Evaluation of Blended Vision With Rotational Asymmetric MIOLs With Additions of +1.5 D and +3.0 D
Due to different optical architecture the results of segmental and trifocal MIOLs for contrast sensitivity (CS), photopsia and VA in intermediate distance improved significantly compared to diffractive bifocal MIOLs. The aim of this study was to further improve the results for patients visual comfort (e.g. less halo and glare) by implanting a refractive IOL (addition +1.5D) in the dominant and a refractive MIOL (addition +3.0D) in the nondominant eye.
We retrospectively analyzed 50 patients after implantation of either MIOL with an addition of +3.0 D and an addition of +1.5 D. Results of subjective refraction as well as visual acuity at far, intermediate and near distance were evaluated. Additionally we analyzed the binocular defocus curves between 33 cm (-3.0 D) and infinity (0.0 D) and compared the area under the respective curves to those of phakic juvenile patients of our patient population as well to other current MIOLs. Halo and glare was assessed with a computer based system. Contrast sensitivity was assessed with the Ginsburg box.
Compared to phakic juvenile eyes, both MIOLs showed a binocular defocus capacity of up to 89%. Photopsia were absent in most cases after three month. 2 patients reported of residual halos with a low intensity in an angel wing like pattern. Patients assessed with the +1.5D near Add. Other patients reported of no halo and glare at all.
Defocus capacity showed results competitive to a trifocal IOLs, which showed a defocus capacity of 84% compared to phakic eyes (100%). The mixed implantation of two different refractive MIOL seems to provide a new comparable alternative to a diffractive trifocal IOL.