BINOCULARLY EXTENDED DEPTH OF FOCUS WITH A NEW INVERTED MENISCUS IOL

Abstract

Purpose : To evaluate the depth of focus induced by a binocular combination of two different models of a new inverted meniscus intraocular lens (IOL), Art40 and Art70 (ArtIOLs, Voptica SL, Murcia, Spain). The two lenses improve the overall off-axis optical quality and induce different amounts of negative spherical aberration.

Methods : Six cataract patients were implanted bilaterally with Art40 and Art70 IOLs to induce low and high values of spherical aberration respectively. The surgery was performed first in the dominant eye with Art40 and a few weeks later in the fellow eye with Art70. As control group, nine patients were bilaterally implanted with a standard monofocal IOL based on aspherical biconvex optics. One month after the last surgery, best-corrected (CDVA) and uncorrected (UDVA) distance visual acuity (LogMAR scale) was measured at 5 m, 66 cm and 40 cm, using trial lenses of -1,5 and -2,5 D and SLOAN charts under photopic lighting conditions.

Results : The monocular CDVA was on average zero in the three groups (eyes implanted with Art40, Art70 models and standard IOLs). In the control group, it decreased rapidly to around 0.25 and 0.43 at intermediate and near distances. In the eyes with Art40, the deterioration was slower to 0.18 and 0.35, while in the eyes with Art70 those values were still better, 0.11 and 0.27. The binocular combination of Art40 and Art70 yielded mean CDVA values of -0.02, 0.01 and 0.12 at far, intermediate and near distances respectively. With the two models of the inverted meniscus lenses, small myopic residual errors were planned (-0.25 and -0.75 D for Art40 and Art70 respectively). As shown in figure, the mean values of binocular UCVA with ArtIOLs were -0.02, 0.01 and 0.06 and in the control group 0.02, 0.17 and 0.39 at 5 m, 66 cm and 40 cm. Inter-subject variability, estimated as standard deviation, ranged between 0.04 and 0.13.

Conclusions : In addition to the optical improvement in the periphery due to the inverted meniscus shape, the binocular combination of the two of ArtIOLs models (Art40 and Art70) improved significantly the useful range of distances. This combination resulted in spectacle independence for the patients without the compromise of halo or disphotopsias.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Defocus curves (mean values of binocular UCVA) of the combination Art40 with Art70 and control group (monofocal IOLs).