Comparison of Primary Duet Lens Procedures: In-The-Bag Monofocal with Sulcus Multifocal, and Standard Single Multifocal Lens for Cataract Surgery

Abstract

Purpose

To assess the safety and efficacy of primary duet intraocular lens (IOL) procedure using an in-The-bag monofocal IOL and a sulcus-based multifocal reversible platform for cataract surgery. The visual outcomes were compared with a single in-The-bag multifocal IOL.

Patients and Methods

Retrospective cohort study. Consecutive patients who underwent primary duet IOL procedures were compared with consecutive patients who underwent single multifocal IOL surgery. Primary outcomes were uncorrected distance and near visual acuities (UDVA and UNVA), refraction and spherical equivalent data. Secondary outcomes included surgical complications.

Results

The study group consisted of 32 eyes (22 toric IOLs) whilst the control group had 57 eyes (29 toric IOLs). There were no statistically significant differences between the two groups on post-operative 1-month and 1-year UDVA (p=0.1522 and 0.4926, respectively) and UNVA (p=0.1248 and 0.2738, respectively). There were no statistically significant differences in the postoperative 1-month spherical equivalent within ± 0.5 diopter (p=0.1891). Postoperative intraocular pressure spikes were observed on day-1 in both groups, with most returned to their baseline at 1-month and all were normal at 1-year post surgery. There were no statistically significant differences in intraocular pressure between the two groups on day-1, 1-month and 1-year after surgery (p=0.6421). There were no statistically significant differences in the IOL axis deviation from the intended axis in the toric subgroup analysis (p=0.5843).

Conclusion

Primary duet IOL procedure is equally effective and safe in correcting distance and near vision when compared with single multifocal IOL in the capsular bag.

Keywords:

• cataract surgery
• duet procedure
• spectacle independence
• 1stQ AddOn

Data Sharing Statement

Data available from the corresponding author on request due to privacy/ethical reasons.

Ethics Approval Statement

This study received ethics approval from the Sydney Local Health District Ethics Review Committee (X21-0126 and 2020/ETH00749). Data were collected in compliance with the National Health and Medical Research Council 2014 recommendations for de-identified Quality Assurance and Evaluation Activities data. Consent was not explicitly required as this was a retrospective study using de-identified data.

Acknowledgments

The authors wish to thank Ms Thu Nguyen of Central Sydney Eye Surgeons, Sydney, for her assistance in data collection.

Author Contributions

All authors made a significant contribution to the work reported, whether that is the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; they took part in drafting, revising or critical reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Brian Harrisberg is a consultant for Medicontur Medical Engineering Ltd. The authors declared that there is no other conflict of interest with respect to the research, authorship, and/or publication of this article.