objective vs subjective outcomes in the latest trifcoal iol physiol (finevision)

Correlation of subjective and objective outcomes in a diffractive trifocal IOL, a case series.

Dr. Ivo Ferreira RíosDra. Karla Zuñiga Posselt

Dr. Eduardo Chávez Mondragón

Disclosure

• No conflict of interest.

Collaborators

• Dra. Karla Zuñiga• Dra. Aida Corona• Dr. Eduardo Chávez Mondragón• Dr. Yonathan Garfias

The key to success• Subjective outcomes

It’s coming…

It’s coming…

It’s here…

It’s here…

It’s here…

It’s here…!!!

It’s here…!!!

• Patient Reported Outcomes Measures (PROMs)

• Subjective outcomes it’s what matters the most in these days….

Our idea..If the subjective outcomes are so

important…

DO THEY CORRELATE?

With the objective outcomes we have

control during cataract surgery and patient

selection?

Purpose

• To evaluate the results and the relationship between Subjective and Objective outcomes of the latest trifocal Intraocular Lens (IOL) Physiol Finevision.

Objective outcomes

• VA, Aberrometry (RMS, PSF, MTF)

Subjective outcomes

• VFQ-25 & CATQUEST-9SF

Design

• Prospective non-interventional study.

Methods• 24 eyes of 12 patients

• Bilateral cataract surgery with implantation of Physiol trifocal IOL.

We analysed: UDVA UNVA VA 70, 60, 50, 40

1, 3 and 6 months

Methods• With a OPD Scan III Software we

performed:

Aberrometry measurements of:

• Higher-order root mean-square (RMS) • Point Spread Function (PSF) with the Strehl

Ratio.

MethodsWith a OPD Scan III Software we performed:

• Bilateral contrast sensitivity was obtained with Modulation Transfer Function (MTF).

MethodsThe subjective outcomes were obtained:

• National Eye Institute VFQ-25 questionnaire

• Catquest-9SF

Methods• Descriptive analysis of our data

• Kolmogorov-Smirnov analysis that presented: normal distribution of UNVA far, near and intermediate

abnormal distribution of questionnaries results.

• Pearson correlation to between our objective and subjective variables.

ResultsPearson correlation to between our objective and subjective variables.

Results• Intermediate VA in Logmar

Results

Mean Monocular UNVA LogMar 0.06 +/- 0.07

Spherical Equivalent (3months)

0.52 =/- 0.47

Mean RMS 0.07

PSF Strehl Ratio 0.38

Results• Score for the VFQ- 25 was global of

91.03 over 100.

• The results of catquest-SF9 the questionnaire was evaluated with rasch analysis for obtaining the final score.

Results

• UDVA (r = 0.89) • UNVA (r=0.71),

and • VA at 70, 60, 50

and 40 cm • Strehl ratio

Good score in both

questionnaires.

Good correlation between

Conclusion• We found a strong correlation in our objective and

subjective outcomes in the variables we described.

• If do a good selection and perform an excellent surgery technique (objective variables) we can predict to have excellent subjective outcomes in our patients.

Bibliography

• 1) Zhang F, Sugar A, Jacobsen G, Collins M. Visual function and spectacle independence after cataract surgery: bilateral diffractive multifocal intraocular lenses versus monovision pseudophakia. J Cataract Refract Surg. 2011; 37:853-8.

• 2) Vryghem JC, Heireman S. Visual performance after the implantation of a new trifocal intraocular lens. Clin Ophthalmol. 2013;7:1957-65.

• 3) Gatinel D, Pagnoulle C, Houbrechts Y, Gobin L. Design and qualification of a diffractive trifocal optical profile for intraocular lenses. J Cataract Refract Surg. 2011;37(11):2060-7.

• 4) Cochener B, Vryghem J, Rozot P, Lesieur G, Heireman S, Blanckaert JA, et al. Visual and refractive outcomes after implantation of a fully diffractive trifocal lens. Clin Ophthalmol. 2012;6:1421-7.

• 5) Sheppard AL, Shah S, Bhatt U, Bhogal G, Wolffsohn JS. Visual outcomes and subjective experience after bilateral implantation of a new diffractive trifocal intraocular lens. J Cataract Refract Surg. 2013;39(3):343-9.

• 6) Lesieur G. Outcomes after implantation of a trifocal diffractive IOL. J Fr Ophtalmol. 2012;35(5):338-42.

• 7) Carson D, Hill WE, Hong X, Karakelle M. Optical bench performance of AcrySof(®) IQ ReSTOR(®), AT LISA(®) tri, and FineVision(®) intraocular lenses. Clin Ophthalmol. 2014;8:2105-13.

• 8) Jonker SM, Bauer NJ, Makhotkina NY, Berendschot TT, van den Biggelaar FJ, Nuijts RM. Comparison of a trifocal intraocular lens with a +3.0 D bifocal IOL: results of a prospective randomized clinical trial. J Cataract Refract Surg. 2015;41(8):1631-40.

Thank you

Correo: ivo.ferreira@institutodeoftalmologia.org ferreira.ivo11@gmail.com

LinkedIn: Dr. Ivo Ferreira RíosTwitter: Ivo Ferreira Ríos MD