Enhanced Depth Of Focus Intraocular Lenses In Eyes With Minor Retinal Pathologies Without Metamorphopsia.

Published 2023 - 41st Congress of the ESCRS

Reference: PO0526 | DOI: 10.82333/xra5-0540

Authors: Katerina Buusova Smeckova* ¹ , Zdenek Smecka ¹ , Barbora Strnadova ¹ , Ariadna Kovacikova ¹

¹Eye Clinic Zlin,Zlin,Czech Republic

The aim of our study is to evaluate the quality of vision and complications in eyes that underwent the implantation of the Extended Depth of Focus (EDOF) IOL and have minor changes in the perifoveolar area of the retina due to a stable or minimally progressive disease such as scaring or asymptomatic puckers.

The absence of retinal pathologies is one of the requirements for the successful implantation of trifocal IOLs. EDOF lenses with their less demanding design may be an option not only for drivers, but also for patients with retinal abnormalities, that have minimal impact on visual acuity and that do not influence Amsler Grid findings.

All patients underwent the implantation of the Acrysof IQ Vivity IOL, Alcon in Eye Clinic Zlin in 2021 and 2022.

Included 23 eyes of 13 men, 5 women. Small ERM, scars or drusen.

The patients have been informed about the condition of their retina, limited selection of suitable IOLs for their condition as well as the expected reduced performance of the lens. They also accepted necessity of regular checkups with OCT and that there may be a slow or sudden progression of the pathology in the future

Prior the surgery has been performed a thorough ophthalmological examination. BCVA has been examined for both distance and near. Examination performed with IOL Master 700, Verion, Pentacam HR, endothelial microscopy and Amsler grid. OCT examination or angioOCT has been performed to evaluate retinal pathologies. More complicated cases have been consulted with a retinal surgeon as well.

One surgeon. Uneventful surgery.

After the surgery the UCVA and BCVA was examined for near, intermediate and near, OCT performed, Amsler grid tested. Postoperative treatment has been modified to minimize the risk of macular oedema. Any adverse effects and visual disturbances have been recorded. Follow-up was from 2 to 18 months.

All patients had no decrease in BCVA in 4 weeks. UCDVA ranged from 0,7 to 1,0. Majority of patients required light and +1D for the near to reach 0,8-1,0 at 40cm- even in eyes with slightly myopic target. No macular edema diagnosed on OCT and Amsler grid was without change in all patients at 2 months. Slightly less spectacle independence for the near compared to healthy fellow eye when applied. No unusual visual disturbances. Future check-ups necessary.

EDOF IOLs may be a possible option how to help patients with minor retinal pathologies outside fovea with good visual functions who are generally not recommended for a diffractive IOLs. These patients may not be capable to gain the full range of function of EDOF IOL- as a healthy eye would have, but when the patients have realistic expectations and are tolerant, EDOF IOLs may provide a high level of spectacle independence similar to healthy eyes.

These eyes are more challenging from the perspective of a pre-op evaluation, a surgery itself and a post-op management. Also more chair time and patience is required from both doctors and patients. In more complicated cases, monofocal IOLs will probably still remain the gold standard of treatment.