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First Author: R.Schmid GERMANY
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For the LENTIS Mplus intraocular lens (IOL), the near segment can be implanted in any direction to create two foci for far and near distance. In theory, the Modular Transfer Function (MTF) of the Mplus will be optimized by positioning the near segment of the IOL with a nasal inferior rotation of 45 degrees. For a non-rotationally symmetrical lens such as the Mplus, the MTF is dependent on the measurement direction. Thus the vertical and the horizontal MTF should be equal with our positioning of the near segment. This is to be evaluated. Additionally, there should be a very good near vision with this position of the near segment because of nasal pupil shift during pupillary near reaction.
AugenAllianz-Zentren Dillingen/Donau, Germany
30 eyes of 15 Patients so far had implantation of the LENTIS Mplus IOL or Mplus toric IOL with the near segment (+ 3 dpt) in a nasal inferior position by refractive lens exchange or cataract surgery. IOL calculation was done with Haigis formula. Eyes with any affection but cataract were disclosed from the study. One month after surgery, a patient evaluation form had to be filled in and an examination with the Optec Vision Tester 6500 was performed (ETDRS-charts for far and near visual acuitiy, Contrast sensitivity in photopic and mesopic conditions with and without glare). The lens position was controlled by slitlamp foto with dilated pupil. Approval of the local Ethics Committee had been obtained.
Over 90% of the patients were very satisfied with the visual outcomes of the lens in this position. More than 90% had an uncorrected visual acuity of 20/20 for far distance, about 85% had an uncorrected visual acuity of 20/20 for near distance. Contrast sensitivity (CS) was in the normal range for all spacial frequencies in photopic conditions. In mesopic conditions, CS was reduced particularly for higher spacial frequencies but still in a lower normal range. In mesopic conditions with glare, CS was reduced for the higher spacial frequencies (12 and 18 cycles per degree). The individual assessments of quality of vision (glare, halos, starbursts, blurring, ghostings) evaluated by the questionnaire were very inhomogenous. Visual disturbance was little in photopic and high mesopic conditions and considerably higher in low mesopic conditions, where glare and starbursts were predominantly present. However, these phenomena still were not a major problem for most patients. Halos or blurring seem to be insignificant.
Lens power calculation was very precise. Uncorrected visual acuity without any enhancement was very good for far and near distance. A theoretically better near vision with our position of the near segment compared to an inferior position because of nasal pupil shift was not evident. A very good performance in contrast sensitivity was seen with this nasal inferior orientation of the near segment. Performance in low mesopic conditions with glare was reduced as in all multifocal IOL. This is in accordance with the subjective assessments. However, neither the contrast sensitivity in mesopic conditions nor the subjective judgements demonstrated a relevant visual problem for most patients. A limited number of eyes have been examined so far and the measurements were done only one month after surgery. This time-lag reveales the very good visual results shortly after surgery. In the long term, visual performance is expected to be even better. The overall satisfaction with this position of the Mplus was encouragingly high.
... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented