SPECTACLE FREE

The new DiffractivaR-aA (HumanOptics, Erlangen, Germany) multifocal intraocular lens (mIOL) can provide a very high degree of spectacle independence and a good quality of vision, according to the results of a study presented at the 16th ESCRS Winter Meeting. “The Diffractiva-aA provides excellent uncorrected distance and near visual acuity and good uncorrected intermediate visual acuity, in addition to very good contrast sensitivity with a low incidence of haloes and glare,†said Alois Dexl MD, Department of Ophthalmology, Paracelsus Medical University Salzburg, Austria. The prospective two-centre study involved 48 eyes of 24 cataract patients who underwent bilateral implantation of this new multifocal lens. The patients in the study had a mean age of 70.8 years, ranged from 57 to 87 years. All had less than 1.5 D of corneal astigmatism and had no other ocular pathologies. The Diffractiva-aA mIOL is a one-piece hydrophilic acrylic multifocal lens. It has a diffractive aspheric aberration-free anterior surface with a 3.5 D near add and a spherical posterior surface.

In addition, the implant’s optic has a 360-degree square edge to prevent PCO. After a mean follow-up of 8.1 months (range six to eight months) the postoperative mean spherical equivalent was 0.12 D. Sixty per cent of patients were within 0.25 D of emmetropia and all were within 0.75 D, Dr Dexl said. In addition, the mean uncorrected distance visual acuity was 0.93, when tested monocularly, and 1.0 when tested binocularly. Furthermore, binocular uncorrected distance visual acuity was 20/20 or better in 83 per cent of eyes and 20/25 or better in all eyes. At a testing distance of around 40cm the patients’ mean uncorrected near visual acuity was 0.86, when tested monocularly, and 0.93, when tested binocularly. Moreover, binocular uncorrected near visual acuity was 20/20 or better in 88 per cent of eyes and 20/25 or better in all eyes. Furthermore, the mean uncorrected intermediate visual acuity was 0.76, when tested monocularly, and 0.90, when tested binocularly. Binocular uncorrected intermediate distance visual acuity at one metre was 20/20 or better in 54 per cent of eyes, 20/25 or better in 83 per cent of eyes, and 20/40 or better in all eyes. Moreover, in response to a questionnaire, 96 per cent of patients said they either did not see or were not disturbed by glare around lights at night. Four per cent said they were moderately disturbed by such dysphotopsias.

In addition, 58 per cent said they did not see or were not disturbed by haloes around lights at night, 25 per cent said they found the phenomenon slightly disturbing, 12.5 per cent said they found it moderately disturbing. The only patient who was disturbed “a lot†by haloes noticed an improvement of the symptoms with time. Furthermore, contrast sensitivity values under photopic and mesopic conditions were within normal range for patients 60 years of age and older. Regarding spectacle independence, 92 per cent of patients said they never had to wear glasses for any distance and the remaining eight per cent (two patients) said they wore them only very rarely, half for reading small print (one patient) and half for watching the television (one patient). Moreover, all patients said they were satisfied with the lens including 92 per cent who were very satisfied, Dr Dexl added.