Performance of the 10-2 and 24-2 SITA Standard Visual Field Test in patients with no history of glaucomatous optic neuropathy after cataract surgery with trifocal intraocular lens implantation

Abstract

INTRODUCTION

Glaucoma is a group of chronic degenerative diseases that are the leading cause of irreversible blindness worldwide, causing progressive loss of the visual field. Therefore, its diagnosis and the timely detection of the progression of glaucomatous neuropathy and visual field defects are of utmost importance. Automated static visual field testing is the most frequently used tool for detecting disease progression. Several factors can influence perimetry results, such as uncorrected refractive errors, patient experience, pupil size, individual response, and the presence of cataracts or other pathologies; these must be taken into account. Visual acuity (VA) and contrast sensitivity (CS) characterize different aspects of visual function.

It has been demonstrated that glaucoma patients with visual acuity better than 0.3 logMAR exhibited contrast sensitivity deficits significantly associated with visual field loss. Conversely, the implantation of premium intraocular lenses has been described as being associated with reduced contrast sensitivity.

OBJECTIVE

To compare performance on the SITA Standard visual field test between patients who underwent surgery with premium “Liberty” lenses and patients who underwent surgery with “Lucia 221” monofocal lenses, considered to be without ocular pathology.

METHODOLOGY

Database of patients who underwent surgery with “Liberty” multifocal lenses and patients who underwent surgery with “Lucia 221” monofocal lenses between June 2023 and June 2024 at the Luis Guillermo Ibarra Ibarra National Institute of Rehabilitation, who performed a 10-2 and 24-2 SITA Standard visual field test.

RESULTS

Fourteen eyes from seven patients were studied: four patients wearing trifocal lenses and three patients wearing monofocal lenses. Inferential analysis was performed using SPSS Statistics version 30.0. No significant differences were found between the two groups in terms of mean age, education level, intraocular pressure, or corrected near visual acuity. A statistically significant difference was found in mean contrast sensitivity, which was lower in the trifocal lens group. No statistically significant differences were found in foveal threshold, mean distance (MD), or peripheral distance (PD) in the SITA standard 10-2 and 24-2 visual field tests.

CONCLUSIONS

Decreased contrast sensitivity was demonstrated in trifocal lens wearers, consistent with what has been described in the literature since the introduction of premium lenses. However, a lower foveal threshold was not observed in the 10-2 and 24-2 visual fields, nor in any of the measurable parameters of interest in patients with glaucoma. The results of this study could indicate that patients with trifocal intraocular lenses could reliably perform visual field tests useful in patients with suspected glaucoma, despite this type of lens not being the first choice for patients with glaucomatous optic neuropathy.