Spectacle Independence After Cataract Surgery: A Prospective Study With a Multifocal Intraocular Lens

Abstract Our aim was to review clinical outcome and patient satisfaction after cataract surgery to obtain spectacle independence following multifocal intraocular lens (IOL) implantation. A prospective case-series study was designed to evaluate the safety and efficacy of the Hanita FullRange pseudophakic multifocal intraocular lens in patients with programmed cataract surgery, performed between October ۲۰۱۷ and May ۲۰۱۸, with follow-up after ۱۲ months. Manifest refraction spherical equivalent (SE), SE refractive accuracy, uncorrected distance (UDVA), intermediate (UIVA) and near visual acuity (UNVA) and a binocular defocus curve were evaluated. In addition, a short satisfaction questionnaire was developed. Surgeries were performed without viscoelastic substance. The corneal endothelial cell density (ECD), central corneal thickness (CCT), and intraocular pressure (IOP) were also evaluated. A total of ۴۸۰ eyes of ۲۴۰ patients with a mean ± standard deviation (SD) of age of ۷۵ ± ۶.۱۲ years were included. The mean ± standard deviation (SD) of preoperative SE was ۲.۰ ± ۲.۱۸ D (range; -۵.۵۰ to ۴.۷۵) which decreased to -۰.۰۴ ± ۰.۲۸ D (range; -۰.۷۵ to ۰.۶۲۵) ۱۲ months after surgery. Regarding SE refractive accuracy ۸۲.۹ % of eyes obtained SE values between -۰.۲۵ and ۰.۲۵ D. There was no loss of lines of vision and ۹۸.۳% of patients achieved UDVA between ۲۰/۲۰ and ۲۰/۲۵. The UNVA (binocular) obtained was J۱ for ۷۲.۵% and J۲ for ۲۷.۵% of patients. Regarding defocus curve, ۰.۰۴ logMAR for -۳.۰ D, ۰.۰۹ logMAR for -۱.۵ D and ۰.۰۳ logMAR for ۰ D was achieved. The mean CCT was increased by ۶.۶۲ ± ۲.۷۹ micrometers (۱.۲۴%), the mean ECD was decreased by ۲۲۶.۰۸ ± ۱۱.۶۳ cell/mm۲ (۹.۰۰ %) and the IOP remained stable one year after surgery. In response to the satisfaction questionnaire, ۹۲% of patients stated that they had obtained spectacle independence. Finally, spectacle independence was achieved in most of the cases, with a high level of patient satisfaction one year after implantation of a FullRange IOL. No complications were detected. We concluded that the refractive efficacy of FullRange multifocal IOL was proved in majority of cases. A large follow up period is necessary in future studies to confirm the results.