ESCRS - P069 - THE IMPORTANCE OF PERIPHERAL(OFF-AXIS) REFRACTION, VISUAL FUNCTION, AND CONTRAST DETECTION SENSITIVITY IN PSEUDOPHAKIC PATIENTS WITH MACULAR DEGENERATION IMPLANTED WITH A NEW MENISCUS INTRAOCULAR EDOF LENS, A CASE REPORT.

THE IMPORTANCE OF PERIPHERAL(OFF-AXIS) REFRACTION, VISUAL FUNCTION, AND CONTRAST DETECTION SENSITIVITY IN PSEUDOPHAKIC PATIENTS WITH MACULAR DEGENERATION IMPLANTED WITH A NEW MENISCUS INTRAOCULAR EDOF LENS, A CASE REPORT.

Published 2023 - 27th ESCRS Winter Meeting

Reference: P069 | Type: Presented Poster & Poster Submission | DOI: 10.82333/pfgd-5f36

Authors: Ali Nowrouzi* 1 , Nabil Ragaei Kamel 1

1Ophthalmology,Hospital Quironsalud Marbella,Marbella,Spain

Purpose

The hypothesis of this case report is that better peripheral optics would provide better vision for the patients with foveal dysfunction and macular degeneration by implantation of the new Art intra oculr lens (IOL) to reproduce the best quality of imaging formation in the periphery of the retina.

Setting

Hospital Quironsalud Marbella, Spain.

Voptica, Murcia, Spain

Methods

An 83-year-old man presented in our clinic asking for cataract surgery due to a progressive loss of vision and Contrast sensitivity loss. He denied any relevant past medical or ophthalmologic history, and corrected distance visual acuity (CDVA) was 0.5 LogMAR in his both eyes. Binocular uncorrected near visual acuity (UNVA) measured at 40cm was 20/200. Routine preoperative assessment was performed in both eyes and biletareal dry macular degeneration was confirmed by optical coherence tomography. As the patient demanded to be spactacles free for intermidate distances by using IOL master 700 and the Barret Universal II formula a 21.5D Art40  EDOF IOL was selected targeting emmetropia for both eyes to provide better preipheral visual optics. Routine right eye cataract surgery was performed without any intra or postoperative complication.The peripheral contrast detection sensitivity was estimated by measuring a psychometric parameter, which consists of the luminance difference threshold to detect a circle in the center of a monitor while maintaining gaze at a peripheral fixation target.

Results

The distance visual acuity (UDVA) was 20/20 for each eye at 12 weeks postoperatively and 20/15 binocularly. The  uncorrected visual acuities (UCVA) and best corrected visual acuities (BCDVA) was improved at intermediate (60 cm) 20/25 and near (40Cm)  20/30 distances at postoperative day 1 compared with the values preoperatively and remained stable until 3 months after the surgery. The patient’s satisfaction score was 37 with VF-14 questionnaire at postoperative 12weeks. Patient’s satisfaction scores were significantly high at far and intermediate distance vision. Peripheral refractive errors after cataract surgery with the Art40 IOL show a significant decrease in the peripheral values of spehrical equivalant (SE) in comparison with standard IOLs from 20° of eccentricity. It is due to the field of curvature provided by this new IOL to match the shape of the retina, achieving a correction of myopic errors of up to 2.00 D at 40° temporally.

Conclusion

Visual processing of people with bilateral central vision affection is differ from that of people with normal foveal function. Therefore, it is reasonable to provide better peripheral vision function by peripheral (off-Axis) Refraction, and contrast detection for patients with bilateral AMD with implantation of new design meniscus Art IOLs. Further studies should be undertaken to investigate the agreement between preoperative and postoperative peripheral refraction and the effect on visual performance in these patients.