Long Term Outcomes After Implantation Of A Dual Optic Accommodative Iol

To evaluate the long-term outcomes including visual performance and patient reported outcomes 15 years after implantation of the accommodative 1-piece dual optic Synchrony IOL (Johnson & Johnson, US, earlier Abbott Medical Optics and Visiogen).

Dept. of Ophthalmology, University of Heidelberg

32 eyes of 20 patients underwent phacoemulsification with mono- or bilateral Synchrony IOL implantation between 2009 and 2011 (mean age 51 ± 14 years). In this ongoing retrospective study, 11 patients (18 eyes) have completed a 15-year follow-up. Assessments included manifest refraction; uncorrected and corrected distance visual acuity (UDVA, CDVA) at 4 m; uncorrected and distance-corrected intermediate visual acuity (UIVA, DCIVA) at 80 and 66 cm; near visual acuities (UNVA, DCNVA, BCNVA) at 40 cm; defocus curves (+2.0 to -4.0 D); contrast sensitivity; stereopsis; halo/glare simulation; and patient-reported outcomes via the Heidelberg Daily Task Evaluation Questionnaire.

Mean binocular acuity was UDVA/CDVA (0.08/-0.08), UIVA/DCIVA (-0.04/-0.02 at 80 cm; -0.03/0.01 at 66 cm), UNVA/DCNVA (0.02/0.09), and BCNVA (-0.10). Mean postop spherical equivalent was -0.47 ± 0.80D; residual astigmatism -0.89 ± 0.54D. Defocus curves showed 0.10 logMAR or better from +1.0 to -2.0D binocularly and +0.5 to -1.0D monocularly. 57% of binocularly implanted patients required reading glasses and 1 patient received a toric add-on IOL after 11 years. For 4 monocularly implanted, the partner eye was phakic (n=2), had a monofocal IOL (n=1) or trifocal IOL (n=1). 80% were satisfied and would repeat the procedure.

Visual acuity, range of vision and halo/glare perception varied considerably among patients. Patients often required a few seconds of accommodation to reach best acuity at tested distances. The majority of patients were satisfied with the result; dissatisfaction was seen in monocularly-implanted patients.