Objective (aim): to test the refractive and visual outcomes and the quality of vision after the bilateral implantation of three different multifocal intraocular lenses (MIOLs) in patients with age-related cataract. Methods: In this retrospective, comparative study including 90 eyes of 45 cataract patients, bilateral implantation of either the hydrophilic trifocal Liberty® 677MY capsular bag IOL, the hydrophilic AT LISA® tri 839M lens, or the hydrophobic AcrySof® IQ PanOptix® IOL was performed during routine cataract surgery. Refractive outcomes, visual acuities (VA) for far, intermediate and near distances, as well as visual quality, dysphotopic events and spectacle use were evaluated six months postoperatively. Results: VA curves were similar for the three MIOLs, however the Liberty lens seemed to be superior for far and near, while AT LISA tri provided somewhat better VA in the intermediate range. Refractive correction was the most effective with the Liberty IOL (p=0.0131). Dysphotopic phenomena were usually perceived in low light conditions. Their frequency was lower with the AT LISA tri and Liberty lenses. Symptoms were significantly less disturbing for patients implanted with the Liberty lens, two-thirds of AT LISA tri and Liberty patients, while only 57% of PanOptix patients achieved spectacle independence. Conclusions: All examined MIOLs were found to be safe and efficient in presbyopia-correction of cataract patients, however different models had different advantages. The vision preferences of each patient should always be taken into consideration when choosing a MIOL, and the possible occurrence of dysphotopic events should be also clearly communicated in each case. Abbreviations: ACD = Anterior chamber depth, ANOVA = Analysis of variance, AXL = Axial length, CDVA = Corrected distance visual acuity, CYL = Cylinder; Cylindric refraction, D = Diopter, IOL = Intraocular lens, K1; K2 = Keratometry values, MIOL = Multifocal intraocular lens, n = Number of cases, n.a. = Not applicable, Postop = Postoperative, QoV = Quality of Vision, SD = Standard deviation, SEQ = Spherical equivalent, SPH = Sphere; Spherical refraction, UDVA = Uncorrected distance visual acuity, UIVA = Uncorrected intermediate visual acuity, UNVA = Uncorrected near visual acuity, VA = Visual acuity
The study included 62 children aged 6 to 14 years with mild to moderate myopia, born at 28-34 weeks of gestation with a birth weight of 970 to 2200 g. Selection criteria: corneal refractive power >46.00 D, no keratoconus or macular degeneration. The main group – 32 children (64 eyes), who were assigned orthokeratologic lenses, the control group – 30 children (60 eyes) – glasses users. Differences between the groups were not significant. Observation period was 3 years. There were no complications. Corrected visual acuity in the main group increased from 0.63±0.08 to 0.98±0.06, in the control – from 0.61±0.05 to 0.73±0.05; p<0.005. Stable restoration of binocular vision was observed in all children of the study group and 83% of children in the control one. Reserves of absolute accommodation in the main group during the observation period increased by 6.7±0.38 D, and in the control group – by 2.3±0.42 D (p<0.001), which is explained by the active use of accommodation by children of the main group. After 3 years of observation in the main group, the anteroposterior size of the eyeball, according to echobiometry data, almost did not change (from 22.32±0.9 to 24.02±1.1 mm, p>0.2), and in the control group, the eye elongation was more pronounced: from 22.45±0.8 to 25.94±0.9 mm (p<0.01). Complete stabilization of myopia was observed in 30 children (93.75%) of the study group. Orthokeratological lenses MoonLens can be used in patients with high corneal curvature; their use in prematurely babies with a high refractive power of the cornea (>46.0 D) allowed to obtain better results of the treatment.
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