The Lumina Accommodative Intraocular Lens Visual Outcomes, Optical Quality, And Accommodative Response.
Published 2023 - 41st Congress of the ESCRS
Reference: PP13.18 | Type: Free paper | DOI: 10.82333/8jnq-9h98
Authors: Jorge L. Alio* 1 , Elinor Megiddo Barnir 2 , Antonio Martinez Abad 3 , PILAR YÉBANA RUBIO 3
1Cornea, Cataract and Refractive Surgery Unit, Vissum Grupo Miranza,VISSUM,Alicante,Spain;Department of ophthalmology,Miguel Hernandez University,Alicante,Spain, 2Cornea, Cataract and Refractive Surgery Unit, Vissum Grupo Miranza,VISSUM,Alicante,Spain, 3Research, Development and Innovation Department, Vissum Grupo Miranza,VISSUM,Alicante,Spain
Purpose
To evaluate the accommodation, refractive outcomes, visual performance for different distances, ocular aberrations, and retinal image quality in the Lumina accommodative intraocular lens (IOL) (Akkolens Clinical BV, Rijswijk, The Netherlands) for the treatment of cataract.
Setting
Prospective, interventional clinical, single-arm, single-center, open label study in the Cornea, Cataract & Refractive Surgery Unit, VISSUM (Miranza Group) and Miguel Hernandez University, Alicante, Spain.
Methods
50 eyes of 25 patients were included. All patients underwent cataract surgery and IOL sulcus implantation with the Lumina (Akkolens) at the 180° meridian. All patients completed 6-months follow-up which included refraction, uncorrected & best-corrected distance visual acuity (UDVA & BCDVA), uncorrected, distance- & best-corrected near visual acuity (UNVA, DCNVA, BCNVA), slit-lamp biomicroscopy, defocus curve (DFC), contrast sensitivity (CS), pyramidal aberrometry & optical quality analyzer system (OQAS, Visiomettrics SL, Spain) obtaining the MTF & PSF for different diameters & open field aberrometer (OFA, CSO, Italy), for accommodation measurement. Near & intermediate vision performance was measured subjectively, using the DFC.
Results
Good level of visual performance after surgery in UDVA, UNVA & DCNVA (0.1±0.14 logMAR, 0.31±0.17 & 0.34±0.1 logRAD, respectively) with a statistically significant difference in UDVA, UNVA & DCNVA at 1 & 3 months postoperatively, better at 3 months (P<.05). Subjective accommodation was 1.37±0.74, 2.05±0.75 & 3.63±0.68D at visual acuities of 0.1, 0.2 & 0.4 logMAR, respectively. Mean CS at 6 months was 1.66±0.15, 1.99±0.18, 1.79±0.19 & 1.34±0.24 log units for 3, 6, 12 & 18 cpd, respectively. The total RMS, HOA & PSF Strehl ratio as determined by the new OFA were 0.72±0.9, 0.54±0.63, 0.45±0.66 μm & 0.23±0.13 respectively. The PSF Strehl ratio did not differ significantly between the validated OQAS, Osiris aberrometer and the new OFA (P ≥ .06)
Conclusions
The Lumina accommodative IOL effectively restores the visual performance for far distances with functional performance for intermediate and near vision, with good contrast sensitivity after cataract surgery. Accommodative range is variable between 1 and 3 D, with accommodation and pseudoaccommodation justifying part of the near vision outcome. The near vision performance of the Lumina is a continuous range of distances from far to intermediate and near viewing distances, with some inter-individual variability.