Recommendation for presbyopia-correcting intraocular lenses: A Delphi consensus statement by the ESASO study group

Vito Romano*, David Madrid-Costa, Jose F. Alfonso, Jorge Alio, Bruce Allan, Romesh Angunawela, Gerd Auffarth, Francesco Carones, Ramin Khoramnia, Johnny Moore, Mayank A. Nanavaty, Giacomo Savini, Luca Pagano, Mario R Romano, Gianni Virgili, Luis Fernández-Vega-Cueto

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)
43 Downloads (Pure)

Abstract

Purpose

To establish consensus among experts in lens and refractive surgery to guide general ophthalmologists on issues related to presbyopia-correcting intraocular lenses (IOLs).

Design

A modified Delphi method to reach a consensus among experts.

Methods

A steering committee formulated 105 relevant items grouped into four sections (preoperative considerations, IOL selection, intraoperative considerations, and postoperative considerations). The consensus was defined as ≥ 70% of experts agreeing with the evaluation of a statement.

Results

Ten experts participated and completed all rounds of questionnaires (100% response rate). Of 68 items considered in the preoperative considerations, consensus was achieved in 48 (70.6%). There was a lack of consensus over IOL selection, the experts only agreed on the importance of the patient's habits for the optical IOL design selection. Of the 14 considerations related to intraoperative issues, the experts reached a consensus on 10 (71.4%). The postoperative considerations section reached the highest consensus in 10 items of 13 (76.9%).

Conclusions

Key recommendations for a diffractive multifocal IOL were a potential postoperative visual acuity > 0.5, a keratometry between 40-45 diopters, a pupil >2.8 mm under photopic conditions and <6.0 mm under scotopic conditions, a root mean square of higher order corneal aberrations <0.5 µm for 6-mm pupil size, while monofocal or non-diffractive IOLs should be considered for patients with coexisting eye disorders. A lack of agreement was found in the issues related to the IOL selection.


Original languageEnglish
Pages (from-to)169-180
JournalAmerican Journal of Ophthalmology
Volume253
Early online date20 Jun 2023
DOIs
Publication statusEarly online date - 20 Jun 2023

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