Spectacle Independence for Pseudophakic Patients – Experience with a Trifocal Supplementary Add-on Intraocular Lens
Received 14 November 2019
Accepted for publication 8 January 2020
Published 9 April 2020 Volume 2020:14 Pages 1043—1054
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Carlos Palomino-Bautista,1,2 Rubén Sánchez-Jean,1 David Carmona Gonzalez,1 Marta Romero Domínguez,1,2 Alfredo Castillo Gómez1,2
1Department of Ophthalmology, University Hospital Quirónsalud Madrid, Madrid, Spain; 2European University of Madrid, Madrid, Spain
Correspondence: Carlos Palomino-Bautista Calle Santa Engracia 6, Madrid 28010, Spain
Tel +34 620 858 128
Purpose: To evaluate the refractive and functional outcomes of the trifocal 1stQ AddOn® (Medicontur) supplementary intraocular lenses (IOLs) designed for implantation into the ciliary sulcus.
Patients and Methods: The study included 18 eyes of 11 pseudophakic patients with uncomplicated previous implantation of monofocal capsular bag IOLs. These patients had a desire for spectacle independence. Distance, intermediate and near visual acuities were measured, and defocus curves were plotted over a period of 6 months following implantation of the add-on IOLs. Intraocular pressure (IOP), endothelial cell density measurements and biomicroscopic evaluation were also performed.
Results: In this study, 83.3% of eyes had spherical refractions within ± 0.5 D from emetropia and 100% of eyes had spherical equivalent refractions that were within ± 1.0 D of the target refraction. Visual acuities and defocus curves clearly confirmed trifocal optical performance (UDVA=0.03 ± 0.05; UIVA=0.21 ± 0.04; UNVA=0.12 ± 0.04 logMAR; expressed as mean ±SD). Depth of focus showed identical results (DOF=0.486 D) compared to a trifocal capsular bag IOL, while the defocus curve was found to be superior in the intermediate and near ranges when compared to a trifocal capsular bag IOL. All patients achieved spectacle independence at all distances. All add-on IOLs were well positioned in the ciliary sulcus. No negative changes were noted in connection with endothelial cell counts, IOPs, the angle structure during surgery and during the follow-up period.
Conclusion: The supplementary trifocal add-on IOL seems to be a safe, efficient and stable solution for achieving spectacle independence in pseudophakic patients with monofocal primary IOLs.
Keywords: cataract surgery, supplementary IOL, trifocal, defocus curve, spectacle independence
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