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. 2024 May 28:18:1491-1501.
doi: 10.2147/OPTH.S458125. eCollection 2024.

Impact of Aspheric Monofocal Intraocular Lens Implantation on Uncorrected Intermediate Visual Acuity: a Combined Analysis

Cathleen M McCabe  1 , Rachael Peterson  2 , Jessie Hull  2 , Chandra Bala  3
Affiliations

Impact of Aspheric Monofocal Intraocular Lens Implantation on Uncorrected Intermediate Visual Acuity: a Combined Analysis

Cathleen M McCabe et al. Clin Ophthalmol. .

Abstract

Purpose: To evaluate binocular intermediate visual acuity (IVA), depth of focus, and other visual outcomes achieved with a monofocal aspheric intraocular lens (IOL) using pooled data from 2 randomized, double-masked, controlled trials.

Patients and methods: The studies conducted at 32 sites included patients aged ≥22 years with bilateral cataracts, preoperative corneal astigmatism 1.0 D, and lens power 18.0-25.0 D. Patients received bilateral AcrySof IQ IOLs (SN60WF). Primary endpoint data were collected at month 6. Binocular uncorrected and corrected distance visual acuity (UDVA and CDVA) at 4 m, binocular uncorrected and corrected IVA (UIVA and DCIVA) at 66 cm, manifest refraction spherical equivalent (MRSE), and binocular defocus curve at 4 m were assessed under photopic conditions. Validated questionnaires were used to assess spectacle use and quality of vision.

Results: Of 233 patients who received SN60WF, 228 had visual acuity data at 6 months. Under photopic conditions, 51% of the eyes had pupils >4 mm, 40% had pupils 3-4 mm, and 9% had pupils <3 mm. Mean ± SD UDVA and CDVA were -0.019 ± 0.110 and -0.088 ± 0.082 logMAR, respectively. Mean ± SD UIVA and DCIVA were 0.125 ± 0.145 and 0.196 ± 0.139 logMAR, respectively. UIVA and DCIVA of 20/32 or better were achieved by 83% (188/228) and 71% (162/228) of patients, respectively. Mean ± SD MRSE was -0.007 ± 0.404 D for the first eye and 0.036 ± 0.371 for the second eye. The defocus curve demonstrated binocular vision of 0.24 logMAR or better from +1.2 to -1.5 D. Spectacle independence for distance and intermediate vision was reported by 86% and 41% of the patients, respectively. Based on questionnaires, 61%, 79%, and 65% of the patients did not experience starbursts, halos, or glare.

Conclusion: A monofocal aspheric IOL (SN60WF) assessed in a large, pooled study provided excellent distance vision and clinically functional intermediate vision.

Keywords: Intermediate visual acuity; monofocal aspheric intraocular lens; spectacle Independence; visual quality.

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Conflict of interest statement

C. McCabe is a shareholder of Engage Technologies; has received grant/research support from Alcon Vision LLC, Allergan, Bausch & Lomb, EyePoint Pharmaceuticals, Glaukos, Ivantis, Johnson & Johnson Vision, Ocular Therapeutix, and Ora; and is a consultant for Alcon Vision LLC, Allergan, Bausch & Lomb, BVI, Atia Vision, Dompe, Easee, Engage Technologies, EyePoint Pharmaceuticals, Imprimis, Ivantis, Novartis, Ocular Therapeutix, Omeros, Orasis, RxSight, Science Based Health, Sight Sciences, Tarsus, and Zeiss. C. Bala has received support from Alcon Vision LLC and Johnson & Johnson. He is also a consultant for Johnson & Johnson. R. Peterson and J. Hull are employees of Alcon Vision LLC. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Mean photopic binocular UDVA and CDVA at 6 months after implantation of the aspheric monofocal lens (A), cumulative distribution of binocular UDVA (B), and cumulative distribution of binocular CDVA (C).
Figure 2
Figure 2
Mean photopic binocular UIVA and DCIVA (66 cm) at 6 months after implantation of the aspheric monofocal lens (A), mean cumulative distribution of binocular UIVA (B), and cumulative distribution of binocular DCIVA (C).
Figure 3
Figure 3
Mean MRSE in first and second eyes at 6 months (A) and cumulative distribution of MRSE in eyes with the aspheric monofocal lenses at 6 months (B). MRSE, manifest refraction spherical equivalent. Error bars represent 95% CIs.
Figure 4
Figure 4
Mean binocular defocus curve at 6 months after implantation.
Figure 5
Figure 5
Percentage of patients who reported vision in the past 7 days without wearing eyeglasses (6 months after implantation). *“Far away” in bright conditions. †At “arm’s length” in bright conditions.
See this image and copyright information in PMC

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