Pupil influence on the quality of vision in rotationally asymmetric multifocal IOLs with surface‐embedded near segment. Issue 11 (November 2017)

• Record Type: Journal Article
• Authors: Pazo, Eric E.; McNeely, Richard N.; Richoz, Olivier; Nesbit, Andrew M.; Moore, Tara C.B.; Moore, Jonathan E.
• Is Part Of: Journal of cataract and refractive surgery. Volume 43:Issue 11(2017)
• Publication Date: 2017-11
• Subjects: 617.7
• DOI: 10.1016/j.jcrs.2017.08.013
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : Purpose : To evaluate the influences of preoperative pupil parameters on the visual outcomes of the SBL‐3, a rotationally asymmetric multifocal intraocular lens (IOL) with a surface‐embedded near segment. Setting : Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom. Design : Retrospective comparative case series. Methods : Postoperatively, patients divided into 4 groups according to their pupil size as follows: Group A: 2.50 to 2.99 mm, Group B: 3.00 to 3.50 mm, Group C: 3.51 to 4.00 mm, and Group D: 4.01 to 4.50 mm. The uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities, IOL centration and tilt, and quality of vision (QoV) questionnaires were compared between the 4 groups for 18 months postoperatively. Results : The study comprised 90 patients (180 eyes). The mean preoperative pupil (photopic and mesopic) diameter was 4.3 mm ± 0.3 (SD) and 5.6 ± 1.4 mm, respectively, which decreased to 3.8 ± 0.7 mm and 4.9 ± 1.2 mm, respectively, at 18 months. Eighteen months postoperatively, both photopic and mesopic pupil groups had a statistically significant reduction in size from preoperative levels. No significant differences in UDVA, UIVA, and UNVA were found between the groups ( P > .001). Significant differences in the QoV questionnaire day scores and night scores were found between the 4 groups ( P < .001). Conclusions : The rotationally asymmetric multifocal IOL provided excellent optical performance during 18‐months follow‐up. The preoperative photopic pupil is an important parameter for consideration of this type of IOL because smaller pupils have a significant negative subjective impact on QoV.