Five-year postoperative outcomes of apodized diffractive multifocal intraocular lens implantation
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CLINICAL INVESTIGATION
Five-year postoperative outcomes of apodized diffractive multifocal intraocular lens implantation Mami Yoshino • Hiroko Bissen-Miyajima Keiichiro Minami • Yoko Taira
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Received: 29 November 2012 / Accepted: 24 June 2013 / Published online: 28 September 2013 Ó Japanese Ophthalmological Society 2013
Abstract Purpose To assess the long-term postoperative visual performance of an apodized diffractive multifocal intraocular lens (IOL). Methods Twenty-one patients (42 eyes) underwent cataract surgery with bilateral implantation of an apodized diffractive multifocal IOL. The monocular uncorrected and corrected distance visual acuities, uncorrected, distancecorrected and corrected near visual acuities, and manifest refractive spherical equivalent were measured 1 and 5 years postoperatively. The contrast sensitivity, incidence of glare or halos, and rate of neodynium:YAG (Nd:YAG) posterior capsulotomy were evaluated 5 years postoperatively. Results No significant differences were found between the distance and near visual acuities at 1 and 5 years postoperatively. The contrast sensitivity was within the normal range for all spatial frequencies. No patients reported severe glare or halos. Six (14.3 %) eyes required Nd:YAG posterior capsulotomy. Conclusions The apodized diffractive multifocal IOL provides good, stable distance and near visual acuity levels over a 5-year follow-up period. Keywords: Multifocal intraocular lens Visual acuity Contrast sensitivity
M. Yoshino (&) H. Bissen-Miyajima K. Minami Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, 2-9-18 Misaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan e-mail: [email protected] Y. Taira Ryuundo Eye Clinic, Saitama, Japan
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Introduction Since the introduction of apodized diffractive multifocal intraocular lenses (IOLs), numerous studies have assessed the visual function in eyes implanted with them. The findings of these studies indicate that superior uncorrected near visual acuity (UNVA) can be achieved and that the uncorrected distance visual acuity (UDVA) is comparable to eyes with a monofocal IOL [1–5]. In one study on patients with a diffractive multifocal IOL, the bifocality that provides both UDVA and UNVA was maintained for 3 years postoperatively [6]. However, with multifocal IOLs stability over the longer term is more important since the outcome is more affected by postoperative degradation, such as development of posterior capsule opacification (PCO) and surface light scattering [7–9]. The development of mild PCO is not critical for corrected distance visual acuity (CDVA) with monofocal IOL, whereas the near visual acuity with multifocal IOLs is more sensitive with the development of PCO [10–13]. Lundqvist et al. [14] reported that the cumulative incidence of neodynium:YAG (Nd:YAG) laser capsulotomy due to PCO in the Acrysof monofocal IOL (MA60BM; Alcon Laboratories, Fort Worth, TX) increased markedly between 2.5 and 6 years postoperatively in patients aged \65 years; however with the AcrySof IOL, increa
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