Contrast sensitivity after refractive lens exchange with a multifocal diffractive aspheric intraocular lens

Abstract

Purpose: To evaluate distance and near contrast sensitivity (CS) under photopic and mesopic conditions before and after refractive lens exchange (RLE) and implantation of the aspheric AcrySof ® ReSTOR ® (SN6AD3 model) intraocular lens (IOL). Methods: Seventy-four eyes of 37 patients after RLE underwent bilateral implantation with the aspheric AcrySof ReSTOR IOL. The patient sample was divided into myopic and hyperopic groups. Monocular uncorrected visual acuity at distance and near (UCVA and UCNVA, respectively) and monocular best corrected visual acuity at distance and near (BCVA and BCNVA, respectively) were measured before and 6 months postoperatively. Monocular CS function was measured at three different luminance levels (85, 5 and 2.5 cd/m 2 ) before and after RLE. Post-implantation results at 6 months were compared with those found before surgery. Results: Our results revealed that patients in both groups obtained good UCVA and BCVA after RLE at distance and near vision in relation to pre-surgery values. No statistically significant differences were found between the values of CS pre and post-RLE at distance and near, at any lighting condition and spatial frequency (p>0.002). Conclusions: Refractive lens exchange with aspheric AcrySof ReSTOR IOL in myo pic and hyperopic population provided good visual function and yield good distance and near CS under photopic and mesopic conditions.

Impact of Low Mesopic Contrast Sensitivity Outcomes in Different Types of Modern Multifocal Intraocular Lenses

“…In addition, many studies have compared mfIOLs with different optic designs and a high variability of results have been published with some authors concluding that diffractive IOLs showed better CSF outcomes than refractive IOLs (4,21) and vice versa (22,23). Another report (24) showed no differences between the preoperative and postoperative CSF after refractive lens exchange with implantation of a bifocal IOL. Due to the high variability of the CSF, our research group has compared several mfIOLs with different optic designs in order to ascertain which IOL provided the highest LMCSF.…”

Dysfunctional lens syndrome: a prospective review

“…The criteria by which some clinicians consider refractive lens exchange as a treatment for presbyopia include stage 2 with increased ocular scatter (2,3) , high myopia (21) , hyperopia (22) , and patients with stage 1 associated with reduced visual quality under low light conditions. (23) However, this decision must consider the risks in performing cataract surgery, including retinal detachment, macular edema, and choroidal effusion. (22) Importantly, there is a percentage increase in these complications when associated with high myopia and high hyperopia.…”

“…(22) Importantly, there is a percentage increase in these complications when associated with high myopia and high hyperopia. (22,23) CONCLUSION While the concept of dysfunctional lens syndrome is now commonly recognized, a standard and universally accepted staging system has yet to be established. In the staging system proposed in this review, transparency and presbyopia are independent factors, but in advanced stages, they can occur concomitantly.…”