Офтальмохирургия (Dec 2017)
VISUAL ASSESSMENT PERFORMANCE AFTER IMPLANTATION OF A NEW TRIFOCAL INTRAOCULAR LENS
Abstract
Today, patients often expect to achieve a high visual acuity at various distances and a spectacle correction independence after cataract surgery. Trifocal intraocular lenses have been developed to try and fulfill this demand. Due to the lack of domestic experience with the new trifocal IOL model (AcrySof® IQ PanOptix®), there is a need for clinical trials to evaluate functional outcomes.Purpose. To evaluate outcomes of visual acuity using various traditional systems of assessment for functional vision and interactive computer program in a comparative aspect, as well as a contrast sensitivity and to determine a subjective patient satisfaction after implantation of a new generation of trifocal IOL AcrySof IQ PanOptix (USA).Material and methods. The study included 19 patients (37 eyes) with cataract. Mean age was 55.6±11.4 years. Visual acuity was measured monocular using different technics at distance (4 m), intermediate (60 cm) and near (40 cm). The Optec 6500 device was used for objective assessment of contrast sensitivity function. The frequency of dysphotopsia and quality of vision were evaluated by the questionnaire.Results. High visual activity results at different distances with the decimal scale and interactive computer program «TIP-TOP» were noted on the 1st day after implantation of the new trifocal IOL model. Improvement of visual acuity at three distances 3-6 months after surgery was associated with a stabilization of refractive results and a completion of neuro-adaptation processes. Mean postoperative spherical equivalent was -0.40±0.34D 1 month postoperatively and -0.28±0.27D 6 months after surgery, respectively. The contrast sensitivity function (CSF) had a typical appearance with a maximum value in the mid-range region and a decrease in the high-frequency range. The levels of photopic and mesopic CS with and without glare increased within 6 months after the operation. Mean value of VF-14 was 95.7, indicating a high level of subjective assessment of intraocular correction. No patient noted a need to use any spectacle correction for far, near or intermediate distances after surgery. More often dysphotopsia was detected through active patient interview. In dynamics, the degree of dysphotopsia decreased, or completely disappeared in 33.3% of patients 6 months after the operation.Conclusions. The new trifocal IOL provides good near, intermediate and far distance visual functions. Evaluation of visual acuity results using different systems showed the advantage of the interactive computer program Tip-Top. The contrast sensitivity function (CSF) had a typical appearance with a maximum value in the mid-range region and a decrease in the highfrequency range. The indicators of photopic and mesopic CS with and without glare increased within 6 months after the operation, however, they did not reach the age standards. Postoperative period was characterized by a high patient satisfaction and a high spectacle correction independence.
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