Clinical Outcomes of M-Plus Intraocular Lenses

Young Kwon Chung; Chang Won Park; Je Hyung Hwang; Choun-Ki Joo

doi:10.3341/jkos.2014.55.4.519

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Chung, Park, Hwang, and Joo: Clinical Outcomes of M-Plus Intraocular Lenses

Original Article

J Korean Ophthalmol Soc 2014;55(4):519-526.

Published online: 7 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.4.519

Clinical Outcomes of M-Plus Intraocular Lenses

Young Kwon Chung, MD¹, Chang Won Park, MD¹, Je Hyung Hwang, MD², Choun-Ki Joo, MD, PhD¹

¹Department of Ophthalmology and Institute for Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea

²Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea

Address reprint requests to Choun-Ki Joo, MD, PhD Department of Ophthalmology, The Catholic University of Korea, Seoul St. Mary’s Hospital, #222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea, Tel: 82-2-2258-1188, Fax: 82-2-599-7405 E-mail: ckjoo@catholic.ac.kr

Received 13 September 20138 November 2013 Accepted 15 March 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical outcomes of eyes implanted with a zonal refractive multifocal intraocular lens (IOL) with an inferior segmental near add (M-plus), and to compare the outcomes between M-plus and a diffractive-type multifocal IOL, AT LISA (366D, bifocal).

Methods

We reviewed 19 eyes from 10 patients who were implanted with M-plus and 52 eyes of 26 patients who were implanted with AT LISA. The clinical outcomes of these 2 intraocular lenses were evaluated at 1 day and 2 months postoperatively, and consisted of distant, intermediate, and near visual acuity, contrast sensitivity, degree of tilt, and decentration using anterior segment photography, depth of focus, and patient satisfaction.

Results

There were no statistical differences between the 2 groups with respect to distant vision, near vision, refractive error, contrast sensitivity, degree of tilt, decentration, or satisfaction score. The M-plus group demonstrated significantly better intermediate visual acuity. In the defocus curve, the M-plus group also demonstrated significantly better visual acuities for intermediate unfocused vision levels.

Conclusions

The M-plus multifocal IOLs are able to provide satisfactory distant and near visual acuity and visual function. The M-plus multifocal IOLs provide better intermediate vision than the AT LISA.

Keywords: Diffractive, IOL, Refractive, Visual acuity

References

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Figure 1.

Contrast sensitivity test of the 2 groups at photopic conditions.

Figure 2.

Contrast sensitivity test of the 2 groups at mesopic conditions.

Figure 3.

Visual acuity at various defocus levels. The values are a mean of logMAR visual acuity (^* p < 0.05).

Figure 4.

M-plus multifocal intraocular lens design (seamless transition between near and far zone).

Table 1.

Demographics of the study group

IOL groups	Mplus LS-313	AT LISA 366D	p-value
No. of patients (eyes)	10 (19)	26 (52)
Mean age (years)	59.9 ± 9.01	69.2 ± 10.00
Pre-operative S.E (D).	-0.25 ± 2.75	+1.43 ± 3.11	0.053
IOL power (D)	18.57 ± 4.10	21.5 ± 1.57	0.116
Axial length (mm)	23.88 ± 1.33	23.54 ± 0.98	0.080
UCVA (log MAR)	0.53 ± 0.29	0.47 ± 0.33	0.732
BCVA (log MAR)	0.20 ± 0.19	0.30 ± 0.25	0.183

Values are presented as mean ± SD; Independent t-test.

UCVA = uncorrected visual acuity; BCVA = best corrected visual acuity; S.E. = spherical equivalent.

Table 2.

Postoperatie visual acuity (log MAR)

IOL groups	Mplus LS-313	AT LISA 366D	p-value
UDVA	0.09 ± 0.13	0.14 ± 0.13	0.58
CDVA	0.06 ± 0.11	0.06 ± 0.06	0.72
UIVA	0.38 ± 0.21	0.46 ± 0.12	0.03^*
CIVA	0.33 ± 0.16	0.37 ± 0.14	0.83
UNVA	0.21 ± 0.18	0.14 ± 0.11	0.54
CNVA	0.15 ± 0.19	0.13 ± 0.08	0.66

Values are presented as mean ± SD; Independent t-test.

UDVA = uncorrected distance visual acuity; CDVA = corrected distance visual acuity; UIVA = uncorrected intermediate visual acuity; CIVA = corrected intermediate visual acuity; UNVA = uncorrected near visual acuity; CNVA = corrected near visual acuity.

^* p < 0.05.

Table 3.

Postoperative refraction (diopter)

IOL groups	Mplus LS-313	AT LISA 366D	p-value
Sphere	-0.67 ± 0.85	-0.31 ± 0.63	0.046
Cylinder	-0.75 ± 0.42	-0.65 ± 0.54	0.498
S.E.	-1.04 ± 0.81	-0.64 ± 0.54	0.022^*
Target refraction	0.10 ± 0.35	-0.16 ± 0.15	< 0.001^*
The difference with S.E. and target refraction	1.15 ± 0.66	0.48 ± 0.57	0.001^*

Values are presented as mean ± SD; Independent t-test.

S.E. = spherical equivalent.

^* p < 0.05.

Table 4.

Postoperative tilt degree and decentration (360’ angle)

	Mplus LS-313		AT LISA 366D
	POD 1 day	POD 2 months	POD 1 day	POD 2 months
Tilt degree	7.75 ± 6.11	7.61 ± 6.40	9.84 ± 5.90	9.96 ± 5.81
Decentration	0.09 ± 0.07	0.10 ± 0.08	0.08 ± 0.09	0.08 ± 0.10

Values are presented as mean ± SD.

POD = post-operative day.

Table 5.

Correlation between the degree of tilt and decentration with visual quality in the M-plus group

	M-plus LS-313		AT LISA 366D
	Tilt	Decentration	Tilt	Decentration
UDVA	r = -0.108	r = 0.127	r = 0.023	r = -0.117
UNVA	r = -0.200	r = -0.032	r = 0.104	r = 0.220
Satisfaction	r = 0.152	r = 0.241	r = 0.012	r = 0.176
Glare or halo	r = 0.128	r = -0.098	r = -0.038	r = -0.095

Pearson correlation test; correlation coefficient (r-square).

UDVA = uncorrected distance visual acuity; UNVA = uncorrected near visual acuity.

Table 6.

Satisfaction Questionnaire

	M-plus LS-313	AT LISA	p-value
Total satisfaction (range 0-5,score)	4.20 ± 0.63	4.09 ± 0.83	0.81
Glare or halos (%)	4.34 ± 0.27	4.10 ± 0.56	0.67
Need spectacles	0	0
Post-operative complication	None	None

Values are presented as mean ± SD; Independent t-test.

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