New Lens Implant After Cataract Surgery Restores Clear Vision Across All Distances Without Glasses: Study

Patients who have a new type of lens implanted in their eyes during surgery for cataracts or to correct their eyesight have excellent or good vision over distances both near and far, and often no longer need spectacles for reading.

Research presented today (Sunday) at the 43rd Congress of the European Society of Cataract and Refractive Surgeons (ESCRS) [1] evaluated outcomes for around 200 patients in 17 sites in Europe and Asia-Pacific who had surgery to implant the TECNIS PureSEETM, a purely refractive extended depth of field (EDF) presbyopia correction Intraocular Lens (IOL). Presbyopia is the condition that affects all people as they age, making it harder to focus clearly on close objects and text.

The study looked at visual acuity after surgery: how well the patients could see over far, intermediate and near distances on the logMAR visual acuity charts used by ophthalmologists that consist of rows of letters that become smaller as they go down the chart. It also measured Manifest Refraction Spherical Equivalent (MRSE) – a way of quantifying the refractive errors of the eye. In addition, the study reported on how patients were managing after surgery in terms of whether or not they needed spectacles for reading, how satisfied they were with their outcomes and whether they would recommend the lens to others.

Data were available for 238 patients at the time of the Congress, making it one of the biggest studies to report on this type of lens so far. The findings showed that the EDF presbyopia correction IOL, on average, provided excellent distance, very good intermediate, and functional near vision without glasses, with little refractive error. (Full details of results are in note).

Nearly all patients (96%) reported needing glasses ‘none’ or ‘a little of the time’ for distance vision; 93% reported this for intermediate distances, 62% for near distances, and 85% for overall vision.

For satisfaction with the outcomes, 96% were ‘mostly’ or ‘completely’ satisfied with their distance vision, 94% with intermediate, 73% with near, and 95% with overall vision; 96% would recommend the lens to their family and friends.

Professor Oliver Findl, Chair of the ESCRS Education Committee, is a consultant eye surgeon and head of the ophthalmology department at Hanusch Hospital, Vienna. He presented the findings to the congress.

He said: “The PureSee EDF IOL gave patients excellent distance, very good intermediate and functional near vision, which resulted in high patient satisfaction with less need for spectacles. The data in this study came from several surgical centres throughout Europe and Asia in a ‘real world setting’ outside of the usual clinical trials.

“The category of EDF IOLs, such as the TECNIS PureSee, are a great alternative to multifocal lenses for patients who wish to be less dependent on spectacles after lens surgery and do not want to take the risk of unwanted optical side-effects.”

Currently, when a person requires cataract surgery, their cloudy lens is replaced with an artificial lens. To enable a patient to see objects both near and far, their surgeon may offer them a choice of lenses, such as:

• Monofocal lens, which enables patients to see clearly at one distance point (far, intermediate or near), but which mean they need spectacles for the distances they have not chosen. If surgery is needed on both eyes, patients can choose to have a lens for close-up work in one eye, and another lens for distances in the other eye. This combination is known as monovision and the brain then adjusts to the two distances so that the patient can see both near and far.

• Multifocal lens, which can provide good vision over all distances, without the need for glasses. The lens is split into different zones or concentric rings, with different prescription lengths for each section, which provide clear, complete vision when combined. However, these lenses may cause some unwanted optical side-effects, especially at night.

• Extended depth of field (EDF) lens, which provides good distance and intermediate (arm’s length) vision, but spectacles may still be needed for close work such as reading small print.

“The difference between some of these lenses and the EDF presbyopia correction IOL that we used in this study is that it is a fully ‘refractive’ IOL, meaning it uses variations in the lens curvature to focus light at a single distance. The surface of the lens is smooth and you don’t see bumps or rings,” said Prof. Findl. “This means you have better night vision and don’t see halos, starbursts, glare and other visual disturbances that can occur with other lenses.”

Dr Joaquín Fernández is ESCRS Secretary, CEO of Qvision and Medical Director of Andalusian Ophthalmology Institute at Vithas Hospitals. He was not involved in the research. He commented: “Eye surgery for cataracts or to correct vision is constantly evolving but, so far, the ‘holy grail’ of developing a lens that can give patients good vision over all distances without any visual disturbances has been elusive. These data from a ‘real world’ study are very encouraging and suggest that the available options are expanding to better meet the expectations of our patients. However, other options still need to be explored. We look forward to further results from the study.”

Reference:

Patients who had cataracts removed or their eyesight corrected with a new type of lens have good vision over all distances without spectacles, European Society of Cataract and Refractive Surgeons, Meeting: 43rd Congress of the European Society of Cataract and Refractive Surgeons.