Improved distance, near vision seen with diffractive lens

May 15, 2007

A prospective study of 20 eyes in 20 patients found that implantation of an apodized diffractive IOL in patients with presbyopia and unilateral cataract and a healthy fellow eye resulted in improved distance and near vision, reduced spectacle dependency, and enhanced binocular function, with quality vision in most cases.

Key Points

Dr. Sancho, associate ophthalmologist, Laser Center Vision 20/20, Quito, Ecuador, reported the results of a prospective study of 20 eyes in 20 patients with cataract in one eye and a healthy fellow eye. The research took place at the Codet Vision Institute, Tijuana, Mexico, and the Shiley Eye Center, University of California, San Diego.

Mean patient age was 61 years (range, 43 to 71 years). Preoperatively, average uncorrected visual acuity was 20/80 in the eye with cataract and 20/30 in the fellow eye. With correction, average visual acuity in the fellow eye was 20/20 preoperatively, Dr. Sancho said.

Follow-up results

At follow-up, Dr. Sancho said, monocular visual acuity results demonstrated that uncorrected distance vision of 20/25 or better was achieved in 75% of patients, and uncorrected near vision of 20/25 or better was achieved in 85% of patients.

Eighty percent of patients reported no glare or halo, 15% reported mild glare or halo, and 5% reported moderate glare or halo, he added.

VF-7 results revealed that 65% of patients had no complaints and 35% had minimal complaints relating to driving at night and fine handiwork, Dr. Sancho said.

"Quality of vision was good in all of the group," he said. Half of the patients reported that they were very satisfied with their quality of vision, Dr. Sancho added, and the other half said they were satisfied.

The researchers didn't find any statistically significant difference in quality of vision between those in whom the multifocal IOL had been implanted in the dominant eye and those in whom the lens had been placed in the non-dominant eye, he said.

Spectacle dependence

Preoperatively, 80% of patients said they sometimes or always wore glasses. Postoperatively at 6 months, 40% of patients reported wearing glasses some or all of the time. Regarding spectacle-dependent distance vision, 65% of patients before surgery said they sometimes or always wore glasses. "After the surgery, we had a decrease to 10%," Dr. Sancho said.

"Spectacle dependency for near vision was even better," he added. Preoperatively, 90% of patients said they sometimes or always needed glasses. Postoperatively, this number decreased to 40%.

"I didn't check intermediate vision because that wasn't the purpose of the study," Dr. Sancho said. "The IOL implantation was only unilateral related to cataract condition."

Dr. Sancho's co-authors were Luis F. Torres, MD, PhD; Tracy L. Purcell, PhD; David J. Schanzlin, MD; and Arturo S. Chayet, MD.