Introduction of Multifocal IOL With +8.0 D Near Addition for Visual Rehabilitation in Patients With Chronic Maculopathy
Evaluating the outcome of visual rehabilitation of low vision patients after implantation of a segment multifocal intraocular lens (MIOL) with a +8.0 D near addition during cataract surgery.
A 68 year old female patient presented to our clinic with a bilateral cataract and an exudative AMD. The high add MIOL was implanted in one eye to create a 1.5 to 2.0 x magnification at a distance of 12cm. Postoperative examinations included the determination of uncorrected and corrected distance visual acuity (UDVA, CDVA), uncorrected and corrected near visual acuity (UNVA, CNVA) using ETDRS charts. The Salzburg Reading Desk (SRD) was used to measure the preferred reading distance. Furthermore, the postoperative applicability of other magnifying tools was tested. Fundus visualization and OCT imaging quality were also evaluated.
One year postoperatively a gain of 2 lines in the UDVA could be determined. UNVA was 0.4 logMAR and was best possible at 13 cm distance. SRD examinations yielded a preferred reading distance of around 10 cm. The use of other magnifying tools was trouble-free. However, only the 1.6 x magnification was required 1 month postoperatively compared to 10-15 x magnification needed preoperatively to read newspapers at 13 cm. No interference of the magnifying part of the IOL with the retinal visualization or with the OCT imaging quality was found. The patient reported a facilitation of performing daily activities.
The high add MIOL shows promising results for low vision patients. Its magnification effect leads to an independence from other magnifying aids in everyday life. An important selection criterion is an expected postoperative visual acuity between 1.3 and 0.4 logMAR. However, examination of a higher number of patients is needed.