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Study finds slight advantage for optic shift IOL vs. conventional IOL

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Implanting the 1CU optic shift IOL gave patients a slight statistical advantage in reading vision compared with those implanted with a conventional monofocal IOL, according to a comparative study by researchers in Germany.

Detlef Uthoff, MD, FSES, FABI, and colleagues at Eye Hospital Bellevue in Kiel compared outcomes for 553 eyes of 436 patients implanted with the 1CU optic shift IOL (HumanOptics AG) with those for 219 eyes of 183 patients implanted with the MCTE monofocal IOL (Dr. Schmidt).

Both groups achieved best corrected visual acuity of 1 for distance at 1 month postop, which was maintained at 12 months follow-up.

However, at 12 months, patients in the 1CU group had a mean Nieden value of 5.77 compared with a mean value of 6.41 for control patients. "Consequently, the 1CU group showed better near reading acuity of half a reading step (P < .01)," the authors said. Eyes implanted with the 1CU IOL also showed a significantly greater accomodative response of 11 cm compared with control eyes (P < .01), they noted.

Of the 436 patients implanted with the 1CU, 2.7% achieved a final near visual acuity of Nieden 1 to 3 with distance BCVA. No control patients achieved such near vision.

Such a correction would require an optic shift of 1.4 mm to 1.8 mm, the authors said. Given the anatomic limitations of the iris, that shift does not seem possible, they noted.

"We believe other factors must be responsible for this effect," the authors said. "Therefore, when interpreting our clinical results, we must keep in mind that currently available subjective or objective methods are not able to precisely measure a true accommodative effect in pseudophakic eyes and differs it from that of pseudoaccommodation."

The 1CU lens became decentered in three eyes due to asymmetric capsular fibrosis and required explantation. A total of 7.3% of eyes in the 1CU group developed posterior capsule opacification and required Nd:YAG capsulotomy vs. 5.5% of the control group. The study is published in the February issue of the Journal of Refractive Surgery.