Dual-optic accommodating IOL provides stable vision at all distances, researcher reports

May 15, 2008

Use of a dual-optic accommodating IOL (Synchrony, Visiogen) results in good visual acuity and spectacle independence at all distances without inducing halos or glare, and outcomes remain stable over time, according to the findings of a prospective, non-comparative case series of patients.

Key Points

Dr. Alarcón, Department of Ophthalmology, ServiOftalmos, Bogotá, Colombia, presented the findings of a prospective, non-comparative case series evaluating the long-term (2-year) functional vision of patients in whom the dual-optic IOL was implanted binocularly after cataract surgery between 2004 and the present.

"The ideal IOL should provide a complete range of vision without compromising quality," he said. "Even more important, it needs to provide stable functionality over time."

Forty-two patients (84 eyes) were seen at 6 months, 39 (78 eyes) were seen at 1 year, and 21 (42 eyes) were seen at 2 years. Patients' mean age was 61 years (range, 40 to 73 years), all were Hispanic, and 64.3% were male and 35.7% were female.

At 1 year, mean UCVA for distance was 0.03 logMAR (20/22 Snellen), for intermediate was –0.10 logMAR (20/16), and for near was 0.12 logMAR (20/26).

Long-term results

After 2 years, mean UCVA remained stable, Dr. Alarcón reported, at 0.03 logMAR (20/22) for distance, –0.10 logMAR (20/16) for intermediate, and 0.06 logMAR (20/23) for near. Mean distance-corrected near and intermediate visual acuity remained stable over time, also, he said, at 20/15 for intermediate and 20/25 for near. Functionality of the lens did not change, Dr. Alarcón added.

After 2 years, 15 of 20 patients (74%) completing the patient satisfaction survey said they were completely spectacle independent, and four patients (20%) said they used glasses less than 2 hours per day, mainly for near activities. Also, more than 90% of patients reported that they can read at a 0.3 logMAR (20/40) level.

Regarding near-vision activities, 95% (19 of 20) of questionnaire respondents said that they can use a computer or read a newspaper without glasses, and about 74% said that they could read fine print such as medication-bottle labels, he added.

Investigators measured reading acuity using a standardized reading chart in Spanish based on the MNRead chart. At 0.4 logRAD (typical text found in a newspaper), the average distance-corrected, no-near-add reading speed was 182 words per minute; 95% of patients reached at least 80 words per minute, considered to be the lower limit for functional, recreational reading performance.

"This study demonstrates that [the IOL] can provide adequate and stable vision at all distances over a 2-year period," Dr. Alarcón concluded.