Comparison Of Contrast Sensitivity And Visual Acuity In Patients Bilaterally Implanted With A Positive And Negative Spherical Aberration Enhanced Monofocal Intraocular Lens (Iol).

The purpose of this study is to investigate contrast sensitivity and visual acuity outcomes of cataract patients bilaterally implanted with RayOne Hydrophobic Aspheric RAO800C (Rayner, UK) (Group 1), RayOne EMV RAO200E (Rayner, UK) (Group 2) and Clareon (Alcon, Switzerland) (Group 3) intraocular lenses (IOLs) and to compare outcomes of subjects targeted for bilateral emmetropia.

The setting in private outpatient surgical ophthalmology center in Wroclaw, Poland.

This prospective, single center masked study is planned for 150 eyes of 75 patients with equal division into 3 groups of intraocular lenses implanted bilaterally. All patients were targeted for emmetropia. Exclusion criteria are corneal astigmatism >1.0 D, corneal, retinal or optic nerve pathologies or previous eye surgery. Follow-up exams, performed at 1 day, 2 weeks, 1 month (1M) and 3 months (3M), included binocular contrast sensitivity (CS) between 3 and 18 cycles per degree (cpd) under photopic and mesopic light conditions using the CSV-1000 (VectorVision) device as well as uncorrected and corrected distance, intermediate (66cm) and near (40cm) visual acuity (UDVA, CDVA, UIVA, and UNVA).

The contrast sensitivity for 3,6,12,18 cpd with mean photopic (mesopic) logCS were 1.6±0.3 (1.5±0.2), 1.8±0.3 (1.6±0.3), 1.4±0.2 (1.3±0.2), 0.9±0.2 (0.8±0.3) in Group 1, 1.7±0.2 (1.7±0.2), 1.9±0.2 (1.8±0.1), 1.5±0.2 (1.5±0.2), 1.1±0.2 (1.0±0.1) in Group 2,  and 1.6±0.2 (1.5±0.2), 1.8±0.2 (1.8±0.1), 1.5±0.2 (1.4±0.1), 1.0±0.2 (1.0±0.1) in Group 3, respectively. At 3M, mean CS outcomes were within the normal band of this age group. Mean CDVA binocular (monocular) in logMAR were -0.05±0.05 (0.0±0.15) for Group 1, -0.05±0.0 (0.0±0.05) for Group 2, and 0.0±0.0 (0.0±0.0) for Group 3, respectively. Mean UIVA binocular (monocular) in Jaeger were 8±3.2 (8.3±2.9) in Group 1, 2.5±0.9 (3.9±0.8) in Group 2 and 7.2±1.2 (8.0±1.1) in Group 3, respectively.

Overall, the preliminary results show promising and expected results. Contrast sensitivity outcomes were in the normal range of this age group, indicating that all IOLs provides a good quality of vision. The intermediate visual acuity was better in the RayOne EMV group in comparison to the group with negative spherical aberration lenses. In our opinion, these preliminary results suggest that the enhanced monofocal IOL may be a good alternative for patients wishing to gain better intermediate vision after cataract surgery without compromising the quality of vision under photopic and demanding mesopic (low light) conditions.