Varifocal asymmetric IOLs ideal for patients with prior refractive surgery
Key takeaways:
- Varifocal segmental asymmetric IOLs may be the best solution for patients who underwent refractive surgery.
- A study showed positive outcomes and high patient satisfaction with these IOLs.
ATHENS, Greece — In patients who have previously undergone corneal refractive surgery, the asymmetric segmental design of the Acunex VarioMax and Lentis Mplus IOLs is an ideal solution, according to a presenter at the ESCRS winter meeting.
“These patients have high expectations for spectacle independence and therefore a stronger desire to achieve full vision after refractive cataract surgery as compared with the general population,” Magda Rau, MD, told Healio.
Both the Lentis Mplus and the Acunex VarioMax (both Teleon Surgical) are useful for correcting presbyopia and astigmatism in this demanding population. Light transmission is high, between 93% and 95%, comparable to that of monofocal lenses, and much higher than the 78% to 86% of trifocal IOLs. Thanks to the segmental design and glistening-free material, glare and halo effects are minimal, and vision is sharp at all distances.
In a poster presented at the meeting, Rau showed the results of a study that included eight eyes of four patients implanted bilaterally with the Acunex VarioMax and 10 eyes of 10 patients implanted with the Lentis Mplus X toric. The first group had sphere values between +0.75 D and –3.5 D and astigmatism between 0 D and 0.75 D. The second group was between +1 D and –2.25 D of sphere and 2 D and 3.75 D of astigmatism.
“IOL calculation after refractive surgery is more difficult, but we were able to end up in the range of ±0.75 D in 80% of the eyes and within 1 D in 100% of the eyes. The mean refraction was 0.5 D,” Rau said.
Distance vision was excellent, between 20/25 and 20/20 with both lenses. Intermediate and near were also 20/25 or better.
“All patients were satisfied, and 60% were very satisfied. All of them were able to perform daily tasks without glasses like cooking, handicraft work, watching TV and driving the car. One hundred percent were able to read the newspaper and 85% were able to read books with small print without glasses,” Rau said.
Both the Acunex VarioMax and the Lentis Mplus models are available in 0.01 D steps for both sphere and cylinder, and each lens is individually custom-made to correct any residual refraction and long-term regression that may occur in patients after refractive surgery.
“In my opinion, these segmental varifocal and asymmetric toric multifocal IOLs are the best solution,” Rau said.
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Rau M. Presbyopia treatment after excimer laser with segment varifocal and segment toric MFIOLs. Presented at: ESCRS winter meeting; Feb. 28-March 2, 2025; Athens, Greece.
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