ESCRS - FPM11.03 - Clinical Retinal Image Quality Of A Non-Diffractive Wavefront-Shaping Extended Depth Of Focus ( Vivity) Compared With Trifocal And Monofocal Intraocular Lenses

Clinical Retinal Image Quality Of A Non-Diffractive Wavefront-Shaping Extended Depth Of Focus ( Vivity) Compared With Trifocal And Monofocal Intraocular Lenses

Published 2022 - 40th Congress of the ESCRS

Reference: FPM11.03 | Type: Free paper | DOI: 10.82333/y5k7-mj46

Authors: Saad Abdulrahman J Al Amri* 1 , Jorge Alió del Barrio 2 , Francesco D’Oria 3 , Ziyad AlHarbi 4 , Nuria Subirana 5 , Ana B. Plaza-Puche 5 , Jorge L. Alió 2

1Cornea, Cataract & Refractive Surgery Unit,VISSUM (Miranza Group),Alicante,Spain;Ophthalmology,Prince Sultan Medical Military City (PSMMC),Riyadh,Saudi Arabia;Ophthalmology,Universidad Miguel Hernández,Alicante,Spain, 2Cornea, Cataract & Refractive Surgery Unit,VISSUM (Miranza Group),Alicante,Spain;Ophthalmology,Universidad Miguel Hernández,Alicante,Spain, 3Section of Ophthalmology, Department of Basic Medical Sciences, Neurosciences and Sense Organs,University of Bari & Santa Maria Hospital,Bari,Italy;Cornea, Cataract & Refractive Surgery Unit,VISSUM (Miranza Group),Alicante,Spain, 4Cornea, Cataract & Refractive Surgery Unit,VISSUM (Miranza Group),Alicante,Spain;Ophthalmology,Al Nakheel Medical Center,Riyadh,Saudi Arabia, 5Cornea, Cataract & Refractive Surgery Unit,VISSUM (Miranza Group),Alicante,Spain

Purpose

To evaluate the clinical retinal optical image quality following the implantation of a new EDOF IOL (Vivity, Alcon) and to compare it with the one provided by a monofocal and a Trifocal IOL. This study was performed by the analysis of the point spread function (PSF) Strehl ratio using a Pyramidal WaveFront-based sensor (PWS) aberrometer at two different pupil sizes.

Setting

Vissum Miranza, Alicante, Spain.

Methods

Prospective, consecutive, comparative, case control study. We included 88 eyes of 50 patients implanted with: (1) 19 AcrySof SA60AT (Alcon) IOLs (monofocal control group); (2) 38 AcrySof IQ Vivity (Alcon) non-diffractive wavefront-shaping extended depth of focus EDOF IOLs (Vivity IOL group); (3) 31 AT LISA Tri (Zeiss) IOLs (Trifocal IOL group). Main outcome measures were PSF Strehl ratio (PSF with LOA), PSF Strehl ratio excluding low order aberrations (PSF without LOA), total root-mean-square (RMS), ocular low and high order aberrations RMS measured by PWS aberrometer. MTF values were deduced from the aberrometry data.

Results

AT LISA Tri showed the highest (PSF w/o LOA) at both 3 and 4mm pupil size respectively (0.52±0.12 and 0.31±0.07), then SA60AT(0.39±0.10 and 0.27±0.07) and Vivity(0.34±0.11 and 0.24±0.09) IOLs (p<0.01). Vivity and monofocal IOLs were comparable (p>0.05). Despite comparable postoperative spherical equivalent (LOA) among groups (monofocal -034±0.45D; Vivity -0.09±0.46D; Trifocal -0.08±0.38D; p>0.05), AT LISA Tri retinal image quality (PSF with LOA) was severely affected by such residual refractive errors (dropped to 0.26±0.06 @3mm; p<0.01) while monofocal (0.24±0.07 @3mm) and Vivity IOL (0.23±0.06 @3mm). PSF with LOA was comparable (p>0.05) among all groups at both 3.0 and 4.0-mm pupil size. Contrast sensitivity data will be also presented.

Conclusions

Although Diffractive Trifocal (AT LISA Tri) IOLs were found to provide a significantly better far distance retinal image quality than monofocal (SA60AT) and EDOF (Vivity) IOLs when LOAs are excluded, they also demonstrated to be the most sensitive to low amounts of residual refractive errors. Our study has also demonstrated that both Vivity and monofocal IOLs show a comparable retinal image quality, and they are also comparable with diffractive Trifocal IOLs when considering the clinically real PSF (the one that takes into account the unavoidable low amount of residual ametropia).