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Objective evaluation of visual function, 12 months after bilateral implantation of a trifocal diffractive IOL (PhysIOL FineVision®)

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Session Details

Session Title: Pseudophakic IOLs/ Multifocals II

Session Date/Time: Tuesday 16/09/2014 | 08:00-10:30

Paper Time: 08:24

Venue: Boulevard A

First Author: : J.Marques PORTUGAL

Co Author(s): :    A. Martins Rosa   F. Silva   B. Quendera   C. Lobo   J. Mira   J. Neto Murta

Abstract Details


To objectively evaluate visual function using computerized psychophysical tests 12 months after bilateral implantation of a new aspheric diffractive trifocal intraocular lens (IOL) and to compare these results with those obtained in the first month postoperatively.


Ophthalmology Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal Visual Neuroscience Laboratory of the Institute for Biomedical Imaging and Life Sciences (IBILI), Coimbra, Portugal


Prospective study. Twenty eyes of 10 consecutive patients that underwent cataract surgery and bilateral implantation of a new aspheric diffractive trifocal IOL (Physiol FineVision®) were included. All eyes had a one-week time frame between surgeries. Monocular and binocular, uncorrected and corrected visual acuities (distance, near and intermediate) were measured. Contrast sensitivity was evaluated with a computerized psychophysical software – Metrovision® – that tests different spatial frequencies (0.6 - 1.1 - 2.2 - 3.4 - 7.1 – 14.2 cpd) under static (0 Hz) and dynamic (10 Hz) conditions, both in photopic (80-90 cd/m2) and mesopic (0.08 cd/m2) settings. The same software was used for pupillometry (100cd/m2; 10cd/m2 and 1cd/m2) and glare (5cd/m2 and 1cd/m2) evaluation. We tested motion discrimination and achromatic contrast discrimination using two innovative 2AFC (two-alternative forced choice) psychophysical tests that required comparison and discrimination of visual features between two separated moving dots. A complete ophthalmologic examination as well as all the above-mentioned computerized psychophysical tests were performed at 1, 3, 6 and 12 months postoperatively. Non-parametric tests were used to compare the results of the psychophysical tests between the first (1 month) and last (12 months) visit. A significance level of 0.05 was used for all statistical tests.


Twelve months postoperatively, distance uncorrected visual acuity (VA) was 0.0 ± 0.08 logMAR and distance corrected VA was 0.0 ± 0.05 logMAR. Distance corrected near VA was 0.2 ± 0.07 logMAR (J1) and distance corrected intermediate VA was 0.0 ± 0.06 logMAR. 
The IOL was centered in all patients and there were no cases of IOL opacification during any of the follow-up visits. Patients were able to read 28.88 ± 22.49% and 79.84 ± 8.68% of optotypes under a glare source of 1cd/m2 and 5cd/m2, respectively. Mean mesopic pupillometry was 3.61 ± 0.72 mm and 3.79 ± 0.52 mm for the right and left eyes, respectively. Mean photopic contrast sensitivity for high spatial frequencies (7.1 and 14.2 cpd) was 18.88 ± 1.46 dB and 11.50 ± 2.93 dB for static conditions and 17.50 ± 1.60 dB and 12.12 ± 1.81 dB for dynamic conditions. The mean results over the horizontal meridian (0º) for motion discrimination and achromatic contrast discrimination were: 0.74 ± 0.51 deg/s and 2.53 ± 0.69 cd/m2, respectively. There were no statistically significant differences (p>0.05) between the first and last visit in any of the psychophysical tests. This was true both for monocular and binocular visual function.


An objective assessment of visual function through quantitative computerized psychophysical approaches allows for a precise and reproducible evaluation that significantly complements a purely subjective analysis. The Physiol FineVision® trifocal IOL provided a satisfactory full range of vision and quality of vision parameters 12 months after surgery. The lack of statistically significant differences between the first and last visit demonstrate that functional recovery is complete as soon as 1 month after surgery.

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