Visual Function and Subjective Perception of Vision following bilateral implantation of monofocal and multifocal intraocular lenses: A Randomised Controlled Trial

Law, Elizabeth M., Aggarwal, Rajesh K., Buckhurst, Hetal, Kasaby, Hosam E., Marsden, Jonathan, Shum, Gary L. and Buckhust, Phillip (2020) Visual Function and Subjective Perception of Vision following bilateral implantation of monofocal and multifocal intraocular lenses: A Randomised Controlled Trial. Journal of Cataract & Refractive Surgery. ISSN 0886-3350

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Abstract

PURPOSE: Following implantation with Multifocal intraocular lenses (MIOLs) or monofocal intraocular lenses (IOLs), the study examines monocular and binocular visual function and patient reporting outcomes using a rigorous series of clinical assessments. Setting: BMI Southend Hospital, UK DESIGN: Prospective, randomised, double-masked clinical trial. METHODS: 100 subjects were randomised for bilateral implantation of either Bi-Flex 677MY MIOL or Bi-Flex 677AB IOL and were assessed at 3-6 months (V1) and 12-18 months (V2). Primary outcomes included distance, intermediate and near LogMAR visual acuities (VA) and defocus curve profile assessment. Secondary outcomes included reading speed, contrast sensitivity (CS) and the subjective perception of quality-of-vision. RESULTS: Uncorrected (MIOL 0.10±0.09LogMAR; IOL 0.09±0.11LogMAR) and best distancecorrected VA (MIOL 0.04±0.06LogMAR; IOL 0.01±0.07LogMAR) were comparable (p>0.05). Unaided near VA (UNVA p<0.001: MIOL 0.23±0.13LogMAR; IOL 0.55±0.20LogMAR) and distancecorrected near VA (DCNVA p<0.001: MIOL 0.24±0.13LogMAR; IOL 0.54±0.17LogMAR) were significantly improved with MIOLs. There was no significant difference in distance-corrected intermediate VA (DCIVA p=0.431: MIOL 0.38±0.13; IOL 0.39±0.13). Defocus curves demonstrated an increased range-of-focus amongst MIOLs (MIOL 4.14±1.10D; IOL 2.57±0.77D). Pelli-Robson CS was different at V1 (p<0.001) but similar by V2 (p=0.059). Overall satisfaction was high (>90%) in both groups for distance tasks whereas significantly different for near (MIOL 18.45±16.53LogUnits; MIOL 55.59±22.52LogUnits). CONCLUSIONS: Unaided near visual acuity is demonstrably better with MIOLs and there was greater subjective satisfaction with their quality-of-near-vision. Halos reported by the MIOL group was significant compared to the IOL group, but did not show an adverse effect on overall satisfaction.

Item Type: Article
Depositing User: Ms Raisa Burton
Date Deposited: 02 Mar 2020 12:44
Last Modified: 15 Apr 2021 03:50
URI: https://marjon.repository.guildhe.ac.uk/id/eprint/17532

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