Purpose: To evaluate the visual performance at different distances of a binocular combination of two models of a new inverted meniscus intraocular lens (IOL), Art40 and Art70 (ArtIOLs, Voptica SL, Murcia, Spain) which improve the overall off-axis optical quality and induce different amounts of negative spherical aberration to increase the depth of focus. The outcomes were compared with those of diffractive trifocal IOLs.
Methods: Ten cataract patients were implanted bilaterally with Art40 and Art70 IOLs to induce low and high values of spherical aberration, respectively. The surgery was performed first in the dominant eye with Art40 and a few weeks later in the fellow eye with Art70. As trifocal group, ten patients were bilaterally implanted with a standard trifocal IOLs based on aspherical biconvex optics. One month after the last surgery, best-corrected (CDVA) and uncorrected (UDVA) distance visual acuity (LogMAR scale) was measured at 5 m, 66 cm and 40 cm, using trial lenses of -1,5 and -2,5 D and SLOAN charts under photopic lighting conditions.
Results: The monocular CDVA was on average zero in the three groups (eyes implanted with Art40, Art70 models and trifocal IOLs). In the trifocal group, it decreased to around 0.10 at both, intermediate and near distances. In the eyes with Art40, the CDVA fell to 0.25 and 0.47, while in the eyes with Art70 those values remained much higher, 0.03 and 0.21. The binocular combination of both ArtIOLs improved the CDVA up to 0.02 for intermediate and 0.15 for near vision. With the two models of the inverted meniscus lenses, small myopic residual errors were planned (-0.25 and -0.75 D for Art40 and Art70, respectively). The mean values of binocular UCVA with ArtIOLs were 0, 0.02 and 0.05 and in the trifocal group 0.05, 0.09 and 0.08 at 5 m, 66 cm and 40 cm.
Conclusions: The binocular combination of the two of ArtIOLs models (Art40 and Art70) significantly extended the depth of focus up to at least 40 cm improving visual performance at intermediate distance in comparison with trifocal LIOs. This combination resulted in spectacle independence for the patients without the compromise of halos or disphotopsias. In addition, these new IOLs improve the periphery performance due to the inverted meniscus shape.
