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Multifocal IOL improves uncorrected and corrected near, distance vision
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A refractive segmented multifocal IOL provided good visual outcomes, high patient satisfaction and a satisfactory complication rate, according to a large study.
The retrospective analysis included 9,366 eyes of 4,683 presbyopic ametropic patients who underwent bilateral phacoemulsification and implantation of the Lentis Mplus (Oculentis), an aspheric nonrotational symmetric multifocal IOL.
LogMAR uncorrected distance visual acuity, corrected distance visual acuity, uncorrected near visual acuity, refraction and keratometry were assessed at 1 day, 1 week, and 1, 3 and 6 months after surgery. Patients completed a computer-based questionnaire on satisfaction at the 3-month follow-up.
Mean sphere decreased from +2.06 D at baseline to +0.24 D at 3 months and +0.29 D at 6 months.
Mean corrected distance visual acuity improved from –0.017 before surgery to –0.033 at 3 months and –0.031 at 6 months.
At 3 months, binocular uncorrected distance visual acuity was 0.0 in 4,247 patients (80.5%) and 0.1 or better in 5,012 patients (95%).
Mean binocular uncorrected near visual acuity was 0.155 at 3 months and 0.159 at 6 months.
Regarding satisfaction, 68.1% of patients said they were very satisfied with their outcome and 25.7% said they were satisfied; 97.5% of patients said they were willing to recommend the procedure.
Fifty-five eyes had severe dysphotopsia that required an IOL exchange.
Disclosure: Schallhorn is a consultant for Abbott Medical Optics. The remaining authors have no relevant financial disclosures.
Perspective
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Mark Packer, MD
Venter and colleagues have published a large retrospective series of both cataract and refractive lens exchange patients implanted bilaterally with the Lentis Mplus IOL. The unconventional Ben Franklin bifocal design of this lens may prompt initial skepticism, especially with regard to potential dysphotopsia. However, experience and this study have shown the incidence of explantation due to unwanted optical side effects to be surprisingly similar to that of more familiar diffractive multifocal IOLs. Unfortunately, the authors do not report the rate of spectacle independence. FDA data for the Tecnis multifocal (Abbott Medical Optics) demonstrate that 88% of patients never wear glasses; for the ReSTOR (Alcon), the figure is 76%. Another useful statistical measure of success not reported in this paper is the percentage of patients achieving various levels of given acuities at both distance and near. Despite these deficiencies, this study demonstrates high patient satisfaction and provides strong support for wider utilization of the Mplus IOL.
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