Comparison Of Visual Outcomes And Defocus Profile With An Enhanced Monofocal Iol Utilizing Controlled Positive Spherical Aberration And An Aspheric Neutral Monofocal Iol.

Published 2023 - 41st Congress of the ESCRS

Reference: PO0274 | Type: Free paper | DOI: 10.82333/jcyd-by07

Authors: Elizabeth Law ¹ , Rajesh Aggarwal ² , Phillip Buckhurst* ³

¹BMI Southend Hospital,Southend on Sea,United Kingdom;Southend University NHS Hospital,Southend on Sea,United Kingdom, ²BMI Southend Hospital,Southend on Sea,United Kingdom, ³Optometry,University of Plymouth,Plymouth,United Kingdom

Purpose

To assess the visual outcomes, defocus profile and contrast sensitivity following implantation with a non-diffractive, enhanced monofocal IOL and an aspheric monofocal IOL

Setting

BMI Southend Private Hospital

Methods

This retrospective cohort study examines 100 subjects following phacoemulsification and IOL implantation by a single Ophthalmic Surgeon with the RayOne EMV enhanced monofocal IOL (n =50) and the BiFlex 677AB aspheric monofocal IOL (n = 50). The RayOne EMV utilizes a controlled positive spherical aberration of between +0.12µm to +0.15µm, whereas the BiFlex 677AB is aspheric neutral, 0.0µm. Subjects attended study visits 12 - 18 months post-operatively. Visual outcomes included unaided and best distance corrected visual acuity(UDVA and BCDVA)(6m), intermediate visual acuity (UIVA and BCIVA)(70cm) and near visual acuity (UNVA and BCNVA)(40cm). Monocular defocus curves were plotted and Pelli-Robson contrast sensitivity testing was performed.

Results

UDVA was significantly better with the RayOne EMV (0.08.±0.05 LogMAR) than the BiFlex 677AB(0.19±0.15 LogMAR) as was BCDVA (-0.01.±

0.06 and 0.07.±0.11 respectively). There was also a significant difference (p<0.01) in BCIVA at 70cms with better acuity found in the RayOne EMV cohort (0.34.± 0.11LogMAR) compared to 0.42.± 0.15LogMAR with the Biflex 677AB. There was no difference in near acuity. Best corrected monocular defocus curves showed VA>0.20LogMAR and similar from +0.50 to -0.50 with both IOLs, however the RayOne EMV showed better performance from -1.00 to -2.50 additionally (p<0.05). Contrast sensitivity was within normal ranges with both (EMV 1.29.±0.10, BiFlex 1.35.±0.15) but was significantly better with the BiFlex 677AB (<0.01)

Conclusions

The use of controlled positive spherical aberration by RayOne EMV shows an enhanced monofocal effect in comparison to an aspheric neutral monofocal with improvements in intermediate acuity and defocus profile. There was no detriment to distance acuity and contrast sensitivity remained within accepted age-related normative values.