Customized Presbyopia-Correcting Intraocular Lens Implants (Iols) In Patients With Extremely High Errors Of Refraction.

To present a review of patients, with extremely high errors of refraction, requiring cataract surgery and/ or refractive lens exchange with  presbyopia-correcting intraocular lens implants (IOLs).

Patients with extremely high errors of refraction who seek spectacle freedon consult for possible laser refractive surgery or phakic Intraocular lens implants. However, in the population of presbyopic patients, spectacle independence would necessitate presbyopia-correcting intraocular lenses as an option. The fac that that they have extreme errors of refraction precludes them form the readily available IOL powers. Hence the need for customized IOLs.

Patients were screened from March 2019 to March 2022  and treated by a single surgeon with the intention of providing the best possible spectacle-free option post cataract surgery or refractive lens exchange.  All patients were seen in a private clinic in Metro Manila, Philippines and underwent either phacoemulsification or Femtosecond Laser Assisted Cataract Surgery, under topical anesthesia,  with implantation of a customized IOL implant (Lentis Mplus  multifocal IOL), which has refractive technology with an innovative sector shaped near vision segment. The unique design affords minimal to no haloes, ghosting, or glare. Its advantages include high contrast sensitivity, no image jumps, pupil independence, and increased depth of focus.

A total of 6 patients (12 eyes) are included in the study. 10 eyes are highly myopic and astigmatic with spherical power requirements way below the readily available powers for multifocal IOLs. One patient was previously deemed profoundly amblyopic by previous physicians but achieved near normal vision after refractive lens exchange. Two eyes of one patient were severely hyperopic due to very short eyeballs (slightly above 20mm in axial length.) All patients improved to the level of preoperative best corrected visual acuity or better.

 

In conclusion, there is a small but significant population of patients with very high myopia, hyperopia and astigmatism who have been visually disabled for majority of the their lives and have been told that nothing or not much can be done to relieve them of their condition but to bear with thick and heavy spectacles. Most of the the time, refractive lens exchange is a possible option but the extreme powers needed preclude the procedure from being offered as viable.  Teleon Lentis Mplus presbyopia-correcting IOLs offer these patients the option of customization of their IOLs and as such relieve these patients of their heretofore permanent burden of spectacle correction.