Офтальмохирургия (Apr 2019)

Comparison of visual functions in cataract patients after implantation of bifocal, trifocal and mono-focal intraocular lenses

  • E. V. Boiko,
  • D. A. Vinnitskiy

DOI
https://doi.org/10.25276/0235-4160-2019-1-11-19
Journal volume & issue
Vol. 0, no. 1
pp. 11 – 19

Abstract

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The widespread implantation of bifocal and trifocal Intraocular lenses (IOL) in the cataract surgery provides patients with a visual independence, however, at the same time some optical phenomena associated with the inner structure of multifocal IOLs may appear, that negatively affect functional results of cataract surgery. Therefore, a comparison of patients’ visual functions after implantation of tri-, bi- and mono-focal intraocular lenses seems topical.Purpose. To compare pseudo-accommodation abilities, contrast sensitivity, satisfactory subjective perception of cataract patients after implantation of refractive-diffractive bi-, tri- and mono-focal IOLs.Material and methods. This study included 150 patients (150 eyes). They were divided into three groups depending on the type of implanted lens: bifocal IOL (45 patients), trifocal IOL (45 patients), mono-focal IOL (the control group, 60 patients). Ultrasound cataract phacoemulsification with IOL implantation was performed in one eye of each patient. Patients were examined for the visual acuity at different distances and the contrast sensitivity function, as well as the subjective satisfaction was evaluated using a questionnaire.Results. An improved distance visual acuity was noted in all research groups, the near visual acuity was higher for implanted bi- and trifocal IOLs (0.64±0.09 and 0.61±0.10, respectively) compared with the mono­focal IOL (0.36±0.07), the visual acuity at medium distances was better for trifocal IOLs (0.61±0.14). The contrast sensitivity function was higher in the mono-focal IOL group. Therewith, the subjective satisfaction was higher for multifocal IOLs compared to mono-focal IOLs. It was revealed that such negative optical phenomena as glares and halos appeared more often after trifocal IOLs implantation (68.2%). The application of spectacles was required in patients of the bifocal IOL group in 22.1% of cases, in the trifocal IOL group in 17.9% of cases and in the mono-focal IOL group in 70.1% of cases.Conclusion. Implantation of multifocal IOLs compared to mono­focal IOLs provides a better pseudo-accommodation function and higher degrees of visual independence and subjective satisfaction compared to mono-IOL. This is offset by a higher frequency of optical phenomena negatively affecting the obtained functional results.

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