Abstract

DO.25.06

Diffractive add-on IOL: first results of a prospective study

Georg Gerten, Omid Kermani, Karl Schmiedt, Andreas Foerster, Elham Farvili, Uwe Oberheide
Augenklinik am Neumarkt, Köln

Objective
Evaluation of a new type of diffractive multifocal IOL as additional lens for sulcus based implantation.
Methods
In a prospective study 73 eyes of 39 patients with a mean age of 64 ± 11.6 years underwent cataract surgery. Patients with additional diseases, which might interfere with multifocal or sulcus based lenses like e.g. AMD, uveitis or glaucoma were excluded prior to the study.
After phakoemulsification a monofocal lens was implanted in the capsular bag and an additional diffractive multifocal lens (Dr. Schmidt MS 714 PB diff) was placed in the sulcus. This add on lens (a 3-piece, foldable silicone lens with angled PMMA haptics) is specially designed for sulcus implantation. The diameter of the optic is 7mm with a central diffractive optic with 3.5mm in diameter leading to a near addition of +3.5 dpt. The implanted monofocal IOL was an aspheric, blue light protective foldable silicone or acrylic lens.
All patients had complete ophthalmic postoperative examinations on day one, after one week, one month and three months. 13 Patients completed one year postoperative examinations.
Results
Three months postop the median of the best corrected visual acuity (BSCVA) was 1.0 (LogMar -0,02 ± 0,06), the median of the uncorrected visual acuity (UCVA) 1,0 (LogMar 0,02 ± 0,08). The average SEQ was 0.09 ± 0.51dpt. The near UCVA was 0.8 (LogMar 0,08 ± 0,09) for a reading distance of 40 cm with EDTRS-chart. The median of the UCVA for intermediary distance of 1m was 0.8 (LogMar 0,13 ± 0,11). All patients achieved a binocular near UCVA of 0.5 /J5 allowing them to read newspapers (8pt letter size).
After one year the VA remained stable, with an average far UCVA of 1,0 (LogMar 0,02 ± 0,01), an average near UCVA of  0,8 (LogMar 0,1 ± 0,14)  and an average UCVA for intermediary distance of  0,8 (LogMar 0,19 ± 0,16).
No complications associated with the sulcus IOL like loss of iris pigment, prolonged irritation of the anterior chamber, shallow anterior chamber, glaucoma, cell proliferation between the IOLs or iris capture occurred.
Conclusions
The additional implantation of a diffractive sulcus IOL is a safe and effective method for the improvement of near visual acuity after monofocal IOL implantation.
If pseudophakic eyes with cataract surgery performed longer times ago might profit from an additional diffractive IOL has to be investigated in further studies.

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