA), which corresponds to a gain of 2 snellen lines. The visual gain, however was higher in a previous macula-off status (gain of more than two snellen lines) compared to macula-on status (gain of nearly one snellen line).
In patients reported outcome of the mIOL group no one had complains referring to the lens after one year, and most of the patients noted they would not need to wear glasses.
Conclusions :
In our study CDVA after ppV for RD repair in eyes with mIOL is worse than in eyes with monofocal lenses after a short period of at least 6 weeks, which was statistically significant.
However, in a prospective evaluation after a longer follow up period of one year VA improves, especially in eyes with macula-off status. Patient reported outcomes after one year was without complains referring to lenses and Patients demonstrated a high contentness overall., indicating that IOL change is not necessary.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.