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Visual acuity results ‘excellent’ with extended range of vision IOLs
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Binocularly implanted extended range of vision IOLs provide “excellent” stereoacuity at distance and near and a high quality of vision, according to a study.
Fifty patients were bilaterally implanted with the Tecnis Symfony IOL (Johnson & Johnson Vision) at the R.P. Centre for Ophthalmic Sciences, AIIMS, New Delhi, India. Stereopsis was assessed by vectograph tests, with patients wearing polarized spectacles, and both distance and near stereoacuity were measured using the Randot stereotest. Visual quality was assessed by measuring modulation transfer function, Strehl ratio and high-order aberrations, using the iTrace ray-tracing aberrometer (Tracey Technologies). Visual acuity and patient satisfaction were included as secondary outcomes.
All patients had a near stereoacuity of 30 arcsec or better, and 80% achieved a perfect near stereopsis of 20 arcsec. Although perfect distance stereopsis of 60 arcsec was achieved by only 36% of the patients, good distance stereoacuity of 100 arcsec or less was achieved by 82%. Modulation transfer function and Strehl ratio showed good contrast and image brightness. Better stereopsis was associated with higher modulation transfer function values.
Dysphotic phenomena, mostly mild to moderate, were reported by about half of the patients initially but were significantly reduced at 1 year. Patients were mostly very satisfied. Nearly 90% did not have difficulties with night driving, no one experienced problems with computer work and portable devices, nearly all reported no visual disturbance while watching TV or performing outdoor activities, and only 8% reported difficulties when reading.
Spectacle independence was achieved by 96% of the patients at distance, 94% at intermediate and 62% at near, mostly compensated by occasional spectacle use. – by Michela Cimberle
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Amar Agarwal, MS, FRCS, FRCOphth
The authors report on a study in which extended range of vision IOLs were placed in both eyes and subjects were assessed for stereoacuity and quality of vision. This study serves as a benchmark for future studies that may be designed to assess stereoacuity in patients undergoing binocular implantation of premium IOLs designed to provide spectacle independence. The study also emphasizes the importance of assessing binocular interaction in pseudophakic eyes, as these data might have a lot of clinical significance and repercussions.
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