Visual Outcomes and Patient Satisfaction after Refractive Lens Exchange with a Single-Piece Diffractive Multifocal Intraocular Lens

Abstract

Purpose. To report visual outcomes and patient satisfaction after unilateral or bilateral refractive lens exchange (RLE) with a single-piece bifocal diffractive multifocal intraocular lens (MIOL). Methods. All patients underwent RLE with the ZMB00 MIOL (Abbott Medical Optics). Patient charts were reviewed to evaluate the distance, intermediate, and near visual acuity (VA), contrast sensitivity, extent of visual symptoms (0–5), satisfaction (1–5), and rate of spectacle independence between unilateral and bilateral RLE group. Results. Forty-seven eyes of 28 patients were included. No intraoperative complications developed. Mean monocular uncorrected VA at distance, intermediate (67 cm), and near (30 cm) were 0.01 ± 0.12 (standard deviation), 0.27 ± 0.18, and 0.15 ± 0.11, respectively. No eyes lost >1 line of corrected distance VA. Monocular contrast sensitivity remained at normal level. Median scores of halos, night glare, and starbursts for 27 patients were 2.0, 3.0, and 0.0, respectively. Median score of satisfaction was 4.0. There were no differences in visual symptom scores or satisfaction between unilateral and bilateral group (P > 0.05). Eighty percent of 25 patients reported total spectacle freedom, with similar rate between bilateral (82%) and unilateral group (75%) (P = 1.000). Conclusions. RLE with the bifocal diffractive MIOL was safe in presbyopic patients and resulted in a high rate of spectacle independence.

Visual Outcomes, Quality of Vision, and Quality of Life of Diffractive Multifocal Intraocular Lens Implantation after Myopic Laser In Situ Keratomileusis: A Prospective, Observational Case Series

“…For the near vision, the current mean DCNVA of 20/27 in the operated eyes was similar to the previously reported values of other bifocal MIOLs with +3- to +4-D near addition in post-LASIK eyes (range, 20/26 to 20/20) [14–16, 18] and eyes with virgin cornea (range, 20/25 to 20/20) at 30 to 40 cm [3, 4, 33]. The intermediate vision of bifocal MIOLs is weak [3–8].…”

“…Compared to our previous study [4] of the ZMB00 in eyes with virgin cornea, the operated eyes in the current study had significantly worse CS at spatial frequency of 3 cpd ( P = 0.009; Mann–Whitney U test). This suggested that visual quality with the ZMB00 could be affected by LASIK and may be explained by the increased SA after LASIK that was not fully compensated.…”

“…The overall diameter is 13 mm and the optic diameter is 6 mm. The energy distribution between the distance and near foci is symmetrical and independent of pupillary size [3, 4, 9, 19–21]. …”

“…The intermediate and near vision were measured using the SLOAN Two-Side EDTRS Format Near Vision Chart (Precision Vision, La Salle, IL). The actual VA in logarithm of the minimum angle of resolution at its corresponding distance was calculated by the visual angle subtended for statistical analyses [3, 4, 25]. The CS was recorded using the CSV-1000E (Vector Vision, Greenville, OH).…”

“…Implantation of diffractive multifocal IOLs (MIOLs) provides excellent distance and near vision in patients who undergo refractive lens exchange and cataract surgery [2–11], but the main drawbacks are visual symptoms such as halos and glare [3, 4, 7] and with bifocal MIOLs, poor intermediate vision [3–8]. A recent study [1] reported that patients who underwent cataract surgery after LASIK had more corneal higher-order aberrations (HOAs) than those in the general population.…”