An Underrated Monofocal Plus Intraocular Lens

To evaluate the range of focus, visual and refractive performance of the Isopure Monofocal Plus lens monocularly and binocularly 6 weeks postoperatively. The performance of the lens was compared to the ANSI standard for EDOF lenses.

 

Centre for Sight, private ambulatory ophthalmic surgical centres

This retrospective study evaluated the outcomes of 13 patients with a mean age 74 (66-81) years who underwent bilateral implantation of the Isopure (Physiol/BVI, Belgium) intraocular lens. The dominant eye had a target refraction of 0.00D and the non-dominant eye between -0.75 to -0.90D) to provide improved near acuity.  The primary effectiveness parameters evaluated included uncorrected distance, intermediate (60 & 80cm) and near (40cm) visual acuity. Monocular and binocular distance corrected  near visual acuities were evaluated . Binocular visual performance at all distances was evaluated and patients level of independence from glasses was assessed.

At 6 weeks postoperatively overall spherical equivalent (n=26) was -0.28D (SD0.44),the dominant group (n=13) 0.00D (SD 0.33) & non-dominant group -0.56D (SD 0.35). Overall UDVA was ≥ 6/12 in 85% and ≥6/6 in 54%. UDVA (dominant) was ≥6/12 in 92% & ≥6/6 in 72%. UDVA(non-dom) was ≥6/12 in 92% and ≥6/6 in 31%.   Binocular UDVA  of ≥6/9.5 in 100% & ≥6/6 in 77%.  Monocular CDA was ≥6/6 in 72% & ≥6/9.5 in 100%Binocular CDA was 85% were ≥6/7.5 and 85% 6/6.

Monocular UNVA was ≥6/12 in 65% of the overall group 69% (non-dominant) 62% (dominant) Binocular UNVA was ≥6/12 in 73%.  Binocular UIVA 60cm was ≥6/12 in 100% and at 80cm 96% were ≥ 6/7.5.  Near VA at 40cm with distance correction was ≥6/12 in 83% monocularly and 80% binocularly.

The Isopure intraocular lens labelled as an enhanced or Monofocal Plus lens reliably provides an increased range of focus and with the non-dominant eye targeted between -0.75 and -0.90D, excellent binocular performance is achieved at distance intermediate and near markedly reducing the need for spectacles. The lens performance by far exceeds the ANSI standard for extended depth of focus (EDOF) lenses. Consideration should be given to classifying this intraocular lens as an increased range of focus lens (IROF). With the advent of more lenses with increasing performance, the ANSI standard might also need revision and modernisation