Improvement In Outcomes With Refinement Of Refractive Methodology In Patients Implanted With Refractive Extended Depth Of Focus Intraocular Lenses
Published 2023 - 41st Congress of the ESCRS
Reference: PP10.09 | Type: Free paper | DOI: 10.82333/ft9y-2x14
Authors: Daniel Black* 1 , Nicole Smith 1 , Mark Hoffmann 2 , Vidhya Vilupuru 3 , Aixa Alarcon 3
1Sunshine Eye Clinic,Sunshine Coast,Australia, 2Queensland University of Technology,Brisbane,Australia, 3Johnson & Johnson,Groningen,Netherlands
Purpose
EDF IOL create a single-elongated focal point which can at times create uncertainty and impact accuracy of subjective refraction. The purpose of this evaluation is to compare the refractive and visual outcomes in patients implanted with EDF IOLs following refinement of the refraction technique to avoid over-minus.
Setting
A comparative evaluation of visual outcomes from two prospective, randomized, subject/evaluator masked clinical studies conducted in Australia/New Zealand (6 sites).
Methods
In the first prospective study, 60 subjects were bilaterally implanted with an EDF IOL (Model DEN00V), and visual outcomes were assessed at 3-months postoperatively (Study 1). In the second prospective study (Study 2), the outcomes of a subgroup of 13 subjects were assessed following refinement to the refraction technique (maximum plus for maximum distance vision). Mean ± stdev of manifest refractive spherical equivalent (MRSE), depth of focus range and best corrected distance (BCDVA), distance-corrected intermediate (DCIVA), and near (DCNVA) are presented.
Results
Mean MRSE was 0.03 ± 0.36 D and 0.27 ± 0.40 D in studies 1 and 2, respectively. The range of defocus over which visual acuity was 0.20 logMAR or better was 1.6 D and 1.9 D in Study 1 and Study 2, respectively. Distance vision (0D) was the same while intermediate vision improved by 0.5 lines at -1.5D and near in 1 line at -2.5D with the refinement in refraction. With the refinement in refraction using maximum plus, the mean BCDVA, DCIVA, DCNVA were -0.04 ± 0.06 (~6/5), 0.10 ± 0.12 (~6/7.5) and 0.34 ± 0.14 logMAR (~6/12), respectively.
Conclusions
The refinement of the refraction technique in an EDF IOL improved intermediate and near VA with no impact on distance vision. The result of this study shows that to measure accurately the refractive endpoint is important to determine the optimal performance of an EDF IOL which can be critical for IOL constants optimizations.