Effect of Multifocal Intraocular Lens on Contrast Sensitivity in Primary Angle-Closure Patients

Naris Kitnarong; Dovchinjamts Dagvadorj

doi:10.33192/smj.v75i7.263254

Authors

Naris Kitnarong Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Dovchinjamts Dagvadorj Mongolian National University of Medical Sciences, Ulan Bator, Mongolia

DOI:

https://doi.org/10.33192/smj.v75i7.263254

Keywords:

Effect, multifocal intraocular lens, monodical intraocular lens, contrast sensitivity, primary angle-closure patients

Abstract

Objective: To study the effect of multifocal intraocular lens (MIOL) implantation on contrast sensitivity (CS) compared to monofocal intraocular lens (mIOL) in primary angle-closure (PAC) or primary angle-closure glaucoma (PACG) patients.

Materials and Methods: This prospective study included patients with PAC or PACG and visually significant cataract. Phacoemulsification with MIOL or mIOL (patient preference) was performed. Collected data included best-corrected distant visual acuity (BCVA), intraocular pressure (IOP), anterior chamber depth (ACD), and contrast sensitivity (CS) measured at spatial frequency 1.5, 3.0, 6.0, 12.0, and 18.0 cycles per degree (CPD) preoperatively, and at 2-6 months postoperatively. Preoperative and postoperative parameters were then compared.

Results: Of the 45 eyes from 35 patients that were enrolled, 33 eyes (15 PAC, 18 PACG) from 26 patients completed the study. Fourteen eyes (11 patients) received diffractive MIOL, and 19 eyes (15 patients) received aspheric mIOL. Preoperative CS was not significantly different between groups. Postoperatively, BCVA, and CS at each spatial frequency were significantly improved in both groups (all p<0.001). Mean postoperative CS at spatial frequency 1.5, 3.0, 6.0, 12.0, and 18.0 CPD was 28.03, 42.63, 44.84, 10.82, and 2.86 in the MIOL group, and 29.55, 49.63, 46.20, 16.83, and 7.09 in the mIOL group, both respectively. Postoperative CS was not significant different between groups at any spatial frequencies. IOP was decreased (p=0.001) and ACD increased (p<0.001) postoperatively in both groups.

Conclusion: No significant difference in visual acuity or contrast sensitivity was observed between MIOL and mIOL after cataract removal in patients with PAC/PACG.

References

Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 2006;90(3):262-7.

Wang YX, Xu L, Yang H, Jonas JB. Prevalence of glaucoma in North China: the Beijing Eye Study. Am J Ophthalmol 2010;150(6):917-24.

Song W, Shan L, Cheng F, Fan P, Zhang L, Qu W, Zhang Q, Yuan H. Prevalence of glaucoma in a rural northern china adult population: a population-based survey in kailu county, inner mongolia. Ophthalmology 2011;118(10):1982-8.

Cheng JW, Cheng SW, Ma XY, Cai JP, Li Y, Wei RL. The prevalence of primary glaucoma in mainland China: a systematic review and meta-analysis. J Glaucoma 2013; 22(4):301-6.

Coffey M, Reidy A, Wormald R, Xian WX, Wright L, Courtney P. Prevalence of glaucoma in the west of Ireland. Br J Ophthalmol 1993;77(1):17-21.

Day AC, Baio G, Gazzard G, Bunce C, Azuara-Blanco A, Munoz B, Friedman DS, Foster PJ. The prevalence of primary angle closure glaucoma in European derived populations: a systematic review. Br J Ophthalmol 2012;96(9):1162-7.

Masis M, Mineault PJ, Phan E, Lin SC. The role of phacoemulsification in glaucoma therapy: A systematic review and meta-analysis. Surv Ophthalmol 2018;63(5):700-10.

Chen PP, Lin SC, Junk AK, Radhakrishnan S, Singh K, Chen TC. The Effect of Phacoemulsification on Intraocular Pressure in Glaucoma Patients: A Report by the American Academy of Ophthalmology. Ophthalmology 2015;122(7):1294-307.

Alio JL, Plaza-Puche AB, Pinero DP, Amparo F, Jimenez R, Rodriguez-Prats JL, et al. Optical analysis, reading performance, and quality-of-life evaluation after implantation of a diffractive multifocal intraocular lens. J Cataract Refract Surg 2011;37(1):27-37.

Ichhpujani P, Bhartiya S, Sharma A. Premium IOLs in Glaucoma. J Curr Glaucoma Pract 2013;7(2):54-57.

Teichman JC, Ahmed II. Intraocular lens choices for patients with glaucoma. Curr Opin Ophthalmol 2010;21(2):135-43.

Kim CY, Chung SH, Kim TI, Cho YJ, Yoon G, Seo KY. Comparison of higher-order aberration and contrast sensitivity in monofocal and multifocal intraocular lenses. Yonsei Med J 2007;48(4):627-33.

Kumar BV, Phillips RP, Prasad S. Multifocal intraocular lenses in the setting of glaucoma. Curr Opin Ophthalmol 2007;18(1):62-66.

Selvan H, Angmo D, Tomar AS, Yadav S, Sharma A, Dada T. Changes in Intraocular Pressure and Angle Status After Phacoemulsification in Primary Angle Closure Hypertension. J Glaucoma 2019;28(2):105-10.

Cao K, Friedman DS, Jin S, Yusufu M, Zhang J, Wang J, et al. Multifocal versus monofocal intraocular lenses for age-related cataract patients: a system review and meta-analysis based on randomized controlled trials. Surv Ophthalmol 2019;64(5):647-58.

Montes-Mico R, Alio JL. Distance and near contrast sensitivity function after multifocal intraocular lens implantation. J Cataract Refract Surg 2003;29(4):703-11.

Negishi K, Hayashi K, Kamiya K, Sato M, Bissen-Miyajima H, Survey Working Group of the Japanese Society of C, Refractive S. Nationwide Prospective Cohort Study on Cataract Surgery With Multifocal Intraocular Lens Implantation in Japan. Am J Ophthalmol 2019;208:133-44.

Steinert RF. Visual outcomes with multifocal intraocular lenses. Curr Opin Ophthalmol 2000;11(1):12-21.

Regan D, Neima D. Low-contrast letter charts in early diabetic retinopathy, ocular hypertension, glaucoma, and Parkinson's disease. Br J Ophthalmol 1984;68(12):885-9.

Lowe RF. Causes of shallow anterior chamber in primary angle-closure glaucoma. Ultrasonic biometry of normal and angle-closure glaucoma eyes. Am J Ophthalmol 1969;67(1):87-93.

Chan W, Garcia JA, Newland HS, Muecke J, McGovern S, Selva D, et al. Killing two birds with one stone: the potential effect of cataract surgery on the incidence of primary angle-closure glaucoma in a high-risk population. Clin Exp Ophthalmol 2012; 40(4):e128-34.

Meyer MA, Savitt ML, Kopitas E. The effect of phacoemulsification on aqueous outflow facility. Ophthalmology 1997;104(8):1221-7.

Post CT Jr. Comparison of depth of focus and low-contrast acuities for monofocal versus multifocal intraocular lens patients at 1 year. Ophthalmology 1992;99(11):1658-63; discussion 1663-54.

Kamath GG, Prasad S, Danson A, Phillips RP. Visual outcome with the array multifocal intraocular lens in patients with concurrent eye disease. J Cataract Refract Surg 2000; 26(4):576-81.