Various strategies for IOL implantation using rotationally asymmetric extended depth of focus (EDOF) implant technology can meet patient needs for a vast array of uncorrected vision issues with good optical quality as well as low risk for disturbing dysphotopsias.
Patient satisfaction after refractive cataract surgery depends upon choosing an IOL that meets the individual’s requirements for uncorrected vision but also tolerance to dysphotopsias. According to ophthalmologists, the techniques utilizing rotationally asymmetric IOLs that do not have a diffractive optic design allow success for patients that are not willing to accept problems with glare as well as halos.
A team of doctors reviewed strategies using the Lentis-313 MF15 or MF20 IOLs (both from Oculentis) and also the performance of these extended depth of emphasis implants.
“Picking these strategies can result in extremely satisfied patients because the rotationally asymmetric IOLs offer high-grade vision and generate reduced degrees of dysphotopsias compared with diffractive presbyopia-correcting IOLs,” stated Dr.
Matching Goals as well as Technology
Ophthalmologists have to actually keep in mind that cataract surgical procedure patients thinking about presbyopia adjustment can be organized right into 3 basic categories based on their top priorities for good uncorrected vision postoperatively. Some patients are near focused and have demands for exceptional vision at reading range (≤ 40 centimeters). Others look for great vision at all ranges. The 3rd group is called distance-focused patients, who are most interested about clear vision at the intermediate to far, and also want to use glasses for reading.
The approaches for attending to these visual needs consist of binocular implantation of the Lentis-313 MF15 or MF20 IOL with a refractive target of emmetropia. These extended depth of focus IOLs give a high level of spectacle freedom from distance to intermediate but also some functional reading vision.
“These IOLs are aberration neutral,” Dr. Kretz claimed. “People will make use of the spherical aberration of the cornea to boost the depth of focus, which can boost their near vision.”
For patients with stronger near vision needs, surgeons can produce blended vision making use of a micro-monovision technique, implanting either the Lentis-313 MF15 or MF20 IOL bilaterally but targeting -1.25 D to -1.75 D in the non-dominant eye. Another way for giving good reading capability is to implant the Lentis-313 MF15 or M20 in the distance dominant eye and a multifocal IOL (Lentis MF30 or Mplus X) in the fellow eye. Incorporating a pinhole lens (IC-8, Acufocus) in the near eye with the Lentis-313 MF15 of MF20 in the leading eye can be an especially excellent selection in individuals who have irregular astigmatism.
“The pinhole hole can make up for uneven astigmatism as well as is likewise not most likely to cause dysphotopsias,” Dr. commented.
Results information from screening of visual acuity, optical high quality, defocus curves, and dysphotopsias supply evidence concerning the superb clinical performance of the Lentis-313 MF15 and MF20 IOLs. Dr. Kretz reported visual acuity results showing that the Lentis-313 MF15 IOL provides range visual acuity that is comparable to a mono-focal aberration neutral IOL (CT Asphina 409). Goal screening of optical top quality (HD Analyzer, Visiometrics) likewise revealed similarity between the presbyopia-correcting IOL and also the mono-focal lens.
Defocus contours from testing of patients implanted with some of the different strategies explained by ophthalmologists revealed the range of excellent uncorrected vision achieved. Checking for dysphotopsias conducted using a halo as well as glare simulator showed no distinction in the occurrence or severity of these dysphotopsias comparing clients implanted with the EDOF IOLs versus the mono-focal lens.
“Bear in mind that even individuals with a mono-focal IOL can have halo and glare because of the presence of spherical aberration and other higher-order aberrations in the cornea,”
“If you look preoperatively at patients that have cataracts, you will see that their problems with dysphotopsias are also worse prior to surgical procedure.”