Abstract

Purpose : Standard intraocular lenses (IOLs) increase peripheral astigmatism and defocus compared with the phakic eye. This reduction in peripheral image quality may interfere with daily tasks such as driving. This study compared the performance of patients implanted with a new meniscus-shaped IOL when driving while performing secondary tasks as compared with a companion group with standard monofocal IOLs.

Methods : The study included patients implanted binocularly with monofocal IOLs (N=17) and with an inverted meniscus IOL (N=15) (ArtIOLs, Voptica SL, Murcia, Spain). This type of IOL improves image quality and contrast sensitivity in the periphery. Peripheral visual acuity and contrast sensitivity were evaluated at 40 degrees of eccentricity. Driving performance was assessed with a driving simulator in two scenarios: dual carriageway and mountain road. Participants performed secondary tasks while driving, using a touch screen located at 40 degrees that simulated an in-vehicle system. The tasks consisted of 1) searching road signs, and 2) typing an address on Google Maps. Different measures of driving performance were obtained, including self-regulation of driving speed.

Results : Peripheral contrast sensitivity was better in the ArtIOL group (p=0.003) while visual acuity was similar. Mean speed was higher overall for the ArtIOL group, being this difference significant on the mountain road (p=0.002). Also, the mean time taken to complete the mountain road was lower in this group (p=0.033). While performing the Google Maps task, the mean speed was higher for the ArtIOL group in the dual carriageway (p=0.018) and the mean time was lower for the mountain road (p=0.027). The monofocal group had twice the number of collisions than the ArtIOL group (p=0.177). The ArtIOL group self-regulated less their speed, mainly when driving the more complex scenario, the mountain road (p=0.002). This means that participants implanted with the ArtIOL were more confident while driving. An association was found between better contrast sensitivity and faster speeds (rho=0.342; p=0.006), indicating the importance of this visual parameter for driver self-confidence and performance.

Conclusions : Our results indicate that implanting new inverted meniscus IOLs that provide better optical quality in the periphery may help pseudophakic subjects increase self-confidence and improve driving performance.

This abstract was presented (poster) at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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