EyeWorld India December 2018 Issue

58 EWAP REFRACTIVE December 2018 for intermediate and near vision when compared to monofocal IOLs. Halo and glare simulation Glare and halo have proven to be the most common grounds for MFIOL explantation. Knowing an IOL’s capacity to induce these bothersome side effects, therefore, has enormous practical value. Using simulation software, Dr. Breyer and his colleagues investi- gated halo and glare effects in 126 phakic, 52 AT LISA, and 12 PanO- ptix eyes. The simulation software subjectively matched patient pho- topsias (binocular, uncorrected eyes) via a graphic user interface. The intensity of visual effects was categorized as none, mild, moder- ate, or severe. According to the simulation, approximately 25% of phakic eyes had no glare or halo. Mild glare and halo effects were observed in roughly 60% of the phakic eyes, 25% of the PanOptix eyes, and just below 25% of the AT LISA eyes. Moderate glare and halo were observed in roughly 10% of the phakic eyes, and in more than 60% of both the AT LISA and PanOptix eyes. Severe glare and halo were reported in less than 10% of the AT LISA eyes only. Implanted AT LISA tri Source: Breyer Kaymak Klabe Augenchirurgie Comparison The AT LISA tri diffractive trifocal IOL achieved a UDVA of logMAR –0.03±0.10, an uncorrected inter- mediate visual acuity (UIVA) of logMAR 0.08±0.08, and a UNDA of logMAR 0.10±0.10. The MFIOL capacity was 83%, when tested monocularly and with correction, and it was 88% when tested bin- ocularly without correction. Halo and glare strength were 57±11%. The PanOptix diffractive trifocal IOL had a UDVA of logMAR 0.01±0.06, a UIVA of logMAR 0.02±0.02, and a UNVA of logMAR 0.05±0.10. The MFIOL capacity was 80% when tested monocularly and with correction, and 94% when tested binocularly without correction. The halo and glare strength were 54±11%. “Both lenses provided a broad range of good binocular vision,” Dr. Breyer said. “The AT LISA tri proved slightly better for far vision, while the PanOptix was better at near and intermediate ranges, which was in agreement with tested optical bench meas- urements. 1 Halo and glare were comparable for both diffractive IOLs but significantly stronger than for phakic eyes (30±16%). It is important to be aware that a postoperative period of several months may be needed for satisfy- ing neuroadaptation, as one study has shown. 2 ” According to the outcomes of an unrelated comparative study that investigated the optical per- formance of three trifocal IOLs, the AcrySof IQ PanOptix, the AT LISA tri, and the FineVision Micro (PhysIOL, Liege, Belgium), the AcrySof IQ PanOptix showed equivalent or better performance in image quality, resolution, and photic phenomena compared with the other two trifocal IOLs. The study’s investigators predict- ed the PanOptix to provide better intermediate vision at 60 cm, compared to the 80 cm distance offered by the other two lenses. EWAP References 1. Carson D, et al. Optical bench perfor- mance of 3 trifocal intraocular lenses. J Cataract Refract Surg. 2016;42:1361–1367. 2. Rosa AM, et al. Functional magnetic resonance imaging to assess neuroadap- tation to multifocal intraocular lenses. J Cataract Refract Surg. 2017;43:1287–1296. Editors’ note: Dr. Breyer has no finan- cial interests related to his comments. Contact information Breyer: premiumeyes@augenchirurgie. clinic Two trifocals – from page 57