Wavefront-Shaping (Acrysof Iq Vivity) And Continuous Transitional Focus (Precizon Presbyopic) Technologies For Extended Depth-Of-Focus Intraocular Lens: An Objective And Subjective Analysis.
Published 2022 - 40th Congress of the ESCRS
Reference: PO498 | Type: Free paper | DOI: 10.82333/dx8c-k004
Authors: Joao Heitor Marques* 1 , Rita Vieira 1 , Ana Carolina Abreu 1 , Sílvia Monteiro 1 , Paulo Sousa 1 , Maria do Céu Pinto 1
1Ophthalmology,Centro Hospitalar Universitário do Porto,Porto,Portugal
Purpose
The HD Analyzer® OQAS (Visiometrics) produces an automatic and objective defocus curve, taking double-pass images from the best focus (distance) correction to a -3.00D defocus. Our purpose was to analyze, in vivo, the objective optical quality and the subjective visual acuity, at different defocus levels, of patients implanted with two different non-diffractive extended depth-of-focus (EDOF) intraocular lens (IOL) technologies: wavefront-shaping (group 1, AcrySof IQ Vivity®, Alcon) and continuous transitional focus (group 2, Precizon Presbyopic®, Ophtec BV). Our secondary purpose was to evaluate how the performance of these IOLs hang on intrinsic features of the eye such as corneal spherical aberration (SA) and pupil diameter (PD).
Setting
Refractive Surgery Unit, Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Methods
A prospective study that included 28 patients (14 in each group). One eye per subject was analyzed. Monocular distance-corrected (DC) visual acuity (VA, in logMAR scale) and with -1 diopters (D), -2D and -3D defocus were evaluated at 3 months postoperatively, together optical quality (OQ), measured with HD Analyzer at the same defocus points. The OQAS Accommodative Range (OAR) was calculated as the dioptric range between the best focus and the point at which the OQ decreased by 50%. Total corneal SA in central 6mm and mesopic PD were measured with Pentacam® (Oculus). Binocular distance-corrected near VA (DCNVA) and spectacle independence were also evaluated. Values are shown as median [interquartile range]. Non-parametric tests were used.
Results
In group 1 and 2 respectively, DCVA was -0.08 [0.08] vs 0.00 [0.12] (p=0.150) and 57 vs 21%, (p=0.053) reached 20/15 or better. At -1D VA was 0.05 [0.05] vs 0.16 [0.12] (p=0.210); at -2D VA was 0.22 [0.10] vs 0.22[0.13] (p=0.769) and at -3.00D VA was 0.52[0.08] vs 0.45[0.15] (p=0.002). OQ was not different at best focus nor at -1D (p>0.841) but it was higher in group 2 at -2D (p=0.004) and at -3D (p=0.016). OAR was 1.00 [0.56] D vs 1.63 [1.19] D (p=0.042). Spectacle independence was possible in 71 vs 71%. (p=1.000). DCNVA, PD and SA, were not different between groups (p>0.210). In group. 1, DCNVA was associated with SA (r=0.597, p=0.024). In group 2, DCNVA was associated with PD and SA (B=-0.949, p<0.001; B=-0.343, p=0.030).
Conclusions
Both IOL offer excellent distance vision, considering both VA and objective OQ. There was a tendency for better DCVA in the Vivity IOL. The Precizon IOL is capable of higher focus amplitude and better VA at 33cm. Still, independence from spectacles and binocular DCNVA were not different between groups. Corneal SA was associated with near VA in both groups, but in opposite ways. This may relate to the fact that central optics in the Vivity IOL are dedicated to near vision while in the Precizion IOL the reverse occurs. The strong association between DCNVA and PD in the Precizon IOL may be explained by its peripheral optic sectors responsible for near correction. Preoperative evaluation of SA and PD can influence the choice of IOL.