Elimination of Hazy Vision: Diffractive IOL Insertion With Posterior Continuous Curvilinear Capsulorhexis
Narrative Responses:
Purpose
It is known that even mild posterior capsular opacification (PCO) seriously diminishes the quality of vision in diffractive multifocal intraocular lens (M-IOL)-implantation eyes. To make the optic axis clear and diminish contrast degradation, we performed and evaluated posterior capsule continuous circular capsulorhexis (PCCC) with M-IOL implantation.
Methods
This study involved 32 eyes of 16 cases that underwent bilateral M-IOL implantation. In each patient, PCCC was combined with the M-IOL implantation in 1 eye (PCCC eyes), yet not on the fellow eye (NPCCC eyes). Postoperative clinical results were then compared. Moreover, visual simulation was performed using a charge-coupled device camera and a filter for artificial PCO with a monofocal IOL and M-IOL in a laboratory setting.
Results
Corrected and uncorrected distance and near visual acuity (CDVA, CNVA, UDVA, UNVA, respectively) were significantly better in the PCCC eyes at 1-day postoperative, although no difference was seen at 6-months postoperative. The PCCC eyes also registered significantly better in 6% and 12% contrast VA. Contrast-sensitivity tests revealed significant differences on the high frequency area at 1-day postoperative, yet no differences at 6-months postoperative. YAG laser capsulotomy was performed in 1 NPCCC eye. Laboratory visual simulation findings revealed that the M-IOLs were more greatly affected by the subtle filter than were the monofocal IOLs in their post-IOL images.
Conclusion
Mild opacity might greatly affect backward M-IOL images, and the combined surgery of PCCC with M-IOL implantation can achieve better clinical results from the early postoperative period and avoid later PCO.