Clinical and functional results of bifocal IOLs implanted during combined cataract and glaucoma surgery

• Published in: Vestnik oftal'mologii Vol. 134; no. 6; p. 46
• Main Authors: Pershin, K B, Pashinova, N F, Tsygankov, A Yu, Solov'eva, G M, Mijovich, O P
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2018
• Subjects: Cataract; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Phacoemulsification; Prospective Studies; Prosthesis Design; cataract phacoemulsification; non-penetrating deep sclerectomy; glaucoma; multifocal intraocular lenses
• ISSN: 0042-465X
• DOI: 10.17116/oftalma201813406146

At present, implantation of multifocal IOLs in patients with primary open-angle glaucoma (POAG) remains questionable. To comparatively analyze the clinical and functional effectiveness of bifocal IOLs implanted during combined cataract and glaucoma surgery. The prospective study included 41 patients (75 eyes) with presbyopia and POAG who underwent one-stage cataract phacoemulsification with implantation of a multifocal IOL and non-penetrating deep sclerectomy (NPDS) with lens capsule. Group 1 included 24 patients (44 eyes) with implantation of diffractive-refractive IOL. Group 2 consisted of 17 patients (31 eyes) who were implanted aspheric diffractive IOL with asymmetric optics. Mean IOP in both groups was 18.1±2.9 mmHg, and the difference with the preoperative parameters (26.1±2.8) was statistically significant (p<0.05). On average, the patients received 1.3±0.5 antihypertensive drugs compared to 2.4±0.61 before surgery (0.05<p<0.1). Near uncorrected visual acuity (nUCVA) in group 1 was 0.51±0.12 (p=0.009), in group 2 - 0.53±0.1 (p=0.01). Distant uncorrected visual acuity (dUCVA) was 0.59±0.09 (p=0.043) In group 1, and 0.57±0.04 (p=0.021) in group 2. Near best corrected visual acuity (nBCVA) in group 1 was 0.64±0.07, and 0.64±0.09 in group 2. In all studied groups postoperative nBCVA after 1 year of observation was significantly higher than before the surgery (p=0.006 and p=0.009 respectively). The main study goal (dBCVA=1.0 at 1 year after surgery) was achieved in 31.8% of cases in group 1 and in 29.1% of cases in group 2 (p>0.1). Implantation of multifocal IOLs in combination cataract and glaucoma surgery is a safe and effective surgical intervention for the described group of patients.