The Impact Of Preoperative Myopia Versus Hyperopia Upon Postoperative Subjective Outcomes With Monofocal Plus And Diffractive Multifocal Intraocular Lenses

To investigate the impact of preoperative myopic and hyperopic refractive error upon overall quality of vision (QoV) and spectacle independence following implantation of bilateral monofocal plus or diffractive multifocal IOLs. This aims to aid IOL selection, preoperative discussion and management of patient expectations.

Cathedral Eye Clinic, Belfast, Northern Ireland, UK.

This study was a retrospective cases series. Ninety-six patients bilaterally implanted with the Rayner EMV IOL and 202 patients with the Artis Symbiose MID/PLUS complementary multifocal IOL (Cristalens) were recruited. QoV questionnaires were completed 3 months postoperatively. Patients were categorized into preoperative myopes (Spherical equivalent (SE) ≤-0.75D) and hyperopes (SE ≥ 0.75D) and the postoperative outcomes were compared.

The preoperative myopes in the multifocal IOL group showed a complete spectacle independence of 73.7% compared to 94.8% with the hyperopes. The myopes had a QoV score of 7.75 ±1.33 at night and 8.65 ±1.09 for day, compared to 8.03 ±1.41 and 8.92 ±1.01 with the hyperopes. With monofocal plus IOL the preoperative myopes showed a complete spectacle independence of 61.1% compared to 69.2% with the hyperopes. The myopes had a QoV score of 7.82 ±1.38 at night and 8.76 ± 0.83 for day, compared to 7.72 ±1.41 and 8.61 ±1.34 with the hyperopes. There was no clinically significant difference between myopic and hyperopic groups regarding unaided distance and near visual acuity, sphere, cylinder or SE.

Preoperative myopia or hyperopia refractive error appears to impact spectacle independence with both IOL designs. This aids clinicians with preoperative IOL selection and management of patient expectations