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A Journal on Ophthalmology
Minerva Oftalmologica 2016 June;58(2):39-45
Analysis of visual outcomes, spectacles dependence and patient satisfaction after implantation of accommodative intraocular lenses
Raffaele NUZZI, Daniele ROLLE, Federico TRIDICO
Unit of Ophthalmology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
BACKGROUND: As today, cataract surgery is based on the implantation of intraocular lenses (IOLs) after lens extraction. Accomodative IOLs are conceived with the intent to provide a residual accommodation capacity for close-up vision after surgery, hence reducing spectacles dependence. The aim of this study was to evaluate visual results and the impact on vision quality of accomodative IOL (FIL618) in patients undergoing surgery for bilateral phacoemulsification with IOL implantation.
METHODS: This observational prospective study is designed to evaluate multifocal IOLs FIL618PV in patients undergoing phacoemulsification with IOL implantation. Hyperopic eyes were subjected to larger capsulorhexis during surgery, with the intent to facilitate the IOL optic plate movements. Patients were asked to attend at ophthalmologic control visits at 1 day, 7 days, 1 year, 3 months and 6 months after surgery.
RESULTS: Improvements in visual acuity for the three working distances were statistically significant in all cases compared to the preoperative status, especially after binocular implantation. Moreover, reduction of additional correction required to obtain the best binocular visual acuity for near and intermediate distance was statistically significant (P≤0.001 for each distance). No significant correlations between capsulorhexis diameter and additional correction for close-up and intermediate distance were noted.
CONCLUSIONS: FIL618 IOL allows achieving an almost complete spectacle independence for distance vision and acts as an excellent monofocal when it does not succeed in exploiting its accommodation properties. Uncorrected visual acuity for intermediate and close-up distance was discreet among all patients, thus often requiring an additional correction to obtain best visual acuity, though lower if compared with usual additional correction needed after monofocal IOLs implantation. Hence a significant spectacle dependence for close distances emerged from answers given by patients to questionnaires about satisfaction after surgery.