Stability and Visual Outcomes of the Capsulotomy-Fixated FEMTIS-IOL After Automated Femtosecond Laser-Assisted Anterior Capsulotomy.

PURPOSE: To evaluate stability and performance of a new monofocal anterior capsulotomy-fixated intraocular lens (IOL) (FEMTIS; Teleon Surgical B.V., Spankeren, Netherlands) after femtosecond laser-assisted cataract surgery (FLACS). DESIGN: Prospective, multicenter, interventional, noncomparative case series. METHODS: FLACS with FEMTIS IOL was performed in 336 eyes of 183 cataract patients with fixation of the IOL to the anterior capsulotomy followed up for 12 months. Examination included uncorrected distance visual acuity (UDVA), best-corrected visual acuity (CDVA), subjective refraction, IOL centration, posterior capsule opacification (PCO), and investigators' satisfaction questionnaire. RESULTS: At 12 months, mean IOL rotation was 1.50 ± 1.76 degrees and decentration 0.14 ± 0.14 mm from baseline (day of surgery). Mean horizontal IOL tilt was 0.70 ± 0.60 degrees and vertical 1.15 ± 1.06 degrees relative to the baseline (crystalline lens). Mean distance between IOL and iris was 0.32 mm to 0.36 mm for all measured meridians. Mean UDVA was 0.12 ± 0.14 logMAR (range -0.20 to 0.54 logMAR), mean CDVA -0.01 ± 0.09 logMAR (range -0.30 to 0.20 logMAR). Mean spherical equivalent was 0.35 ± 0.53 diopter (D) and 98% of eyes (n = 235) were within ±1.0 D. Median PCO score was 1 with an Nd:YAG laser rate of 3.1% after 12 months. Most surgeons were very satisfied (median score: 1) with surgery and implanted IOL. CONCLUSIONS: Implantation of FEMTIS IOL provided excellent visual and stable refractive outcomes. IOL decentration was very low compared to other published studies and showed an exceptional high in-the-bag stability over a 12-month period. This lens benefits from femtosecond laser capsulotomies. It can be positioned very predictably and offers an optimal platform for toric and multifocal IOL optics.

Quality of life related variables measured for three multifocal diffractive intraocular lenses: a prospective randomised clinical trial.

IMPORTANCE: Quality of vision after multifocal intraocular lens (IOLs) implantation in relation to patient satisfaction. It is important to include the evaluation of visual quality and patient satisfaction in clinical practice. BACKGROUND: To evaluate and compare quality of life and patient satisfaction after implantation of three types of diffractive-refractive and apodized-diffractive bifocal and trifocal multifocal IOLs. DESIGN: Comparative, prospective, case series and randomized. PARTICIPANTS: Hundred and four eyes of 52 patients. METHODS: Three multifocal IOLs: AT LISA 809 M (Carl Zeiss Meditec) (AT LISA group, 38 eyes), AT LISAtri 839MP (Carl Zeiss Meditec) (AT LISAtri group, 32 eyes), and ReSTOR SN6AD1 (Alcon) (ReSTOR group, 34 eyes) were implanted after cataract surgery. MAIN OUTCOME MEASURES: Contrast sensitivity, photopic phenomena, patient satisfaction and quality of life criteria were evaluated. RESULTS: Patient of ≥ 88% were satisfied with near and intermediate visual outcomes. Better distance-corrected intermediate visual acuity at 90 cm was detected for AT LISA tri group (P < 0.04). No statistically significant differences were found among groups in postoperative contrast sensitivity (P ≥ 0.053). There were no significant differences in spectacle dependence scores among the groups (P ≥ 0.180). The addition of an intermediate focus did not statistically affect halo and glare size and intensity (P ≥ 0.256) or subjective impact (P ≥ 0.077). Patient satisfaction was consistently high for all groups (P ≥ 0.154). CONCLUSIONS AND RELEVANCE: Contrast sensitivity outcomes and patient satisfaction remained high in the trifocal group when compared to the bifocal IOL groups.