Evaluation of stability and retinal sensitivity by micropeimetry in a paients with multifocal and monofokal intraocular lenses implanted

Objective: Various studies have reported several disadvantages of multifocal intraocular lenses (IOLs). However, to our knowledge, there is no study on the effects of these lenses on microperimetry measurement parameters. The main purpose of this study is to evaluate fixation stability and retinal sensitivity in patients with multifocal and monofocal IOLs using microperimetry. The study is designed to understand the impact of multifocal IOLs on microperimetric measurements, compare them with monofocal IOLs, and provide valuable information for clinical applications. The results obtained may contribute to making more informed decisions regarding intraocular lens selection and implantation. Materials and Methods: A total of 82 eyes that had only cataract surgery, had not undergone any other eye surgery, had no ocular or systemic disease that would affect their vision, and had a visual acuity of at least 0.8 were included in the study. Participants were divided into two groups according to whether they were implanted with a monofocal or multifocal IOL (38 multifocal, 44 monofocal). Best-corrected visual acuity (BCVA), contrast sensitivity (HR), retinal sensitivity (RH-2°, 6° and 10°), fixation points (FN 2° and 4°), fixation location (FL), fixation stability ( FS), corneal aberration measurements were made. MP-1 microperimeter and Pelli-Robson chart were used as microperimetry devices.. Results: In this study, the demographic characteristics of patients who underwent monofocal and multifocal IOL implantation were examined and it was determined that there was no significant difference between the two groups in terms of variables such as gender, age, spherical equivalent, and astigmatism values. BCVA and HR were found to be significantly lower in patients wearing multifocal lenses (p=0.04, p=0.003, respectively). In patients with multifocal IOLs, macular sensitivity in 2°, 6° and 10° fields of view was 19.0625±1.46 dB, 19.1880±1.14 dB and 18.9374±1.17 dB, respectively, while it was 19.0625±1.46 dB, 19.1880±1.14 dB and 18.9374±1.17 dB, respectively, in patients with monofocal lenses. They were 6790±0.49 dB, 19.6889±0.39 dB and 19.4892±0.51 dB, and were statistically lower in the multifocal IOL group in all three fields (p=0.013, p=0.012 and p=0.035). When the points provided from the device were used for the fixation location, there was lower centralization in the multifocal IOL group in terms of fixation points at 2°, while no difference was found between the groups when based on the 4° area. When categorized and compared with the system defined by Fujii et al., no significant difference was found between the groups in terms of FL and FS. Conclusion: According to the results of this study, multifocal IOLs lead to a decrease in BCVA, HR and retinal sensitivity values compared to monofocal IOLs. Although it also causes a decrease in central fixation points, it does not create a significant difference in the defined FL and FS values. These findings suggest that multifocal lenses differ from monofocal lenses in some visual parameters, but have no obvious effect on fixation stability.