Impact of Light Conditions on Visual Performance following Premium Pseudophakic Presbyopia Corrections

Abstract

The primary objective of this study was to objectively compare the visual performance of patients following premium pseudophakic presbyopia corrections in different light combinations for near- and intermediate-vision activities of daily living (ADLs). This is a prospective, comparative study. A total of 75 patients populated three study groups: G1-patients with bilateral trifocal implantation, G2-patients with bilateral bifocal implantation, and G3-patients with bilateral monofocal implantation. All participants addressed 10 ADLs in nine combinations of light temperature (3000 K, 4000 K, and 6000 K) and light intensity (25 fc, 50 fc, and 75 fc) and declared their subjectively optimal light combination while reading. G2 and G3 had the best total ADL scores in 6000 K/75 fc, while G1 had the best total ADL score in 4000 K/75 fc. Total ADL, easy ADL, and moderate difficulty ADL scores were significantly better in G2, while difficult ADL score was significantly better in G1. The majority of all groups selected 6000 K/75 fc as the most comfortable light combination, and no group selected 3000 K and 25 fc. In conclusion, trifocal patients benefit from intense daylight, while bifocal and monofocal patients benefit from intense, cold lighting. Trifocal patients present superior near-vision capacity in difficult near-vision daily tasks, while bifocal patients present superiority in easy and moderate-difficulty ADLs.

Keywords: activities of daily living; light intensity; light temperature; multifocal intraocular lens; presbyopia.

Figure 1

A three-dimensional (3D) illustration of the examination room with the four luminaires installed on the ceiling at their actual positions using the RELUX software. (A) The light intensity on the surfaces inside the room is overlaid and encoded in color according to the chromatic scale shown at the bottom (units: lx). (B) The three light temperatures (3000, 4000, and 6000 K) used are illustrated in a 3D simulation of the examination room.

Figure 1

A three-dimensional (3D) illustration of the examination room with the four luminaires installed on the ceiling at their actual positions using the RELUX software. (A) The light intensity on the surfaces inside the room is overlaid and encoded in color according to the chromatic scale shown at the bottom (units: lx). (B) The three light temperatures (3000, 4000, and 6000 K) used are illustrated in a 3D simulation of the examination room.

Figure 2

Comparison among light temperature levels (3000, 4000, and 6000 K) for the three light intensity levels (25, 50, and 75 fc) for each study group (G1: trifocal diffractive IOL, G2: bifocal hybrid IOL, G3: monofocal IOL) for all ADLs. Abbreviations: BR: book reading; CES: cellular entry search; CM: cellular message; DR: drops bottle reading; ODT: open door test; PBS: phone book search; RCS: reading computer screen; ST: screwdriver test; SubRe: subtitles reading; SupRe: supermarket receipt.

Figure 2

Comparison among light temperature levels (3000, 4000, and 6000 K) for the three light intensity levels (25, 50, and 75 fc) for each study group (G1: trifocal diffractive IOL, G2: bifocal hybrid IOL, G3: monofocal IOL) for all ADLs. Abbreviations: BR: book reading; CES: cellular entry search; CM: cellular message; DR: drops bottle reading; ODT: open door test; PBS: phone book search; RCS: reading computer screen; ST: screwdriver test; SubRe: subtitles reading; SupRe: supermarket receipt.