What visual results can we expect? Technology in recent decades has accustomed us to progress advancing at the speed of light. This is true in areas such as communications, where the digital revolution is now a reality, but especially in the field of health, where new technologies have achieved results in diagnosis and therapy that would have been considered impossible only 20 years ago. Interview with Prof. Robert Montés-Micó.
Considering that we all age and that we will almost certainly have visual problems due to eyes that become physiologically presbyopic, we are clearly very interested in what the most advanced technologies in cataract surgery for the correction of presbyopia can promise us today.
We asked Prof. Robert Montés-Micó of the University of Valencia to tell us about the latest updates.
Refractive cataract is now a widespread surgical practice, but eye surgeons now seem to be aiming at an even more ambitious goal: the surgical treatment of presbyopia. Could you tell our readers about the state of the art of the new EDOF IOLs?
R. Montés-Micó: From a general point of view, Extended Depth Of Focus (EDOF) intraocular lenses are designed to achieve a continuous vision at all distances. There are currently two different EDOF IOLs, which have different optical characteristics. On the one hand Mini WELL ready (SIFI Medtech, Catania, Italy) is a progressive multifocal lens that includes a monofocal zone in the periphery of the lens. On the other hand, TECNIS Symfony (Abbott Laboratories, Illinois, USA) is a diffractive lens that corrects chromatic aberration.
To date, only one study has compared the optical quality in-vitro of these lenses as a function of aperture and vergence. According to this study, both IOLs provide comparable image quality for the best distance, intermediate and near vision of each lens at the 3 mm optical aperture. However, the Mini WELL ready provides better image quality than the TECNIS Symfony for the same positions when the aperture is 4.5 mm.
What are the main differences between EDOF IOLs and trifocal multifocal IOLs?
R. Montés-Micó: The main difference between EDOF IOLs and trifocal lenses is related to their optical design. Trifocal lenses are designed to have three foci, defined as distance, intermediate and near vision, respectively. EDOF IOLs, on the other hand, provide a continuum of fires between distance and near vision.
In terms of optical quality, the "through focus MTF" (Modulation Transfer Function) of trifocal lenses, which describes the MTF as a function of vergence, showed more abrupt transitions between foci than EDOF IOLs. Based on these results, a wider defocus tolerance is expected compared to trifocal lenses. Scientific evidence has recently confirmed this hypothesis.
How has the concept of 'Quality of Vision' changed that we can promise our patients?
R. Montés-Micó: With the introduction of EDOF IOLs, the concept of vision quality has been extended to all rays of vision due to the wider defocus tolerance.
Robert Montés-Micó
Robert Montés-Micó is Professor of Optics at the University of Valencia, Spain. He currently serves on the Editorial Board of the Journal of Cataract and Refractive Surgery and the Journal of Refractive Surgery and Ophthalmic and Physiological Optics. He has published more than 200 papers in peer-reviewed journals and works on the development of solutions for presbyopia, myopia and tear film analysis.
Read this article in English
For more information, see our review on presbyopia surgery:
- Innovative IOLs: the future is already tomorrow
- The new EDOF IOLs in the correction of presbyopia
– Biometrics and the success of refractive cataract surgery
– Presbyopia and economic growth
Dr. Carmelo Chines
Direttore responsabile
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