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. 2024 Feb 19;24(1):74.
doi: 10.1186/s12886-024-03316-w.

Ocular parameters associated with visual performance of enhanced monofocal intraocular lens

Da Ran Kim  1 , Young Chae Yoon  1 , Woong-Joo Whang  1 , Ho Sik Hwang  1 , Kyung-Sun Na  2
Affiliations

Ocular parameters associated with visual performance of enhanced monofocal intraocular lens

Da Ran Kim et al. BMC Ophthalmol. .

Abstract

Background: An enhanced monofocal intraocular lenses (IOLs) (Tecnis Eyhance ICB00 and Tecnis Eyhance Toric DIU) has been developed to enhance intermediate vision while avoiding the disadvantages of multifocal IOLs. Although many studies have demonstrated the improvement of intermediate visual acuity with enhanced monofocal IOLs, it is not known specifically for which patients these IOLs should be recommended or avoided. In this study, we aim to find out which ocular parameters affect vision performance and photic phenomenon of ICB00 or DIU at different distances.

Methods: Patients who underwent cataract surgery with ICB00 or DIU, performed by a single surgeon, were included. Before surgery, the patients' age, gender, axial length, anterior chamber depth, spherical aberration Z (4,0), vertical coma, horizontal coma, angle kappa (κ), angle alpha (α), and other ocular parameters were investigated. One month after surgery, uncorrected near visual acuity (UNVA at 40 cm), uncorrected intermediate visual acuity (UIVA at 66 cm), uncorrected distance logMAR visual acuity (UDVA), IOL decentration, and quality of vision (QoV) questionnaires were conducted.

Results: A total of 43 patients (58 eyes) were included. The results of the univariate linear regression analyses showed a negative correlation between spherical aberration and logMAR UNVA and UIVA (p = 0.003, β=-0.51 and p = 0.018, β=-0.23, respectively) and a positive correlation between angle α and logMAR UIVA (p = 0.036, β = 0.19). Deeper anterior chamber depth (ACD) was associated with poorer total QoV (p = 0.018, β = 14.43), particularly in glare, halo, blur, and fluctuation perception. A higher degree of IOL decentration tended to decrease UNVA and UIVA (Pearson correlation coefficient, r = 0.336 and r = 0.221, respectively); however, no significant effect was observed on UDVA (Pearson correlation coefficient, r = 0.042).

Conclusions: In enhanced monofocal IOLs, a higher level of spherical aberration is associated with better performance in UNVA and UIVA, whereas a larger angle α has a negative impact. A deeper ACD negatively affects the QoV.

Keywords: Angle alpha; Anterior chamber depth; Enhanced monofocal intraocular Lens; Quality of vision; Spherical aberration.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Retrobulbar illumination analysis mode of the OPD-scan III aberrometer. The intersection of the blue and red lines is the visual axis. The blue cross indicates the center of the IOL. The pink line represents the overall decentration connecting the IOL center and the visual axis. The decentration amount is displayed as a yellow box on the lower right
Fig. 2
Fig. 2
a The correlation between the decentration amount of IOL and postoperative UNVA. b The correlation between the decentration amount of IOL and postoperative UIVA. c The correlation between the decentration amount of IOL and postoperative UDVA
See this image and copyright information in PMC

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