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Less astigmatism and better contrast sensitivity in the periphery of pseudophakic patients implanted with a new intraocular lens


Purpose : The optical quality in the periphery of the retina in pseudophakic patients implanted with standard intraocular lenses (IOLs) is worse than those in the normal phakic eye (Jaeken et al., IOVS, 2013). This may affect specific visual tasks impacting patient’s orientation in space and therefore may pose a hazard to their safety. We have evaluated peripheral astigmatism and contrast sensitivity in a group of patients implanted with a new type of IOL that was designed to provide better peripheral optics and compared results with a group of patients implanted with a standard IOL.

Methods : A new type of IOL (ArtIOLs, Voptica SL, Murcia, Spain) with an inverted meniscus shape designed to improve the optical quality of the pseudophakic eye in the periphery was evaluated. These lenses were implanted in a group of 87 patients undergoing cataract surgery. A control group of 38 patients were implanted with a standard monofocal IOL as reference. Peripheral refraction in the horizontal meridian was obtained using a scanning Hartmann-Shack wavefront sensor. Contrast detection threshold at 45 degrees of visual angle (both horizontally and vertically) was measured psychophysically by means of an adaptive staircase technique, using a 30-arcmin round stimulus 1 m in front of the patient’s eyes and a green LED for foveal fixation.

Results : Patients implanted with ArtIOLs presented a reduced amount of peripheral astigmatism as compared with the control group. At 30 degrees, the average cylinder in the control group was 3 D, dropping to 2 D in the ArtIOL’s group. At 45 degrees, cylinder mean values were 6 D and 3.5 D respectively. This reduction in astigmatism had a positive impact in contrast sensitivity. In the horizontal meridian, average sensitivity values were 0.07 (SD=0.04) and 0.10 (SD=0.05) for the control and ArtIOL groups respectively. In the vertical meridian, average sensitivity values were 0.06 (SD=0.03) and 0.08 (SD=0.03) for the control and ArtIOL groups respectively.

Conclusions : Patients implanted with a new meniscus-shaped IOL present a reduced amount of peripheral astigmatism compared to patients implanted with standard lenses. This improvement in optical quality leads to a better contrast sensitivity measured at 45 degrees of eccentricity. Further research would be required to evaluate how this IOL may have also an impact in the patient’s functional vision.

This is a 2021 ARVO Annual Meeting abstract.

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