Eyeworld

EW CATARACT 41 June 2018 Posterior capsule opacification No complications were reported either during the surgery or within the 6-month follow-up period. Sim- ilarly, no reinterventions were nec- essary up to 6 months after surgery. Of the 15 eyes operated on, two eyes developed posterior capsule opacifi- cation (PCO) in a mean time of 2.2 years after surgery and underwent capsulotomy with Nd:YAG laser with visual improvement. "Visual outcomes achieved with multifocal or extended depth of focus IOL implantation were good and remained stable during the fol- low-up time," Dr. Malheiro said. "All of the patients achieved spectacle independence for distance and near visual acuity, except in one patient who remained dependent on specta- cles for distance visual acuity." Agreement and disagreement Hyperopia can be a strong indica- tion for multifocals, at any age. An unrelated study that implemented bilateral multifocal IOL implan- tation (Acri.LISA 366D, Carl Zeiss Meditec) in 85 moderate to high hy- peropic patients (170 eyes) substan- tiated the level of satisfaction seen in Dr. Malheiro's outcomes, showing a satisfactory full range of vision in high hyperopes, comparable to that obtained in low to moderate hyperopes. 1 In another unrelated investiga- tion that studied the outcomes of refractive lens exchange in pre-pres- byopic eyes, the study coordinators found that the implantation of a diffractive MFIOL (ReSTOR MFIOL, Alcon, Fort Worth, Texas) gave good distance and near contrast sensi- tivity under photopic and mesopic conditions, and although mesopic contrast sensitivity was reduced at distance and near compared to that achieved under photopic condi- tions, the performance was compa- rable to that with the natural lens preoperatively. 2 Young eyes, however, have not always responded well to multifo- cals, as was shown in a different study of presbyopic (n=17) and non-presbyopic patients (n=7; aged under 45 years) with monocular cataracts who received ReSTOR MFI- OLs as part of a study that evaluated the visual acuity and subjective satisfaction of different aged monoc- ular cataract patients with ReSTOR MFIOLs. It revealed near and inter- mediate vision in young eyes that was worse than that of the contra- lateral clear lens eyes and with lower subjective satisfaction (compared to the presbyopic patients in the same study). However, pre-presbyopic pa- tients were very satisfied with their distance vision, according to the study outcomes. 3 EW References 1. Fernandez-Vega L, et al. Visual and refrac- tive outcomes in hyperopic pseudophakic patients implanted with the Acri.LISA 366D multifocal intraocular lens. Am J Ophthalmol. 2009;148: 214–220. 2. Ferrer-Blasco T, et al. Contrast sensitivity after refractive lens exchange with diffrac- tive multifocal intraocular lens implantation in hyperopic eyes. J Cataract Refract Surg. 2008; 34:2043–8. 3. Li JH, et al. Comparison of visual acuity in pseudophakic eyes with multifocal intraocular lens versus fellow eyes with clear lens. Zhon- ghua Yan Ke Za Zhi. 2010;46:691– 6. Editors' note: Dr. Malheiro has no financial interests related to her comments. Contact information Malheiro: luisamalheiro90@gmail.com

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