Official ESCRS | European Society of Cataract & Refractive Surgeons


Corneal and extraocular factors influencing defocus curve

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Session Details

Session Title: Extended-Depth-Of-Focus IOLs II

Session Date/Time: Monday 16/09/2019 | 14:00-16:00

Paper Time: 15:48

Venue: Free Paper Forum: Podium 1

First Author: : C.Isanta Otal SPAIN

Co Author(s): :    F. Bartol-Puyal   G. Giménez Calvo   I. Altemir   J. Larrosa   V. Polo   L. Pablo              

Abstract Details


To evaluate the defocus curve (DC) in patients implanted with Tecnis Symfony intraocular lens (IOL) (Johnson&Johnson) and to analise corneal and extraocular influencing factors.


Miguel Servet University Hospital, Zaragoza, Spain.


Cross-sectional study including patients bilaterally implanted with Symfony IOL 3-5 months before. Inclusion criteria were: age 60-70 years old and an axial length (AL) between 22 and 25 mm. Exclusion criteria were: ocular pathologies, previous intraocular treatment/surgery, amblyopia and corneal astigmatism >1D. DC were performed with ETDRS charts at a 6m distance under photopia and with distance optical correction. Clear vision range (CVR) (visual acuity,VA≤0.1 logMAR), the best VA and its location, and the nearest location with clear VA (NL) were analysed. Patients were examined with KR-1W aberrometer (Topcon) and they fulfilled the NEI RQL-42 quality-of-life questionnaire.


Mean age was 64.38±6.79 years old and mean IOL power was 21.32±2.33D. Mean best VA was -0.05±0.09 and its location was -0.18±0.42D, mean CVR was 2.32±0.78D, and mean NL was -1.39±0.56D. The best VA was correlated (p>0.05) with: visual clarity (r=-0.22), symptoms (r=0.24), dependence on correction (r=-0.23) and satisfaction (r=0.21). Its location was correlated with limitation of diary activities (r=0.21) and worry (r=0.26). CVR was correlated with: age (r=-0.29), scotopic pupil diameter (r=-0.23), symptoms (r=0.34), distance vision (r=0.23) and diurnal fluctuations (r=0.30). NL was correlated with: age (r=0.26), AL (r=0.25) and symptoms (r=-0.24).


Despite the same IOL implanted in similar eyes, extraocular factors influence DC. A higher age implies a lower CVR by reducing near vision. However, these factors influence neither the best VA nor its location. Corneal aberrations do not have any influence. Negative visual symptoms are greater in patients with a higher CVR. Nevertheless, these facts are not correlated with glare. In conclusion, the ciliary muscle may still have some influence on accommodation in pseudophakic eyes.

Financial Disclosure:

travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, travel has been funded, fully or partially, by a competing company

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