The impact of multifocal intraocular lens in retinal imaging with optical coherence tomography

Abstract

Multifocal intraocular lenses (MF IOLs) have concentric optical zones with different dioptric power, enabling patients to have good visual acuity at multiple focal points. However, several optical limitations have been attributed to this particular design. The purpose of this study is to access the effect of MF IOLs design on the accuracy of retinal optical coherence tomography (OCT). Cross-sectional study conducted at the Refractive Surgery Department of Central Lisbon Hospital Center. Twenty-three eyes of 15 patients with a diffractive MF IOL and 27 eyes of 15 patients with an aspheric monofocal IOL were included in this study. All patients underwent OCT macular scans using Heidelberg Spectralis Ò . Macular thickness and volume values and image quality (Q factor) were compared between the two groups. There were no statistically significant differences between both groups regarding macular thickness or volume measurements. Retinal OCT image quality was significantly lower in the MF IOL group (p \ 0.01). MF IOLs are associated with a significant decrease in OCT image quality. However, this fact does not seem to compromise the accuracy of spectral domain OCT retinal measurements.

Changes in retinal nerve fiber layer thickness measurements in response to a trifocal intraocular lens implantation

“…The peripapillary RNFL thickness differences produced by a multifocal IOL implantation compared to a monofocal one have not been detected in macular studies based on spectral-domain OCT or other OCT systems [14,15].…”

Analysis of Korean Retinal Specialists’ Opinions on Implanting Diffractive Multifocal Intraocular Lenses in Eyes with Underlying Retinal Diseases

“…The problems with MF-IOL implantation in eyes with retinal disease include not only the reduction in contrast sensitivity but also the effect on the diagnosis and treatment of preexisting retinal diseases [ 14 , 17 , 18 , 19 , 20 , 21 ]. Difficulties during retinal surgery in eyes with diffractive MF-IOL have been reported and include decreased contrast sensitivity for removal of the epiretinal membrane and skipped/ghost images of intravitreal triamcinolone crystals at some depth, which interfere with the intraoperative view [ 17 , 18 ].…”

“…Wavy, horizontal artifacts have been reported on OCT line-scanning ophthalmoscopy images (monitor images) in eyes with diffractive MF-IOLs; however, there were no artifacts in OCT images or scanning laser ophthalmoscopy images [ 18 ]. Retinal OCT image quality has been reported to be significantly decreased by more than 3 dB in the MF-IOL group; however, there were no significant differences in measurements of macular thickness or volume [ 20 , 24 ]. There were also some comments on the decreased quality of the OCT images in our preliminary survey; however, most of the respondents reported that it was not critical for proper diagnosis.…”

Comparing the Effect of Monofocal and Multifocal Intraocular Lenses on Macular Surgery

“…Some studies reporting that multifocal IOLs of multiple concentric optical regions with different dioptric power cause various optical limitations. Macular diseases are relative contraindications for multifocal IOL implantation [ 16 ]. Braga-Mele et al reported development of dystopic disorders, glare, and decreased contrast sensitivity after multifocal IOL implantation in patients with macular disease [ 9 ].…”