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Single IOL may be option in some small, highly hyperopic eyes

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LONDON – One thicker lens may be a better option than two thinner IOLs in small, highly hyperopic eyes, a speaker here said.

“When dealing with small eyes, a very common question that arises is what is optically better – a single, thicker, higher-powered lens or to split the power into two lower-powered thinner lenses?” Bruno C. Trindade, MD, said at the European Society of Cataract and Refractive Surgeons Congress here.

Bruno C. Trindade

Using simulation software, Trindade and colleagues modeled 65 different eye models needing a 60 D lens to achieve emmetropia using corneal curvatures varied between 42 D and 50 D and axial lengths between 15.23 mm and 16.90 mm, but all with constant effective lens position.

Using a 3 mm pupil size, Trindade and colleagues compared spherical and aspheric performance of a single 60 D lens with two piggyback models: one with matching 30 D lenses and the other with a 20 D lens in front and a 40 D lens in back.

In spherical lenses, the single lens had the worst performance, Trindade said; however, considering aspheric lenses, the single lens performed statistically significantly better than either of the other two lens strategies.

“One IOL is optically better to be used in a highly hyperopic nanophthalmic eye if […] this IOL is aspheric and this IOL is well-centered,” Trindade said.