Clinical Assessment Of Brain Adaptation After Multifocal Iol Implantation

To simply assess the patients’ potential brain adaptation following Multifocal IOL implantation.

Nishi Eye Hospital, Osaka, Japan

We carried on a retrospective pilot study, using MMSE (Mini-Mental State Examination) test 1 week postoperatively for 20 patients that underwent PEA and implantation of Tecnis Synergy (J＆J)、PanOptix（Alcon)、Vivity（Alcon)、FineVision（BVI）or Intensity（Hanita Lenses).  Patients were divided into 2 groups. Group A showed best corrected distant visual acuity (BCDVA、LogMAR) of better than 0 without any symptom of blurred vision (14 patients、62±10 y.) within 1 week postoperatively.　BCDVA  of Group B (6 patients、76±5.6 y.) did not reach 0.1 or even with blurred vision later than 1 month postoperatively. The MMSE test scores and the necessary time to complete the test of both groups were compared with each other.

The test scores of Group A and Group B were 28.9±1.7 and 29.2±0.69 each (p=0.68). The necessary time was 256±50 seconds and 346±67 seconds each (p<0.05). In Group A, 13 among 14 patients (93%) completed the test within 5 minutes, while in Group B, 1 among 6 patients (17%) managed it. Preoperative higher order aberration was 0.24±0.08㎛ for Group A and 0.23±0.05㎛ for Group B (p=0.57). The preoperative photopic pupil size was 3.3±0.36mm for Group A and 3.0±0.10 mm for Group B (p<0.05). 1 week postoperative astigmatism was -0.61±0.59 D for Group A and -0.90±0.45 D for Group B (p=0.19). 1 month postoperative astigmatism did not change significantly, resulting in -0.66±0.49 D and -0.90±0.44 D each.

This retrospective pilot study indicated that the speed of possible brain adaptation following MIOL implantation may be related to the time necessary to complete the MMSE test. A larger scale trial with various kinds of MIOLs with different conditions using different tests to quantify and assess the brain adaptation speed may be clinically beneficial.