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Study finds better near vision in hyperopic eye after diffractive multifocal IOL implantation

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Implanting a diffractive multifocal IOL after clear lens extraction can predictably correct ametropia and presbyopia in hyperopic and myopic patients, a study found. However, hyperopic corrections were associated with higher near vision safety and efficacy indices, the study authors noted.

Luis Fernández-Vega, MD, PhD, and colleagues in Spain prospectively evaluated the outcomes for clear lens extraction performed in 224 eyes of 112 consecutive patients. In all eyes, surgeons implanted an AcrySof Natural ReSTOR IOL (Alcon).

The researchers compared safety, predictability and stability of the procedure between patients treated for either hyperopia or myopia. The hyperopic group had a mean spherical equivalent of +3.86 D, and the myopic group had a mean spherical equivalent of -6.01 D, according to the study.

At 6-months postop, all eyes had uncorrected distance visual acuity of 20/25 or better, and no eyes lost 2 or more lines of best corrected distance visual acuity.

Specifically, in the myopic group, 10 eyes gained 1 line of distance vision and 10 eyes gained 2 lines or more.

In the hyperopic group, 20 eyes gained 1 line and 15 eyes gained 2 lines or more of distance vision, according to the study.

No eyes lost more than 2 lines of best distance-corrected near vision. For the myopic group, 10 eyes lost 2 lines or less, 15 eyes gained 1 line and five eyes gained 2 lines. For the hyperopic group, eight eyes lost 2 lines or less, 20 eyes gained 1 line and 16 eyes gained 2 lines.

However, hyperopic patients achieved better uncorrected near vision, which averaged 0.95 compared with 0.88 for myopic patients, the authors reported.

All eyes were within 1 D of the desired refraction, they noted.

"Safety and efficacy indices at distance were comparable in myopic and hyperopic patients. However, at near, both indices were larger for hyperopic patients," the authors said.

Near vision efficacy indices were 1.03 for the myopic group and 1.1 for the hyperopic group.

The study is published in the August issue of Ophthalmology.