Bilateral Implantation Of The Acrysof® Iq Vivity® Extended Depth Of Focus Intraocular Lens In Patients With Cataracts And Unilateral Epiretinal Membrane Undergoing Pars Plana Vitrectomy. A Prospective Study.

Some macular disorders, such as epiretinal membranes (ERM), are a relative contraindication for implantation of multifocal or extended depth of focus (EDOF) intraocular lenses (IOL). These lenses may decrease contrast sensitivity (CS) and induce dysphotopsias in eyes with an already compromised visual function due to the underlying retinal disease. However, new EDOF designs may not affect CS and therefore could potentially allow spectacle independence in a range of daily activities in patients with mild to moderate ERM. We will report the visual results of a prospective study of patients with bilateral cataracts and unilateral ERM undergoing pars plana vitrectomy implanted with the AcrySof^® IQ Vivity^® (Alcon, USA) EDOF IOL.

OMIQ (Oftalmologia Mèdica i Quirúrgica) clinic in Barcelona, Spain. Follow-up is ongoing and the final results of the study will be presented at the ESCRS Meeting.

A prospective, longitudinal, descriptive study of visual outcomes in patients with bilateral cataracts and unilateral grade 2 or 3 ERM. All eyes underwent cataract surgery with AcrySof^® IQ Vivity^® implantation. In eyes with ERM, a combined surgery with additional pars plana vitrectomy and membrane peeling was performed. Eyes with other concomitant diseases were excluded. The follow-up was 6 months. The outcomes of interest included monocular and binocular distance, intermediate and near corrected and uncorrected visual acuities (VA), CS (Pelli-Robson) and low contrast VA at 66 and 40 cm. Dysphotopsias were measured with the Light-distorsion analyzer (LDA) and a standardized questionnaire.

Twenty patients were included. The analyses of patients with complete 6-month follow-up at present showed a spherical equivalent within +/-0.50D in more than 80% of eyes and a modest anatomic thinning in central macular thickness in eyes with ERM. In these eyes, uncorrected VA at distance, near, and intermediate distances at 6 months were 0.10, 0.21 and 0.49 logMAR, respectively, while CS was 1.54 and low contrast VA was 0.72 (66 cm) and 0.80 (40 cm) logMAR. All measurements were similar in eyes with and without ERM. There were no statistically significant differences in mean LDA parameters between the two groups and most patients did not report dysphotopic symptoms.

These preliminary results show that the EDOF IOL AcrySof^® IQ Vivity^® implanted in patients with bilateral cataracts who also undergo pars plana vitrectomy due to unilateral ERM provides good functional results with few dysphotopic phenomena. Indeed, the results six months after the surgery were similar in eyes with and without the ERM, suggesting that this approach may be considered in patients with unilateral stage 2 or 3 disease.