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Visual Outcomes and Patient-Reported Dysphotopsia After PanOptix and PanOptix Toric Implantation Stratified by
Xia Zhang1, Lu Sun1, Yongxiang Tang1
1Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
Introduction:
We aimed to evaluate the tolerance of preoperative chord mu (angle kappa) after cataract or clear lens exchange surgery and implantation of AcrySof IQ PanOptix and PanOptix Toric in a Chinese cohort.
Methods:
This prospective observational study consecutively enrolled patients undergoing PanOptix/PanOptix Toric implantation at Peking Union Medical College Hospital. Eyes were analyzed by chord mu (< 0.3 mm vs. ≥ 0.3 mm), lens opacity (clear lens or cataract), and intraocular lens (PanOptix or PanOptix Toric). Visual acuity was assessed at 1 and 3 months. Patient-reported outcomes were assessed at 3 months using the IOLSAT and the QUVID.
Results:
A total of 122 eyes from 62 patients were analyzed. Seventy-nine eyes received PanOptix Toric lenses, and 43 eyes received non-toric PanOptix lenses. The κ ≥ 0.3 mm group had less myopic spherical equivalent (P = 0.004) than the κ < 0.3 mm group. At 1 and 3 months, the uncorrected and corrected distance, intermediate, and near visual acuity outcomes were excellent and did not differ significantly between κ groups in the overall cohort (all P > 0.05). In the toric subgroup,1-m UNVA was better in eyes with κ < 0.3 mm (P < 0.001, adj. P = 0.024) than in those with κ ≥ 0.3 mm. Overall spectacle independence was 90% (45/50), with 100% for distance and intermediate vision in both κ groups; near spectacle independence was similar between groups (P = 0.797). The most frequent visual disturbances were halos (78%, 39/50), starbursts (60%, 30/50), and glare (42%, 21/50), with no significant differences between the κ groups (all P > 0.05). Patient-reported outcomes and disturbance frequencies were similar between PanOptix and PanOptix Toric (all P > 0.05). Compared with cataract surgery, clear lens exchange resulted in increased rates of halos (92.3% vs. 62.5%, P = 0.016).
Conclusions:
In this carefully selected, small sample Chinese cohort implanted with PanOptix/PanOptix Toric lense and restricted to eyes with chord mu ≤ 0.5 mm, a κ ≥ 0.3 mm was not associated with worse overall visual acuity, spectacle independence, or the likelihood/severity of visual disturbances. The PanOptix Toric lens demonstrated patient-reported outcomes comparable to those of the non-toric PanOptix. Patients who underwent clear lens exchange reported more visual disturbances than those who underwent cataract surgery, suggesting a need for careful candidate selection and preoperative counseling.
