Eyeworld

EW CATARACT 40 June 2018 Cataract editor's corner of the world by Stefanie Petrou Binder, MD, EyeWorld Contributing Writer The study's outcomes The mean preoperative BCDVA was logMAR 0.4 and improved to logMAR 0.9 at 6 months after surgery (P=.02). BCDVA remained unchanged in 86% of the eyes from the third postoperative month until the end of the follow-up period. Near visual acuity remained stable in 80% of the eyes during the 6 months of follow-up time. All of the patients who received extended depth of focus lenses (n=4) achieved uncorrected near visual acuity of J 1.5 at 40 cm. The near uncorrected visual acuity at 6 months in eyes with multifocal IOLs was J 1 in 45% and J 1.5 in 55% of eyes. The preoperative sphere was 2.16 and the preoperative cylinder was 0.89. Postoperatively, the sphere was 0.07 and the cylinder was 0.13. There was a significant improve- ment in the postoperative refractive status, for sphere (P=.05) and for cylinder (P=.12), 3 months after sur- gery. The refractive status remained stable until 6 months after surgery and until the end of the follow-up period. One patient from the sample was dependent on spectacles for distance visual acuity. All of the patients in this study expressed a high degree of satisfac- tion, subjectively, with their postop- erative visual acuity outcomes. and at 1 month, 3 months, and 6 months postoperatively. The rea- sons for cataract surgery included: cataract and high hyperopia (in two eyes), congenital cataract (in three eyes), posterior subcapsular cata- ract (in six eyes), traumatic cataract (in one eye), and total cataract (in three eyes). Uncorrected distance visual acuity (UCDVA; logMAR), best corrected distance visual acuity (BCDVA; logMAR), uncorrected near visual acuity (UCNVA; Jaeger scale: at 33 and 40 cm), manifest refrac- tion, spectacle dependency, patient satisfaction after surgery, compli- cations, and reinterventions were analyzed. Following cataract surgery, the patients received one of three lenses; two eyes received the Tecnis MFIOL (Johnson & Johnson Vision, Santa Ana, California), nine eyes received the AT LISA trifocal IOL (Carl Zeiss Meditec, Jena, Germany), and four eyes received the Tecnis Symfony EDOF IOL (Johnson & Johnson Vision). In six of the eyes, toric versions of the devices were im- planted: four Tecnis Symfony toric IOLs and two AT LISA toric trifocal IOLs. Three patients were submitted to unilateral multifocal IOL implan- tation, one of which had unilat- eral eye trauma, another of which received a monofocal IOL implanted in the fellow amblyopic eye, and the last of which had a total unilateral cataract in one eye. implanting multifocals and antic- ipate the appearance of photopic phenomena and decreased contrast sensitivity. The study was shown in an e-poster at the XXXV Congress of the ESCRS. Results demonstrated a high level of satisfaction with the visual acuity achieved 6 months following surgery in the study that evaluated the refractive and visual outcomes and patient satisfaction after cataract surgery of multifo- cal (MFIOL) or extended depth of focus (EDOF) IOL implantations in patients under 40 years of age. The study demonstrated that multifo- cal or EDOF IOL implantation is a feasible and valuable option for the restoration of both distance and near visual acuity in young patients who need to undergo cataract sur- gery, according to the first author of the poster, Luisa Malheiro, MD, De- partment of Ophthalmology, Centro Hospitalar Universitario do Porto, Portugal. Retrospective study of 15 eyes The study was a retrospective anal- ysis of 15 eyes of nine patients who underwent cataract surgery with multifocal/EDOF lens implantation between June 2011 and November 2016. The patients were 44% male and 56% female, with ages ranging from 29–40 years (mean age of 37 years). They underwent ophthalmo- logical examinations preoperatively Multifocal and extended depth of focus IOL implantations in patients under 40 years of age were well tolerated and visually efficacious, according to a recent study M ultifocal IOLs provide a high degree of spec- tacle independence for all ranges of vision following implantation in presbyopic patients undergoing cataract surgery. But what about patients at pre-presbyopic ages? Are there any limitations? According to the results of a recent study, it seems that physicians can expect the same visual acuity outcomes using mul- tifocal IOLs in younger patients as those achieved in older, presbyopic patients. Patient selection is import- ant, with lifestyle, occupation, and patient expectations playing major roles and perfectionist personali- ties being the hardest to manage. Also, physicians need to watch for blurred vision from ametropia when Young patients express high satisfaction in visual acuity with multifocal IOLs Tecnis Symfony IOL after cataract surgery in a male patient, 37 years old with congenital cataracts; UDCVA of 10/10 and J1.5 at 40 cm I n this month's "Cataract editor's corner of the world," we delve into the results of a study presented at the XXXV Congress of the ESCRS. It looks at patient satisfaction with MFIOL implantation but in a younger patient co- hort. One would think that younger patients undergoing cataract surgery would prefer to have a presbyopia-correcting IOL since they are not used to needing reading aids yet. If you read on you will see what the outcome of the study is. No matter what the age of the patient, full disclosure on expectations and outcomes is important to achieve good results. Read on to learn more about the use of MFIOLs and EDOF IOLs in a younger patient cohort. Rosa Braga-Mele, MD, Cataract editor Tecnis MFIOL after cataract surgery in a female patient, 36 years old with bilateral posterior subcapsular cataracts; UDCVA of 10/10 and J1 at 33 cm Source: Luisa Malheiro, MD

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