Abstract
Purpose :
A broad selection of presbyopia-correcting intraocular lenses (IOL) is available to address individual requirements of patients. This virtual study analyses objective visual behavioural data collected by a wearable Monitor from multiple users in order to evaluate expected performance of IOLs available on the market.
Methods :
The visual behavioural profiles of more than 400 users were collected with the Vivior Monitor. The profiles represent the occurrence of the different distances to the objects of visual activity of the user. By overlaying these profiles with the defocus curves of the intraocular lenses, we are able to characterise expected impact on the lifestyle of the patient using a number of metrics, including expected spectacle independence. We have used the published defocus curves to derive the range of visual performance of the lens solutions. The percentage of time that the patient is expected to benefit from clear vision was assessed at specific distances (lifestyle match index). We have evaluated and compared examples of monofocal, bifocal, trifocal and extended depth of focus lenses.
Results :
Fitness of IOL solutions vary significantly, depending on the individual profile of the patient. For example, the best performing trifocal solution provides on average 59.0% of patient’s time with visual acuity within 0.1 logMar from the maximum visual acuity with 95% CI=36.5-79.1%. In comparison, EDOF solution delivered 50.9% (95% CI=22.6-78.8%) and general monofocal provided in average 25.2% (95% CI=4.3-56.4%). Due to dependence on specific patient’s lifestyle, trifocal solutions have outperformed other options in 66% of cases, while EDOF lenses were the best solution in 28% of cases.
Conclusions :
The modern IOLs are capable of covering the daily visual needs of patients. However, statistics of the visual lifestyle of patients clearly demonstrate that care should be taken when choosing the appropriate solution, since one-size-fits-all is not applicable to the different visual lifestyles of the patients. In particular, patients favouring far and intermediate distances are benefiting from EDOF solutions and patients with balance of near, far and intermediate distances, require multifocal or trifocal solutions. While we have not observed a single case of a monofocal lens coming out as a best solution, while it can deliver a satisfactory match for users with a visual lifestyle dominated by far viewing distances.
This is a 2020 ARVO Annual Meeting abstract.