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Modern refractive cataract surgery utilizes premium intraocular lenses to strive for spectacle free vision. The purpose of this project is to evaluate and compare binocular visual acuity of patients receiving a combination of presbyopia correcting lenses after bilateral cataract surgery.
A retrospective chart review was completed for 150 patients from 2013-2018. Patients were included if they underwent uncomplicated bilateral cataract surgery with implantation of combinations of the following intraocular lenses (IOL): extended depth of focus (EDOF), +2.5D multifocal (MF), +3.0D MF, and monofocal lens aiming for near correction. Patients were excluded if they had visually significant ocular disease. Binocular uncorrected visual acuity (UCVA) at distance, intermediate, and near were checked using a Snellen eye chart at standard distances. LogMAR values and statistical analysis were used to compare mean UCVA, standard deviation, and statistical significance for each distance.
141 patients underwent presbyopic correcting lens implantation were examined. Of these patients, 83 underwent bilateral implantation. 46 received bilateral EDOF lenses (Symphony, Tecnis), 13 with bilateral 2.5D MF (Restor 2.5, Alcon), 17 with 2.5D/3.0D MF combination (Restor 2.5/3.0, Alcon), and 7 with 2.5MF/EDOF. Distance and near UCVA did not show a significant statistical difference; however, the bilateral EDOF demonstrated a statistically significant intermediate distance UCVA advantage over the second and third groups (p= 0.00277 and 0.0494 respectively). The third group likely needed more patients for adequate power.
Presbyopia-correcting lenses are one of the newest innovations in refractive cataract surgery. The lens combinations we tested all showed good visual acuity at a wide range of distances. However, bilateral EDOF lenses appeared to show a statistically significant improvement in intermediate distance compared with other combinations.