Effect of Monofocal, Wavefront-Shaped, and Diffractive Trifocal Intraocular Lenses on Scanning-Slit Automated
Larissa Gouvea1, Sara Alshaker2, Karolinne Maia Rocha3
1From the Department of Ophthalmology and Visual Sciences, University of Toronto (L.G., S.A., C.C.C., D.S.R.), Toronto, Ontario, Canada; Department of Ophthalmology, Federal University of São Paulo (L.G., W.C.), São Paulo, Brazil; Storm Eye Institute, Medical University of South Carolina (L.G., K.M.R.), Charleston, South Carolina, USA.
Purpose:
To compare scanning-slit retinoscopy automated refraction spherical equivalent (ARSE) to subjective manifest refraction spherical equivalent (MRSE) in normal eyes with four different types of intraocular lenses (IOLs).
Design:
Retrospective cross-sectional study.
Methods:
A total of 279 pseudophakic eyes that underwent lens extraction at a private center with implantation of either a wavefront shaped IOL (Acrysof® Vivity, DFT015), a nonapodized diffractive trifocal IOL (Acrysof® Panoptix), or a monofocal IOL with negative spherical aberration (Tecnis ZCBOO) or aberration-free (Envista Mx60E). Patients who had an automated refraction measurement with retinoscopy refractometer and aberrometer (NIDEK OPD Scan III, Nidek Technologies) and subjective refraction data 1-2 months postoperatively were included in the study. Main outcome measured was the difference between automated refraction and subjective refraction.
Results:
Sixty-one eyes implanted with a DFT015 IOL, 78 eyes with a TFNT00 IOL, 40 with a ZCBOO IOL and 100 with a Mx60E IOL were enrolled in this study. Statistically significant myopic results were observed when using ARSE compared to MRSE in the DFT015 (-0.95 ± 0.64, -0.33 ± 0.65, P < .001), TFNT00 (-0.43 ± 0.36, -0.2 ± 0.35, P < .001), ZCBOO (-0.81 ± 0.63, -0.4 ± 0.69, P = .008) and Mx60E (-0.75 ± 0.65, -0.45 ± 0.52; P < .05) IOL groups. The absolute difference between the 2 methods was statistically significant in the DFT015 IOL group (0.65 ± 0.49; P < .05).
Conclusion:
Automated refraction yields myopic results in pseudophakic eyes with monofocal and presbyopia correcting IOLs and may be used with caution. Manifest refraction "push-plus" technique should be used in all pseudophakic eyes to avoid over-minus prescriptions, especially in patient with residual refractive error following cataract surgery.
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