The Efficacy of Modified Monofocal and Trifocal-EDoF Intraocular Lenses in staged and combined Descemet Membrane Endothelial Keratoplasty procedures

Theme: Cornea, external disease & refractive surgery
What: Cornea, external disease & refractive surgery
Part of: Cornea IV: When cataract and cornea intersect / Cornée IV: Quand la cataracte et la cornée se croisent
When: 6/1/2024, 11:15 AM - 12:45 PM
Where: Room | Salle 713 AB

Abstract

Purpose: To assess outcomes of modified monofocal and trifocal-EDoF intraocular lens (IOL) implantation in Descemet Membrane Endothelial Keratoplasty (DMEK) procedures in patients with Fuchs endothelial corneal dystrophy (FECD). 

Study design and Methods: This two-center retrospective study evaluated a consecutive series of patients to quantify post operative best corrected visual acuity (BCVA), uncorrected distance (UDVA), intermediate (UIVA), near visual acuity (UNVA) and the spherical equivalent refraction in all patients with FECD operated for DMEK and cataract surgery. We also compared the results between combined and staged DMEK.  

Results: 25 modified monofocal IOLs (Tecnis Eyhance, Johnson and Johnson) and 1 trifocal-EDoF (Tecnis Synergy, Johnson and Johnson) IOL were implanted in 26 eyes of 20 patients (11 women and 9 men; age 56-78). 8 were spherical and 18 were toric. Postoperatively, the median BCVA was 0 logMAR (range 0 to 0.3), the median UDVA was 0.1 logMAR (range to 0-0.3), the median UIVA was 0.1 logMAR (range 0.1 to 0.18), the median UNVA was 0.4 logMAR (range 0.1 to 0.4) and the median spherical equivalent refraction was 0.0625 (range -1.625D to +1.25D). The median BCVA in combined was 0.05 logMAR (range 0 to 0.3) and the median BCVA in staged procedures was 0.1 logMAR (range 0 to 0.18). 

Conclusion: Favourable visual and refractive outcomes were obtained with modified monofocal IOLs and trifocal-EDoF in patients with FECD and cataract post DMEK, phacoemulsification and IOL implantation surgery. In our study there are no significant differences in visual outcomes between staged and combined DMEK procedures. Modified monofocal and trifocal-EDoF IOLs may offer DMEK patients an alternative option to standard monofocal IOLs, with an improvement in near and intermediate vision. 

 

Presenter(s)

Presenting Author: Louis Vaudoisey

Additional Author(s):

Johanna Choremis, Centre Universitaire de l’Université de Montréal à l’Hôpital Maisonneuve-Rosemont (CUO-HMR)

Sara Al-Zanki, Centre Universitaire de l’Université de Montréal à l’Hôpital Maisonneuve-Rosemont (CUO-HMR)

Samir Jabbour, Centre hospitalier de l’Université de Montréal (CHUM)

Julia Talajic, Centre Universitaire de l’Université de Montréal à l’Hôpital Maisonneuve-Rosemont (CUO-HMR)

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