Visual outcomes after vitrectomy for epiretinal membrane in pseudophakic eyes with a diffractive trifocal intraocular lens: a retrospective cohort study

Abstract

Background Diffractive intraocular lenses (IOLs) could affect visual acuity in patients with macular pathologies such as epiretinal membrane (ERM) and could influence the results of pars plana vitrectomy (PPV) for ERM removal in pseudophakic eyes with these IOLs. The aim of this study is to evaluate the effect on visual outcomes of a diffractive trifocal IOL in PPV for ERM peeling. Methods This is a retrospective cohort study on 20 eyes with a single model of trifocal IOL that underwent PPV for removal of ERM between January 2015 and September 2018 in our clinics. Follow up was at least 1 year. Primary outcome measure was mean change in visual acuity. Secondary outcome measures were mean change in central macular thickness (CMT), recovery of the external retinal layers, and change in spherical equivalent (SE). Results Mean corrected distance visual acuity (CDVA) was 0.03 ± 0.03 logMAR after phacoemulsification; this worsened to 0.23 ± 0.10 logMAR with ERM, improving to 0.10 ± 0.04 log MAR 12 months after PPV (p = 0.001). Mean uncorrected near visual acuity (UNVA) was Jaeger 2.62 ± 0.51 after lensectomy. This worsened to Jaeger 5.46 ± 1.67 with ERM and improved to the initial Jaeger 2.69 ± 0.84 after PPV (p = 0.005). CMT decreased significantly, from 380.15 ± 60.50 μm with the ERM to 313.70 ± 36.98 μm after PPV. Mean SE after lensectomy was − 0.18 ± 0.38 D, which minimally changed to – 0.18 ± 0.47 D after PPV (p = 0.99). The only complication recorded after PPV was a case of cystoid macular edema. No difficulties in visualization due to IOL design were reported during PPV. Conclusion PPV for ERM in eyes with this trifocal IOL seems to be safe and effective, and allows recovery of the loss of UNVA.

Comparative Evaluation of Visual Outcomes in Combined Cataract and Vitrectomy for Idiopathic Epiretinal Membrane with an Advanced or Conventional Intraocular Lens

“…Yoshino and Inoue reported difficulties in fundus visualization during PPV using a diffractive multifocal IOL. In contrast, Velasco et al [31] reported no perioperative difficulty related to diffractive multifocal IOLs, but they did not recommend simultaneous cataract and vitrectomy surgery with diffractive rings or lenses. The Eyhance IOL is also an EDOF IOL, but instead of using a diffractive structure, it adds a high-order aspheric structure in the centre location to extend the depth of focus [26, 32, 33].…”

Phacoemulsification with implantation of a trifocal intraocular lens in eyes with asteroid hyalosis and synchysis scintillans

“…Patient satisfaction and spectacle dependence were assessed using a questionnaire that has been used previously in patients implanted with multifocal IOLs and based on our clinical experience and patients' demands. 1,2,12 Patients rated their satisfaction after surgery on a scale of 1 to 5 (1 = very unsatis ed; 5 = very satis ed). Those who described their quality of vision as ''satis ed'' or ''very satis ed'' were considered as satis ed in this study.…”

“…No patients with these conditions were included in the study group. Although optimal results have been published after pars plana vitrectomy for various vitreoretinal conditions in patients who receive trifocal IOLs,12 caution should be exercised in patients with AH or SS and extremely dense vitreous opacities. Patients should receive careful counselling with realistic expectations before lens surgery and trifocal IOL implantation, with emphasis on the persistence of visual disturbances related to the vitreous opacities and the unlikely possibility that vitrectomy could be required in the future.Besides, no interference in the eye fundus examination (which currently includes funduscopy and macular optical coherence tomography) was recorded in any of the patients in the AH/SS group before or after the lens surgery.…”