Presbyopia Correction With Phakic Diffractive Intra-Ocular Lens Implantation

To evaluate refractive and visual parameters related to distance and near vision as well as patient satisfaction after implantation of a diffractive phakic intraocular lens for correction of ametropia and presbyopia. Advantage of this type of phakic IOL is the reversible nature as well as preservation of the humane crystalline lens. This is a report on a single-center, observational, retrospective study of the diffractive IPCL (Care-group)

OOGINSTITUUT AALST

Retrospective chart review of 41 eyes of 22 patients with implantation of a diffractive phakic intra-ocular lens as refractive eye surgery.

A complete ophthalmological examination was performed preoperatively and postoperatively. Visual acuity (VA) measurements were taken 4 weeks post-implant of second eye for distance and near (40cm). The main outcome measures were uncorrected distance (UDVA) and corrected distance (CDVA), uncorrected near (UCVA-N) and distance corrected near (DCVA-N) visual acuities. Three months post-operatively a subjective inquiry was done on quality of vision for distance, intermediate and near using a score from 1 (unsatisfied) to 5 (very satisfied). Additional need for glasses,  overall satisfaction rate and haloes.

Mean age was 52,3 years (range: 47-60). Pre-operatively 35 eyes of 18 patients had a mean myopia of -5.56 Diopters (D) (range -1.5- -11.5D), 6 eyes of 3 patients a mean hyperopia of 1D (range +0.5- +2D).Ten eyes had astigmatism with a mean of 1.5D (range 0.5 – 3D). Four weeks post-operatively mean ametropia was -0.25D (range -0.75-+0.5D) . Mean UCDVA was 0.93 (range 0.7-1.2), mean CDVA was 0.97 (range 0.8-1.2). UCVA-N was 0.84 (range 0.25-1.0). Three months post-operatively 16 patients (76%) were  spectacle free, 6 patients (26%) needed glasses (2 for reading, 4 for intermediate). Seven patients (33%)  experienced non-disturbing haloes. Mean satisfaction score was 4.2 for distance, 3.3 for intermediate and 3.5 for near.

Presbyopia correction with a phakic diffractive intra-ocular lens seemed to be a safe and effective procedure for presbyopic patients. While distance vision is corrected it can also reduce the need for reading glasses.