Eyeworld

18 | EYEWORLD | NOVEMBER 2019 ASCRS NEWS EYEWORLD JOURNAL CLUB Contact information Pettey: jeff.pettey@hsc.utah.edu four presbyopia-correcting intraocular lenses with four designs: diffractive panfocal, diffrac- tive trifocal, segmental refractive, and extend- ed depth of focus," Dr. Myriam Böhm and colleagues compared not only the diffractive panfocal (PanOptix) and diffractive trifocal (AT LISA tri839MP), but also the segmental refrac- tive (LENTIS Mplus X LS-323 MF30, Oculen- tis) and the extended depth of focus (TECNIS Symfony ZXR00, Johnson & Johnson Vision) lenses. The study included patients who underwent bilateral cataract or refractive lens exchange surgery. Of note, those who underwent refrac- tive lens exchange only chose the PanOptix or AT LISA IOLs, with higher proportion re- ceiving the AT LISA. Patients with significant ocular pathology or prior ocular surgeries were excluded. The uncorrected or distance-corrected visual acuity at 80 cm of the Symfony and AT LISA IOLs was found to be significantly better than that of the PanOptix or Mplus IOLs. At 60 cm, the PanOptix and Symfony groups both had excellent uncorrected and distance-cor- rected visual acuity. At a near target of 40 cm, the Symfony demonstrated worse uncorrected visual acuity than the other three IOLs. Notably, the PanOptix had the best visual acuity at 50 cm compared to all other IOLs, and was equivalent to the AT LISA and Mplus at 40 cm. The defocus curves of the four IOLs were tested, revealing that the PanOptix IOL performed better than all other IOLs at –2 D, and better than the AT LISA IOL at –1.5 D. Meanwhile, the Symfony IOL had greater vision at –1 D compared to all others. All IOLs tested had excellent, similar visual acuity at a defocus level of 0 D and –0.5 D. Böhm and colleagues report that over 90% of patients who received the AT LISA, PanOp- tix, or Mplus IOLs reported spectacle indepen- dence, compared to only 70.8% of patients with Symfony IOLs. continued from page 17 Comparative analysis of defocus curves of four presbyopia-correcting intraocular lenses with four designs: diffractive panfocal, diffractive trifocal, segmental refractive, and extended depth of focus Myriam Böhm, MD, Kerstin Petermann, MSc, Eva Hemkeppler, MSc, Thomas Kohnen, MD, PhD, FEBO J Cataract Refract Surg. 2019;Epub ahead of print. Panfocal and SegRef IOL at 80 cm (p<0.001), and both the EDOF and Panfocal IOL demonstrated comparable DCIVA at 60 cm (p>0.05). Defocus curves among IOLs presented no significant difference from 4 m to 2 m (p>0.05). The EDOF IOL showed better VA from 1 m to 67 cm than the Trifocal and SegRef IOL, and better VA than the Panfocal IOL at 1 m (p>0.05). The Panfocal IOL revealed a significantly better VA at 50cm (<0.001) and the EDOF IOL a worse VA at 40 cm compared to the other IOLs (p<0.01). Spectacle independence showed a significant difference between the Panfocal IOL (96.3%) and the EDOF IOL (70.8%) (p<0.05), but no difference between the other groups (Trifocal IOL: 92.5%, SegRef IOL: 92%). n Conclusion: The four presbyopia-correcting IOLs measured equally good CDVA. The EDOF IOL demonstrated slightly better DCIVA, however worse DCNVA than the other IOLs, with only the Panfocal IOL presenting better DCIVA at 50 cm. n Purpose: To investigate defocus curves of four presbyopia-correcting intraocular lenses (IOLs). n Setting: Department of Ophthalmology, Goethe University, Frankfurt, Germany. n Design: Prospective comparative study. n Methods: One hundred five patients received bilateral lens surgery with implantation of one of four presbyopia-correcting IOLs: diffractive Panfocal, diffractive Trifocal, Segmental Refractive (SegRef) and Extended-depth-of-Focus (EDOF). Uncorrected and distance-corrected far, intermediate and near visual acuity (UDVA, CDVA, UIVA, DCIVA, UNVA, DCNVA), defocus curve and spectacle independence. n Results: UDVA and CDVA showed no significant difference between groups (p>0.05), however the EDOF IOL presented worse near CDVA (p<0.001). The Trifocal and EDOF IOL showed better DCIVA compared to the References 1. Monaco G, Gari M, Di Censo F, et al. Visual performance after bilateral implantation of 2 new presbyopia-correcting intraocular lenses: Trifocal versus extended range of vision. J Cataract Refract Surg. 2017;43(6):737–747. 2. Kohnen T, Herzog M, Hemkep- pler E, et al. Visual performance of a quadrifocal (trifocal) intraocular lens following removal of the crystalline lens. Am J Ophthalmol. 2017;184:52–62. 3. Ruiz-Mesa R, Abengózar-Vela A, Ruiz-Santos M. A comparative study of the visual outcomes between a new trifocal and an extended depth of focus intra- ocular lens. Eur J Ophthalmol. 2018;28(2):182–187.

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