ESCRS - PP22.03 - Clinical Evaluation Of Enhanced Intermediate Vision With Monofocal Intraocular Lens Implantation In Retinal Nerve Fiber Layer Defect Patients

Clinical Evaluation Of Enhanced Intermediate Vision With Monofocal Intraocular Lens Implantation In Retinal Nerve Fiber Layer Defect Patients

Published 2022 - 40th Congress of the ESCRS

Reference: PP22.03 | Type: Free paper | DOI: 10.82333/50hv-ww11

Authors: Hungwon Tchah* 1 , Sanghyu Nam 1 , Ko Eun Lee 1 , Joon Hyuk Jang 1 , Hun Lee 1 , Jae Yong Kim 1

1ASAN MEDICAL CENTER, UNIVERSITY OF ULSAN,Seoul,Korea, Republic Of

Purpose

To evaluate the clinical outcomes after enhanced intermediate vision with monofocal  intraocular lens (IOL) implantation which is known to have no loss of light energy for monofocal design in retinal nerve fiber layer (RNFL) defect patients

Setting

Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea

Methods

Retrospective design, all patients were implanted bilateral enhanced intermediate vision with monofocal IOL (Eyhance, J&J Inc.) and were screened for RNFL defect using Cirrus spectral-domain optical coherence tomography (SD-OCT, Call Zeiss Meditec Inc.). RNFL defect was analyzed with clock-hour and average RNFL thickness. 25 eyes of 13 patients with RNFL defect were compared with 38 control eyes without RNFL defect. Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), defocus curve, contrast sensitivity and satisfaction score were evaluated at 3 months after surgery. 

Results

The average RNFL thickness was significantly lower in RNFL defect group than control group (79.1±15.2 vs 99.65±10.00, p<0.05). All RNFL defect group showed more than 1 clock-hour at the ≤5% level in the RNFL thickness. There was no difference in visual acuity between RNFL defect group and control group. The mean postoperative binocular CDVA was 0.049±0.08 vs 0.03±0.05 logMAR, UIVA was 0.23±0.15 vs 0.10±0.08 logMAR, and UNVA was 0.55±0.30 vs 0.38±0.25 logMAR. 3 subjects (15.8%) showed severe glare or halo in RNFL defect group while 17.2% in control group. No patients in both groups showed severe or more dissatisfaction with their vision.

Conclusions

A mild RNFL defect has no effect on visual acuity in distal, intermediate or near distance with enhanced intermediate vision with monofocal IOL implantation. In patients with mild RNFL defect with a need for near vision, enhanced intermediate vision with monofocal IOL could be considered to improve visual outcome.