Análisis comparativo a largo plazo entre distintas combinaciones de la técnica mix-and-match y la implantación bilateral de lentes intraoculares (lio) multifocales

Abstract

This doctoral thesis focuses on the detailed evaluation of bilateral surgical techniques for cataract extraction and intraocular lens (IOL) implantation, with a particular emphasis on comparing visual outcomes and identifying associated postoperative complications. Specific aspects such as visual indicators and defocus curves of LENTIS IOLs are also analyzed. Through an in vivo approach supported by numerical and experimental analyses, this research aims to provide valuable insights for improving informed surgical decision-making and optimizing clinical outcomes. In the first study, the 'Mix and Match' technique was compared with bilateral implantation of multifocal IOLs, specifically using LENTIS IOLs. Visual acuity at different distances (far, intermediate, and near) and adverse visual effects such as halos and glare were evaluated in patients undergoing cataract surgery with different combinations of segmental bifocal IOLs and the Mix-and-Match technique. The results revealed that the combination of segmental bifocal IOLs in the Mix-and-Match technique provided superior visual acuity, especially at intermediate distances, and reduced the incidence of adverse visual effects compared to bilateral implantation of multifocal IOLs with the same addition. This underscores the importance of considering the individual visual needs of each patient when selecting the type of IOL in cataract surgery. The second study focused on analyzing defocus curves associated with different multifocal IOL techniques and designs. These defocus curves have been identified as valuable indicators to assist surgeons in selecting the most suitable IOL for each patient. The stability, consistency, and reliability of defocus curves were evaluated in patients who underwent bilateral implantation of LENTIS IOLs, both with the Mix-and-Match strategy and bilateral implantation of IOLs with the same addition. The results supported the hypothesis that bilateral implantation of LENTIS IOLs would result in stable and reliable defocus curves, allowing for a better understanding of the visual performance of these lenses under different strategies and, therefore, a more precise selection of IOL based on individual visual preferences and needs. Regarding adverse effects, it was observed that the Mix-and-Match technique was associated with a lower incidence of glare compared to bilateral implantation of multifocal IOLs with the same addition. Glare is a common adverse visual effect reported by patients after cataract surgery, and these findings suggest that IOL selection using the Mix-and-Match technique can contribute to reducing this uncomfortable side effect. Overall, this research lays the foundation for future investigations in the field of cataract surgery and IOL selection. Areas of interest are highlighted, such as long-term research on the impact of the Mix-and-Match technique on visual quality and patient satisfaction, as well as further studies exploring defocus curves as predictive indicators for IOL selection in patients with different visual profiles and needs. This thesis offers a comprehensive insight into cataract surgery and IOL selection, with the aim of improving the quality of life of patients and optimizing postoperative visual outcomes.