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Refractive lens exchange and the Lentis® MPlus IOL: long term stability and predictability
Session Title: Intraocular correction of presbyopia : multifocal IOLs, Monovision
Session Date/Time: Tuesday 08/10/2013 | 14:00-16:00
Paper Time: 14:06
Venue: Elicium 1 (First Floor)
First Author: : K.Gundersen NORWAY
Co Author(s): : Utheim
To evaluate the predictability and refractive stability of clinical outcomes with in patients undergoing refractive lens exchange with either the Lentis MPlus spherical or toric multifocal IOL.
Single, private ophthalmology clinic.
Routine visual acuity and refractive data were collected in the post-operative period (Day 1 to 12 months) for refractive lens exchange patients receiving a Lentis MPlus spherical or toric IOL. A patient satisfaction questionnaire was also administered.
Data were collected from a total of 95 eyes implanted. Refractive outcomes in the early post-operative period (day 1 to day 7) indicated good refractive predictability, with 82% of eyes within 0.5D of the target refraction. Uncorrected visual acuity was better than 0.8 (decimal acuity) in 71% of patients at Day 1.
Over time, a statistically significant hyperopic drift in refractive outcomes was observed, with 35% of patients experiencing a refractive change >0.5D at 6 months. Secondarly laser procedures were required in about 8% of eyes, with significant hyperopia being the most common reason. The observed range of refractive changes increased from 3 to 12 months, suggesting increasing variability in outcomes.
Patients who completed the questionnaire indicated that halos, particularly at night, were a significant concern. Only 50% indicated that the lens met their expectations, and only 76% would recommend the surgery to friends or family, despite the good visual acuity results achieved in the early post-operative period.
This rotationally asymmetric IOL performs predictably in the early post-operative period with a high percentage of patients achieving good uncorrected visual acuity. However, issues outside of visual acuity (such as halos) appear to negatively affect patient satisfaction with the lens.
A systematic hyperopic drift was noted in a significant percentage of patients, suggesting the need to target myopia at the time of surgery. Observed variability in the refractive change over time makes it more difficult to choose optimal target refraction at the time of surgery. In addition, aiming for a myopic refraction is likely to reduce any wow effect from the patient. With these considerations, selective use of this lens may be required for refractive lens exchange patients.