Presbyopia-Correcting Intraocular Lens Improves Reading Function

A continuous-range-of-vision intraocular lens can offer improvements in uncorrected intermediate and near reading function.

A refractive lens exchange procedure that employs a diffractive continuous-range-of-vision intraocular lens (IOL) provides improvements in uncorrected intermediate and near reading function, according to findings published in the American Journal of Ophthalmology. 

Researchers used a Salzburg Reading Desk (SRD) to measure reading function in patients implanted with a novel presbyopia-correcting IOL (TECNIS Synergy IOL) in refractive lens exchange. The study included 56 eyes of 28 patients who received bilateral implantation of the IOL during a bilateral delayed sequential refractive lens exchange procedure. The researchers assessed uncorrected and distance corrected reading acuity, reading distance, reading speed, and the smallest print size that could be read effectively at a set and subjectively chosen near and intermediate distance (40 cm and 80 cm, respectively). Measurements were taken preoperatively and 6 months after surgery.

The study found that after the procedure uncorrected near reading acuity increased from 0.61±0.16 logMAR to 0.05±0.09 logMAR at the set near distance (40 cm) and from 0.60±0.11 logMAR to 0.07±0.08 logMAR at the subjectively preferred distance (39.6±5.3 cm and 37.7±4.3 cm). 

Preoperatively, uncorrected intermediate reading acuity was 0.39±0.19 logMAR, and postoperatively it was 0.08±0.07 logMAR at the set intermediate distance (80 cm). At the preferred intermediate distance (73.5±9.5 cm and 73.3±5.9 cm), visual acuity was (73.5±9.5 cm and 73.3 ± 5.9 cm).

As the shorter distance is considered by the SRD in the calculation of reading acuity, reading acuity does not increase even when smaller print sizes can be read or reading speed is faster.

The researchers explain that, although the subjectively preferred near and intermediate distances were shorter than the set distances, reading acuity was comparable for both. Additionally, they highlight that, for several testing conditions, patients were able to read at a faster speed or smaller print sizes at the preferred distances.

“As the shorter distance is considered by the SRD in the calculation of reading acuity, reading acuity does not increase even when smaller print sizes can be read or reading speed is faster,” the study authors explain.

Study limitations include the lack of assessment of reading performance in low light or contrast conditions, which could impair reading ability.

Disclosure: This research was supported by Johnson & Johnson. Multiple study authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

References:

Baur ID, Auffarth GU, Labuz G, Stengele A, Hallak  MK, Khoramnia R. Clinical evaluation of reading performance in refractive lens exchange with a diffractive continuous-range-of-vision intraocular lens. Am J Ophthalmol. Published online January 17, 2023. doi:10.1016/j.ajo.2023.01.011