LONG-TERM OUTCOMES OF PREMIUM INTRAOCULAR LENSES IN CATARACT SURGERY

This study aims to evaluate the outcomes—preoperative, intraoperative, and postoperative—of phacoemulsification combined with the implantation of premium intraocular lenses (IOLs).

Conducted at the Department of Ophthalmology, AHEPA University Hospital.

A retrospective analysis was performed on patients who underwent phacoemulsification by a single surgeon at AHEPA University Hospital, Thessaloniki, from October 2020 to October 2024. The study involved the implantation of advanced monofocal  IOLs (TECNIS Eyhance IOL; model ICB00/DIB) in 7 patients , multifocal IOLs (Alcon Laboratories, AcrySof IQ PanOptix; model TFNT00) in 4 patients, premium monofocal IOLs designed to provide functional intermediate vision (BVI, IsoPure  IOL; model 1.2.3) in 9 patients and toric IOLs (Alcon Laboratories, AcrySof IQ Toric; model SN6ATT) in 7 patients. Key parameters analyzed included patient demographics (age, gender, comorbidities), surgical techniques, perioperative challenges, and preoperative visual acuity. Secondary outcomes included quality of vision and the degree of spectacle independence.

A total of 27 out of 1,012 eyes were evaluated. Primary outcomes included postoperative monocular uncorrected distance visual acuity (UDVA), intermediate visual acuity (UIVA), and near visual acuity (UNVA) measured at one month post-surgery. The trifocal IOLs demonstrated statistically superior UNVA compared to both the advanced monofocal and toric IOLs. Notably, 87.5% of the advanced monofocal IOLs achieved a postoperative spherical equivalent within ±0.50 diopters, with 100% and 81.25% of eyes attaining UDVA and UIVA of 6/7.5 or better, respectively. No significant differences were found in UDVA across the groups; however, UIVA exceeded 6/9 in all patients with multifocal IOLs and in 50% and 75% of those with toric and advanced monofocal IOLs, respectively. Ultimately, 88.88% of patients attained spectacle independence for distance vision, with 85.18% achieving visual acuity equal to or better than 6/8.6. No cases of postoperative toric IOL misalignment were reported, and patient satisfaction regarding subjective quality of vision was notably high.

All four types of IOLs delivered excellent UDVA, significantly enhancing patients' daily functioning. Multifocal and advanced monofocal IOLs provided a broader depth of focus with minimal visual symptoms, while multifocal IOLs offered superior near vision compared to the other groups. Toric IOLs proved effective for patients with astigmatism. Careful preoperative evaluation is crucial for optimal outcomes, ensuring appropriate patient selection for premium IOLs.