A Study to Evaluate the Visual Outcomes of Bilateral Implantation of the Diffractive Multifocal Intraocular Lenses in Patients with Cataract.

Abstract

Background : To evaluate the visual outcomes of bilateral implantation of the diffractive multifocal intraocular
lenses in patients with cataract.
Methods : This was a prospective observational study done on 200 eyes of 100 patients to evaluate the visual
functions, spherical equivalent & subjective response of patients after bilateral implantation of diffractive multifocal
IOL. Patients who wanted to be independent from spectacle use, following uncomplicated phacoemulsification
cataract surgery were included in our study. The patients' expectation regarding spectacle independence and
visual quality was assessed. Pre-operative examination like visual acuity for distance and near had been taken,
subjective refraction and IOP was taken. IOLpower was calculated with the help of IOL MASTER 700. Calculation
of IOLpower was done by optical biometry and SRK-T formula. Post operatively subjective refraction and distance
and near visual acuity had been taken in all patients at 3follow-ups after Cataract Surgery.
Results : A total of 200 eyes of 100 patients who underwent Phacoemulsification with Diffractive Multifocal IOL
implantation for cataract surgery. There were 69 females and 31 males aged between 40 to 80 years. In our
studies, 100% of patients have uncorrected distance visual acuity- 6/9 or better and 100% have uncorrected near
visual acuity of N6 which is statistically significant (p value < 0.0000001). While Post-operative spherical
equivalent was observed after 3 month of cataract surgery, there was marked improvement in spherical equivalent
after surgery which was statistically significant having Pvalue (0.002151), spherical equivalent ranges from ±1.25
>95% eyes had spherical equivalent less than or equal to ±0.5D. 100% has spherical equivalent less than or equal
to ± 1.25 D. Questionnaire of Patient's visual responses were recorded for near and distance, 95% of patients
reported were highly satisfied and 98% of patients were independent of spectacle for near work while 100% of
patients were independent of spectacle for Distance work. Finally, 97% patient was satisfied with their cataract
surgery.
Conclusion : Cataract surgery with bilateral implantation of apodised diffractive multifocal IOL have improved
quality of life in active patients who wish to reduce their dependence on glasses for good distance and near visual
acuity. Therefore, by using multifocal IOL, patient becomes spectacle independence in majority of cases. The
quality of life questionnaire confirm that patient underwent cataract surgery with multifocal IOLhave high level of
satisfaction. However, patients have more glare and haloes as compared to traditional Monofocal IOL