Офтальмохирургия (Mar 2013)
Intraocular correction of high-degree ametropia using individual multifocal LentisMPlus IOL
Abstract
ABSTRACT Background. For surgical correction of high-degree ametropia aggravated with astigmatism the following options are available: excimer laser correction; phakic lens implantation; bioptika – a combination of ablating the transparent crystalline lens (ATL) with implantation of multifocal toric diopter IOL of standard series and LASIK for the correction of a residual refractive error, ATL using 2 IOLs according to the Technology «Piggy Back»; additional meniscus IOL implantation «Add-On»; ATL with implantation of an individual multifocal toric IOL. Purpose. To show a possibility of intraocular correction of high ametropia aggravated with astigmatism using toric multifocal custom IOLs. Material and methods. We observed two patients: the first female patient, 39 years old with a diagnosis of OU: high myopia, compound myopic astigmatism, initial complicated cataract, moderate amblyopia, peripheral chorioretinal degeneration (PCRD). On admission the distance visual acuity was vis OD=0.01 sph (-) 15.5 D cyl (-) 2.5 D ax 0°=0.6; vis OS=0.01 sph (-) 18.0 D cyl (-) 2.5 D ax 0°=0.5. The second patient was a 35-year woman with a diagnosis of OU: high hyperopia, compound hyperopic astigmatism, moderate amblyopia. Distance visual acuity on admission was OD=0.03 sph (+) 8.0 D cyl (+) 1.5 D ax 95°=0.5; OS=0.03 sph (+) 8.0 D cyl (+) 0.75 D ax 75°=0.6. Individual multifocal toric IOLs were implanted in both patents after the removal of the lens phacoemulsification. All standard ophthalmic examinations were used as well as the ultrasound biomicroscopy (UBM). Results. In the follow-up: 6 months after the surgery in the first patient the uncorrected visual acuity (UCVA) was far vis OD=0.6, vis OS=0.5, near vis OD=0.4, vis OS=0.5, middle distance vis OD=0.4, vis OS=0.4. The second patient 3 months after surgery had the UCVA far vis OD=0.5, vis OS=0.6, near vis OD=0.4, vis OS=0.5, middle distance vis OD=0.2, vis OS=0.3. The maximum possible distance visual acuity was achieved in both cases. Conclusion. The LentisMplus (Otsulentis) IOL with a toric component, made custom taking into account individual features of eyes allow to achieve clinical and functional results declared by the manufacturer of these lenses for the standard diopter range.
