Secondary Piggyback Intraocular Lens for Management of Residual Ametropia after Cataract Surgery

Comparison of Primary Duet Lens Procedures: In-The-Bag Monofocal with Sulcus Multifocal, and Standard Single Multifocal Lens for Cataract Surgery

Purpose

To assess the safety and efficacy of primary duet intraocular lens (IOL) procedure using an in-The-bag monofocal IOL and a sulcus-based multifocal reversible platform for cataract surgery. The visual outcomes were compared with a single in-The-bag multifocal IOL.

Patients and Methods

Retrospective cohort study. Consecutive patients who underwent primary duet IOL procedures were compared with consecutive patients who underwent single multifocal IOL surgery. Primary outcomes were uncorrected distance and near visual acuities (UDVA and UNVA), refraction and spherical equivalent data. Secondary outcomes included surgical complications.

Results

The study group consisted of 32 eyes (22 toric IOLs) whilst the control group had 57 eyes (29 toric IOLs). There were no statistically significant differences between the two groups on post-operative 1-month and 1-year UDVA (p=0.1522 and 0.4926, respectively) and UNVA (p=0.1248 and 0.2738, respectively). There were no statistically significant differences in the postoperative 1-month spherical equivalent within ± 0.5 diopter (p=0.1891). Postoperative intraocular pressure spikes were observed on day-1 in both groups, with most returned to their baseline at 1-month and all were normal at 1-year post surgery. There were no statistically significant differences in intraocular pressure between the two groups on day-1, 1-month and 1-year after surgery (p=0.6421). There were no statistically significant differences in the IOL axis deviation from the intended axis in the toric subgroup analysis (p=0.5843).

Conclusion

Primary duet IOL procedure is equally effective and safe in correcting distance and near vision when compared with single multifocal IOL in the capsular bag.

Refractive and Visual Outcomes After Implantation of a Secondary Sulcus Intraocular Lens with an Extended Depth of Focus

Purpose

To evaluate the range of vision, visual function, and quality of vision after implantation of a secondary extended depth of focus intraocular lens (EDOF IOL) implanted in the sulcus.

Setting

One clinical practice in Haugesund, Norway.

Design

Prospective single arm non-interventional study.

Methods

Eligible subjects presenting for surgery, or who had previous successful primary cataract or refractive lens exchange surgery in both eyes were subsequently implanted with the AddOn® secondary EDOF IOL in the sulcus. Manifest refraction and visual acuity at distance, intermediate and near were measured 3 months after surgery, along with the monocular defocus curve. Subjects also completed a visual function and a quality of vision questionnaire.

Results

The study included 32 eyes of 16 subjects. At 3 months postoperative, the mean refraction spherical equivalent (MRSE) was −0.16 ± 0.30 D, with a residual cylinder of 0.29 ± 0.27 D. The mean monocular uncorrected VA was 0.1 logMAR (20/25) or better at all test distances. The monocular defocus curves showed a depth of focus of 2.0 D. For every category except reading fine print, all but one subject (94%) had no difficulty or little difficulty with near tasks. Glare and halos were the most common visual disturbances, with no reports of starbursts. There was no evidence of any intralenticular opacification in any of the eyes, and no evidence of iris chafing/depigmentation.

Conclusion

This secondary EDOF IOL provided excellent distance and intermediate vision, and very good near vision to subjects. Subject reported near visual function was also very good and visual disturbances were limited. This lens appears to be a good option for patients who would like to improve their range of vision. Results appear as good or better than those reported for primary EDOF lenses.