Implantation of supplemental multifocal intraocular lens into the ciliary sulcus during cataract surgery

Introduction
Efficacy and safety evaluation of simultaneous implantation of a monofocal lens into the lens bag and a multifocal lens Reverso into the ciliary sulcus during cataract surgery.

Material and methods
The prospective study included 80 patients (160 eyes) divided randomly into Reverso (RG) and control (CG) groups who underwent bilateral cataract surgery. A monofocal lens was implanted into the lens bag in both groups. RG additionally received sulcus placement of a supplemental multifocal Reverso lens. Postoperative follow-up was about 6 months.

Results
Three months postoperatively, both groups had good monocular and very good binocular distant uncorrected visual acuity (RG: V = 0.97 vs. CG: V = 0.92). Near uncorrected visual acuity was better in RG, both monocularly and binocularly (RG: V = 0.5 vs. CG: V = 1.09). Postoperative contrast sensitivity was significantly higher in CG. Analysis of optical aberrations revealed no significant differences between the groups. High vision quality satisfaction was obtained in both groups, with significantly greater independence from spectacles in RG. There was no correlation between group and the presence of pigment deposits in the anterior eye, intraocular pressure or flarimetry. The incidence of minor complications and procedure duration were higher in RG, with no effect on final vision quality.

Conclusions
Combined implantation of monofocal capsular bag and supplemental, removable Reverso implants was safe and effective in improving uncorrected distant and near visual acuity. This seems to be a good solution for patients with high visual expectations who want to achieve postoperative independence from spectacles.