Eyeworld

MARCH 2020 | EYEWORLD | 21 by Kellyn Bellsmith, MD, Caitlin Kakigi, MD, Nathan Lambert, MD, Nathan Law, MD, Joseph Simonett, MD, Ambar Faridi, MD, Thomas Hwang, MD near visual acuity (UNVA). Patients under- went a visual function assessment at 3 months following surgery, including both best correct- ed and uncorrected monocular and binocular visual acuity at distance, intermediate (67 cm), and near (40 cm) under photopic and mesopic conditions, which represented bright light (i.e., daytime) and low light (i.e., nighttime outdoors and night driving) conditions, respectively. Additionally, patients completed a study-de- signed questionnaire based on the National Eye Institute Visual Function Questionnaire (NEI-VFQ), a survey initially created to mea- sure quality of life for people with chronic eye diseases. The study questionnaire was developed to assess satisfaction with the visual outcomes of bilateral cataract surgery. The randomized groups were similar in age and cataract grade and there were no surgical complications or optic decentration noted during follow-up. Deviation from target refrac- tion was low and without significant variability between groups. Uncorrected binocular distance visual acui- ty was excellent in both groups, with a small but statistically significant benefit to the IC-8 group under photopic and mesopic lighting conditions (photopic: dominant eye logMAR 0.03 vs. 0.11, p=0.03, non-dominant eye logMAR 0.12 vs. 0.22, p=0.03, both eyes –0.01 vs. 0.07, p=0.02; mesopic: dominant eye 0.15 vs. 0.27, p<0.01, both eyes 0.12 vs. 0.22, p<0.01). UIVA and UNVA were significantly better in the Symfony group in the dominant eye (which was a Symfony lens in the Symfony group and a ZCB00 lens in the IC-8 group). There was no difference between groups in the non-dominant eye (Symfony lens in the Symfo- ny group, and IC-8 lens in the IC-8 group). Bin- ocularly, there was no difference between UIVA (p=0.35) and UNVA (p=0.14) in the groups. A s IOL designs evolve, patients have an increasing number of options to become "glasses free" after cataract surgery. Emerging technologies, such as multifocal and extended depth of focus IOLs, have been designed to provide functional vision at a variety of working distances. Recent IOL develop- ments have added the use of a small pupillary aperture design to the cataract surgeon's arma- mentarium. The study "Prospective randomized comparative trial: Visual performance compar- ison of two enhanced depth of focus IOLs – Symfony and IC-8" is the first randomized controlled trial to directly compare outcomes between two extended depth of focus IOL plat- forms. The Symfony lens (Johnson & Johnson Vision) combines multifocality and an achro- matic diffractive echelette design to provide an extended range of vision. 1 In contrast, the IC-8 IOL (AcuFocus) is a single-piece acrylic poste- rior chamber IOL with an embedded circular mask with a small 1.36 mm central aperture. 2 Similar small aperture optics have been used as corneal inlays. 3 Both lens designs offer patients an extended range of vision while preserving excellent distance acuity after cataract surgery. This study compared visual acuity and patient satisfaction between the Tecnis Symfony multifocal lens and the IC-8 lens. Thirty-six pa- tients were recruited and randomized into two treatment groups. The IC-8 group had a ZCB00 monofocal lens (Johnson & Johnson Vision) implanted in the dominant eye and an IC-8 lens in the non-dominant eye. The Symfony group had a Symfony multifocal IOL implanted in both eyes. All surgeries were performed by the same surgeon. Target refraction for both groups was plano for the dominant eye and –0.75 D in the non-dominant eye. Primary endpoints were uncorrected inter- mediate visual acuity (UIVA) and uncorrected Review of "Prospective randomized comparative trial: Visual performance comparison of two enhanced depth of focus IOLs – Symfony and IC-8" continued on page 22 EYEWORLD JOURNAL CLUB The Symfony and the IC-8 IOLs use very different methods to increase depth of focus. I asked the Oregon Health and Science University residents to review this clinical compar- ison study that appears in the March issue of JCRS. —David F. Chang, MD EyeWorld Journal Club Editor Thomas Hwang, MD Residency program director Casey Eye Institute Oregon Health and Science University

• Blank Page
• Blank Page (1)