Vision Outcomes With Presbyopia-Correcting IOLs in Patients With 20/40 or Worse CDVA Versus Better Than 20/40 CDVA Before Cataract Surgery
Narrative Responses:
Purpose
To compare distance and near vision outcomes after cataract surgery with presbyopia-correcting IOL implantation in patients with 20/40 or worse BSCVA before surgery vs. better than 20/40 BSCVA
Methods
59 eyes of 40 patients who underwent phacoemulsifiction cataract extraction with presbyopia-correcting IOL implantation were retrospectively analyzed. The eyes were targeted for plano. Eyes with intraoperative or postoperative complications were excluded. 32 eyes (Group 1) with better than 20/40 BSCVA preop were compared with 27 eyes (Group 2) with 20/40 or worse BSCVA. The groups were matched in age, gender, preop spherical equivalent (SE), cylinder (Cyl), and pathology. In Group 1, 65.7% received Crystalens AO, 25.7% AcrySof IQ ReSTOR, and 8.6% TECHNIS Multifocal. In Group 2, 58.3% received Crystalens AO, AcrySof IQ 33.3% ReSTOR, and 8.3% TECHNIS Multifocal.
Results
At 1 week postop, mean UCDVA was 20/30 in both groups. Mean UCNVA was J3 Group 1 and J5 Group 2 (p<0.05). Mean SE and Cyl were similar in both groups (p>0.05); BSCVA was 20/20 in Group 1 and 20/25 in Group 2 (p>0.05). At 1 to 2 months postop, mean UCDVA was 20/30 in both groups, mean UCNVA was J3 Group 1 and J5 Group 2 (p<0.05). Mean SE, Cyl, and BSCVA were similar to 1 week postop (p>0.05). Posterior capsular opacity (PCO) was noted in 37% of eyes in Group 1 and 50% in Group 2 (p>0.05).
Conclusion
Patients with better than 20/40 BSCVA before cataract surgery with presbyopia-correcting IOL have better uncorrected near vision after surgery than patients with 20/40 and worse BSCVA. This could be due to greater prevalence of posterior capsular opacity in eyes with 20/40 or worse BSCVA before surgery.