Optical Aberrations Following Implantation Of Multifocal Iols: A Systematic Review And Meta-Analysis

Published 2022 - 40th Congress of the ESCRS

Reference: FPM11.09 | Type: Free paper | DOI: 10.82333/cg9g-6h59

Authors: Christin Henein ¹ , Clarissa Ern Hui Fang* ² , Ishani Barai ³ , Desta Bokre ⁴ , Yann Bouremel ⁴ , Ahmed Adan ⁵ , Maaz Khan ⁵ , Mayank Nanavaty ⁶

¹University College London Institute of Ophthalmology,London,United Kingdom;NIHR Moorfields Biomedical Research Centre,London,United Kingdom, ²Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust,Manchester,United Kingdom, ³Western Eye Hospital, Imperial College Healthcare NHS Trust,London,United Kingdom, ⁴University College London Institute of Ophthalmology,London,United Kingdom, ⁵School of Medicine, University of Liverpool,Liverpool,United Kingdom, ⁶Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust,Brighton,United Kingdom;Sussex and Brighton Medical School, University of Sussex,Brighton,United Kingdom

Purpose

Multifocal Intraocular Lenses (mIOL) restore vision at different focal distances, a technology that is constantly advancing. We aimed to systematically review patient reported optical aberrations and spectacle independence following implantation of, diffractive, refractive and hybrid (refractive + diffractive) mIOLs to treat presbyopia.

Setting

Meta-analysis

Methods

We conducted electronic database searches in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and ClinicalTrials.gov. Eligibility criteria included RCTs written in English and containing data on optical aberrations in adults receiving mIOLs for presbyopia. Methodological quality was assessed using Cochrane Handbook 6.2. Metaprop command in Stata 17 was used to pool the proportion of patients reporting optical aberrations. 95% confidence intervals were computed and Freeman-Turkey double arcsine was used for transformation of proportions.

Results

Of the 1140 abstracts screened, 36 full texts met the eligibility criteria and 19 RCTs were included in the meta-analysis. For diffractive, refractive and hybrid mIOLs, proportions of patients reporting glare were 0.26 (0.05-0.53), 0.35 (0.25-0.46) and 0.05 (0.00-0.19) (p=0.01); reporting halos were 0.27 (0.14-0.43), 0.44 (0.29-0.59) and 0.17 (0.02-0.39) (p=0.11) and those with spectacle independence was 0.82 (0.76-0.87), 0.63 (0.47-0.77) and 0.86 (0.70-0.97) (p=0.03) respectively.

Conclusions

There is moderate evidence to suggest fewer patients report optical aberrations of glare and halos with better spectacle independence following implantation of diffractive or hybrid mIOLs following refractive lens exchange for presbyopia.