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Visual performance after implantation of a trifocal intraocular lens
Session Title: Multifocal IOL results
Session Date/Time: Sunday 06/10/2013 | 14:30-16:00
Paper Time: 15:27
Venue: Forum (Ground Floor)
First Author: : E.Law UK
Co Author(s): : R. Aggarwal S. Kasaby
To evaluate the visual and refractive outcomes after implantation of a trifocal intraocular lens (IOL), considering distance, near and intermediate vision.
BMI Southend Private Hospital
This study comprised patients who had bilateral implantation of the AT LISA Trifocal IOL after phacoemulsification. The main outcome measures were Uncorrected (UDVA) and Best Corrected Distance Visual Acuity (BCDVA) measured in logMAR. Near visual acuity (NVA) and Intermediate visual acuity (IVA) were measured in logRAD using the Radner reading charts. Preferred working distance and reading range were measured. The patients also completed a short quality of vision questionaire.
25 patients (50 eyes) were included having undergone phacoemulsification for cataract (10 patients) or refractive lens exchange (15 patients). Mean Spherical refraction was 0.39DS ± 0.25 (SD) and astigmatic refraction was 0.46DC±0.24(SD). At 1 month Post-Op , the mean UDVA was 0.10LogMAR ±0.07 and BCDVA was 0.00LogMAR±0.06. This improved to UDVA of 0.04±0.05 and 0.02±0.03 at 3 and 6 months respectively. BCDVA improved to -0.04±0.03LogMAR at 3 months and -0.06±0.03 at 6 months. Comparison between 3 and 6 month data was performed by paired t tests. Differences were not found to be statistically significant. P = 0.06. Statistically significant differences between UDVA at 1 month and 3 months post-operative were found where P = 0.004 but difference in BCDVA was not statistically significant. Near Visual Acuity at 1 month post op was 0.20LogRAD±0.08 and at 3 months 0.13LogRAD±0.07. Intermediate Visual Acuity was 0.42 LogRAD and did not differ significantly between 1, 3 and 6 months. Preferred reading distance was 34.6cms and mean range 25-42cms. 1 of 25 patients used reading spectacles intermittently. Night glare and halos were reported by all patients at all visits, the severity rating of these symptoms reduced at 3 and 6 months in 84% of patients.
Post operative visual acuity was good at distance, intermediate and near. It can be seen that UDVA improves from 1 month to 3 months post-operatively, but there is no significant further improvement at 6 months. No patients had refraction of more than 1.00DS post op and only 1 patient used spectacles at all, (intermittently for detailed closework only). Mild dysphotopsia was reported by all patients, but the majority reported these symptoms to be reduced by 3 months. All patients reported that they were pleased with their vision and quality of life after trifocal lens implantation.