Visual Results After Implantation Of An Extended Depth Of Focus Intraocular Lens With An X-Wavetm Design In Eyes With A Large Chord Mu

Chord mu (µ) is the distance between the center of the pupil and the subject-fixated coaxially sighted corneal light reflex, and it is an approximate measurement of angle kappa. For some authors, a large chord mu is a relative contraindication for premium intraocular lenses (IOL) because of the increased risk in dysphotopic phenomena. This study describes the visual results in eyes with a large chord mu implanted with the extended depth of focus (EDOF) IOL with the X-WAVE^TM design AcrySof^® IQ Vivity^® (Alcon, USA).

This study was conducted in OMIQ (Oftalmologia Mèdica i Quirúrgica) facilities, a private institution in Barcelona, Spain.

This was a retrospective case series of eyes with a chord mu ≥0.40 mm who underwent caratact surgery with implantation of the AcrySof^® IQ Vivity^® IOL. Chord mu was measured under photopic conditions using the Pentacam^TM AXL Wave (Oculus, Germany), a corneal tomography system. After a minimum postoperative period of six months, we determined the uncorrected and distance corrected (UDVA and CDVA, respectively), intermediate (UIVA and DCIVA) and near (UNVA and DCNVA) monocular visual acuity, a nine-item questionnaire related to visual satisfaction in different tasks and procedure safety.

Six eyes of 5 patients were included with a median follow-up of 10 months (range, 6 to 15). The median age was 70.5 years (range, 51 to 80) and 16.7% were females. The median chord mu was 0.50 mm (range, 0.40 to 0.58) and decreased to 0.41 mm (range, 0.22 a 0.46) after surgery (p=0.03). The median (range) logMAR UDVA and CDVA were 0.00 (0.15 to -0.10) and 0.00 (0.10 to -0.10); UIVA and DCIVA were 0.00 (0.10 to 0.00) and 0.00 (0.30 to 0.00); and UNVA and DCNVA were both 0.20 (0.50 to 0.20). The median questionnaire satisfaction score was the highest for 7/9 questions: 4 (range, 3 to 4); for the other two questions, the median was 3 (difficulties with manual tasks) and 3.5 (difficulties with hobbies). There were no surgical complications.

Eyes with a large chord mu implanted with the AcrySof^® IQ Vivity^® EDOF IOL showed good visual acuity at distance, intermediate and near and a high level of satisfaction after at least six months after surgery. A reduction in the value of chord mu was observed in all cases after surgery.