Dual intraocular lens implantation: Monofocal lens in the bag and additional diffractive multifocal lens in the sulcus

Abstract

To evaluate a new diffractive multifocal intraocular lens (IOL) as an additional (add-on) IOL for sulcus-based implantation.Augenklinik am Neumarkt, Köln, Germany.In this prospective study, cataract patients had phacoemulsification and IOL implantation. After phacoemulsification, an aspheric silicone monofocal IOL (MS 612 ASP-Y) with a power range of +4.00 to +27.00 diopters [D]) was implanted in the capsular bag. This was followed by sulcus placement of an add-on multifocal IOL (MS 714 PB) with a +3.50 D diffractive element for near but zero refractive power for distance.The study included 56 eyes of 30 patients. Three months postoperatively, the mean monocular uncorrected distance visual acuity was 0.10 logMAR +/- 0.11 (SD) (median 1.00 decimal; 20/20 Snellen), with a remaining mean postoperative spherical equivalent of 0.01 +/- 0.51 D. The mean uncorrected intermediate visual acuity was 0.20 +/- 0.15 logMAR (median 0.63 decimal; 20/30 Snellen) with a luminance of 500 lux at 1 m. The mean uncorrected near visual acuity (Early Treatment Diabetic Retinopathy chart) was 0.16 +/- 0.13 logMAR (median 0.80 decimal; Jaeger 2). No major complications (eg, iris chafing, iris capture, lens epithelial cell ingrowth, glaucoma) were associated with the add-on IOL in the sulcus.Combined implantation of an add-on diffractive sulcus IOL and a monofocal capsular bag IOL was safe and effective in improving far and near visual acuity in cataract surgery. Preliminary visual acuity results were similar to those in eyes with a single 1-piece diffractive multifocal IOL.