Clinical Outcomes Of An Enhanced Monofocal Intraocular Lens After Cataract Surgery In Eyes With Age-Related Macular Degeneration

Purpose of this retrospective case-series study was to investigate clinical outcomes after cataract surgery in subjects implanted with an enhanced monofocal intraocular lens (IOL) with increased range of vision in a population diagnosed with early dry age-related macular degeneration (AMD).

Freedom Vision, Bolton, UK

Medical records of patients implanted with an enhanced monofocal IOL were screened and 16 eyes of 10 patients (age: 83.4±7.3 years) diagnosed with dry AMD were analysed. 11 eyes were implanted with the RayOne EMV (RAO200E, Rayner) and 5 eyes received the RayOne EMV Toric (RAO210T, Rayner). Eyes diagnosed with systemic or mild ocular comorbidities were included. Depending on the subjects’ preferences, eyes were targeted for emmetropia or monovision with a target of -1.0 D in the non-dominant eye. Measured parameters included manifest refraction incl. manifest refraction spherical equivalent (MRSE), Uncorrected distance and near visual acuity (UDVA, and UNVA) as well as corrected distance visual acuity (CDVA). Angle kappa.

Refractive outcomes show a change in MRSE from preoperative -0.29±2.67 D to postoperative -0.48±0.80 D with a mean prediction error of -0.12±0.62 D. The refractive cylinder significantly decreased from preoperative 1.52±1.26 D to postoperative 0.67±0.50D. UDVA and CDVA improved from 0.61±0.27 and 0.27±0.07 logMAR to 0.22±0.20 and 0.00±0.14 logMAR, respectively. Both changes were statistically significant (p<0.001). Postoperative UDVA range was -0.10 to 0.60 logMAR and the corresponding CVDA range was -0.20 to 0.40 logMAR. One eye was diagnosed with a central retinal vein occlusion 3 months prior to surgery and the CDVA increased from 0.3 logMAR prior to surgery, to 0.2 logMAR at 4 weeks post-op.

Our current results show that IOLs with enhanced depth of focus (RayOne EMV and RayOne EMV Toric) can safely be implanted in eyes diagnosed with early dry AMD. Such AMD diagnosis is a contraindication for implanting diffractive multifocal IOLs. The implantation of EMV lenses led to a very satisfying restoration of distance visual acuities. Moreover, an increased range of vision is expected due to the optical properties of the lenses and by applying a monovision approach in most subjects. Further investigations on potential long-term benefits in far, but also intermediate and near distances are still ongoing and will be available for presentation at a later stage.