<p>Implantation of a Trifocal Intraocular Lens in High Myopic Eyes with Nasal-Inferior Staphyloma</p>

Abstract

Purpose: To assess visual outcomes in high myopic eyes with nasal-inferior staphyloma implanted with a pseudophakic trifocal intraocular lens (IOL). Methods: We retrospectively analyzed the visual outcomes of 50 eyes of 45 patients who had cataract surgery after AT LISA trifocal IOL implantation. Twenty-five eyes diagnosed with posterior staphyloma (nasal-inferior, type IV and V), and 25 eyes as long eyes. Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) values were used to assess the efficacy and safety of the surgery. Refraction and defocus curves were also evaluated at 6 months. Results: No intra-or post-operative problems occurred during the 6 months of follow-up. After the surgery, the mean Snellen decimal UDVA ranged from 0.50 to 1.00, and CDVA from 0.60 to 1.00 for both groups. CDVA was 0.91 and 0.74 for the long eye and nasalinferior staphyloma groups, respectively. Efficacy and safety indexes were 1.22 and 1.32 for the long eye, and 1.26 and 1.43 for the nasal-inferior staphyloma group, respectively. All eyes of both groups showed a postoperative spherical equivalent within ±1.00D. The long eye group showed the highest percentage of spherical equivalent between −0.13D and +0.13D (56%) and the nasal-inferior staphyloma group was between −0.51D and −0.14D (40%). Conclusion: The outcomes of the present study show that a trifocal IOL provides good visual acuity in high myopic eyes, being worse for nasal-inferior staphyloma eyes. The degree of tilt of the macular plane is related with the expected visual acuity.

Association Between Types of Posterior Staphyloma and Refractive Error After Cataract Surgery for High Myopia

“…The present findings suggest that even highly myopic cases seem to present no significant difference in axial length, depending on the subclassification of PS evaluated by wide-field fundus imaging. The present findings are consistent with those of previous studies on eyes with high myopia and PS ( 30 ), showing that refractive outcomes vary significantly among different types of PS after cataract surgery. In addition, a significant correlation between posterior staphyloma classification and postoperative RE was observed.…”

Analysis of visual quality after multifocal intraocular lens implantation in post-LASIK cataract patients

“…In summary, it was shown that the aspheric-enhanced MIOL provided good distance visual acuity while the trifocal diffractive IOL provided good intermediate visual acuity in patients with post-LASIK cataract. Furthermore, the outcomes of the present study [ 32 ] show that a trifocal IOL(AT LISA tri 839 MP) provides good visual acuity in high myopic eyes, being worse for nasal-inferior staphyloma eyes. Whether such patients with a history of LASIK have additional visual acuity effects after trifocal IOL implantation has not been reported.…”

The Role of Multifocal Intraocular Lens Implantation in Extreme Axial Myopia: A Case Report and Literature Review

“…However, the severity of a posterior staphyloma can vary and does not completely exclude a patient from a MfIOL but should cause hesitation in the surgeon. One study examining extreme myopes with and without staphylomas for AT LISA trifocal IOL (Carl Zeiss, Meditec) implantation found superior visual outcomes in eyes without a staphyloma [ 11 ]. Corrective distance acuity was 0.91 and 0.74 for the negative versus positive staphyloma group, respectively.…”

“…Corrective distance acuity was 0.91 and 0.74 for the negative versus positive staphyloma group, respectively. Specifically, nasal-inferior macula staphyloma with higher macula plane tilt (>30 degrees) showed worse outcomes [ 11 ].…”