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Multifocal IOLs are a reliable option for cataract patients, study confirms
Surgeons can confidently rely on this option, thereby minimizing patients’ dependence on spectacles.
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SIRACUSA, Italy — A study on 50 cataract patients implanted with multifocal IOLs (AMO Array SA40N; Allergan, Irvine, Calif.) in the Siracusa Umberto Primo Eye Clinic, and tested for binocular vision results and general visual comfort, confirms that surgeons can confidently rely on this option, minimizing the patient’s dependence on spectacles.
“Cataract surgery has rapidly evolved from simple disease treatment to a sophisticated restoration of functional vision,” said Antonello Rapisarda, MD, head of the Siracusa Umberto Primo Eye Clinic here, who co-authored the study with Andrea Centaro, MD; Riccardo Sciacca, MD, and Emilia Gallo, CO. “The first priority was to obtain the best visual acuity without glasses. However, to satisfy the patients’ demands, we should be able to improve close distance vision, provide an adequate pseudoaccommodation, and reduce halos, glare and other discomforts to a minimum. Multifocal implants seem to meet these needs very effectively.”
The AMO Array SA40N is a silicone based, multifocal, 6-mm optic diameter lens with rings of varying optical power. The haptics are made of extruded PMMA (Figure 1).
Preop and postop examinations
---The AMO Array SA40N is a silicone based, multifocal, 6-mm optic diameter lens with rings of varying optical power. The haptics are made of extruded PMMA.
The 50 patients selected for the study had ages ranging from 48 to 89 years. They were required to have no anterior or posterior pole pathology, normal intraocular pressure (IOP) and no history of anisometropia or amblyopia. They underwent a preoperative full examination, including refraction, ophthalmometry, slit lamp examination, IOP evaluation, retina examination, ocular motility and biometry.
All patients underwent the same technique of cataract extraction in both eyes at different times (1 to 2 weeks between the two eyes). Corneal incisions and phacoemulsification were performed, and AMO Array SA40N foldable multifocal IOLs were implanted in both eyes (Figure 2).
Postoperative vision
---Implantation of the AMO Array SA40N multifocal IOL.
The postop examinations were planned at 1, 4 and 8 weeks after surgery. They included visual acuity, contrast sensitivity and binocular vision.
Snellen visual acuity was measured at 20 ft and D.W. reading charts were used. Precision Vision Contrast Sensitivity test ’98 (L. Hevarynen) was used for the contrast sensitivity test at 1 m distance. Bin ocular vision was evaluated by cover test 1-2, amplitude of fusion, stereo test (Titmus and Lang) and ocular motility. These tests were repeated at all postoperative appointments.
Postoperatively, the patients were asked to answer a questionnaire, reporting on visual comfort, general satisfaction, possible complaints of glare, halos or diplopia and use of near correction.
“The questionnaire took into account the age of the patients, their occupation and interests. We also took into account how motivated the patients were on visual application and how long in the day they needed to rely on efficient near and distance visual performance,” Dr. Rapisarda said.
The results on visual acuity are reported in figures 3, 4 and 5.
Mean value of contrast sensitivity was about 36%. A loss of contrast sensitivity was reported in patients implanted with multifocal IOL 6-7 type.
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