Advanced Technology Intraocular Lens Implants (ATIOLs) and Microinvasive Glaucoma Surgery (MIGS): Visual and Intraocular Pressure Outcomes

ORCID

0009-0001-5710-3268 (Drake)

Document Type

Abstract

Publication Date

2025

Publication Title

Investigative Ophthalmology & Visual Science

Volume

66

Issue

8

Pages

5097

Conference Name

2025 ARVO Annual Meeting, 4-8 May 2025, Salt Lake City, Utah

Abstract

Purpose : Advanced technology intraocular lenses (ATIOLs), including extended depth of focus (EDOF) and multifocal intraocular lenses (IOLs), are designed to enhance vision across multiple distances. However, their impact on patients with glaucoma requires further investigation. This study evaluates visual and intraocular pressure (IOP) outcomes in patients who underwent cataract surgery with ATIOLs, either alone or in conjunction with MIGS.

Methods : This single-center, retrospective clinical study analyzed electronic medical record data from patients who underwent cataract surgery with an ATIOL between 2016 and 2023. A total of 158 eyes were included, with 68 (43%) male and 90 (57%) female patients, and a mean age of 69 years. Inclusion criteria were mild to moderate primary or secondary glaucoma, ocular hypertension, or anatomical narrow angle. Patients with severe glaucoma, fewer than three months of follow-up, or younger than 18 years were excluded. Data were collected at baseline (Pre-Op) and postoperatively at 1 day (POD1), 1 week (POW1), 1 month (POM1), 3–6 months (POM3-6), and 9–12 months (POM9-12). Outcomes assessed included corrected and uncorrected distance (UDVA) and near (UNVA) visual acuity, IOP, and IOP-lowering medication use.

Results : Of the 158 eyes, 98 (62%) had mild glaucoma, 26 (16.5%) moderate glaucoma, and 34 (21.5%) ocular hypertension or anatomical narrow angle. EDOF and multifocal IOLs were implanted in 104 (65.8%) and 54 (34.2%) eyes, respectively. Both groups demonstrated improvements in UDVA and UNVA by POM9-12. At POM9-12, UDVA of 20/20 or 20/25 was achieved in 58.3% of eyes with an EDOF IOL and 67.7% of eyes with a multifocal IOL. UNVA of 20/40 or better was observed in 78.6% of eyes with an EDOF IOL and 71.4% with a multifocal IOL. Concurrent MIGS, performed in 125 (79.1%) surgeries, was associated with significant reductions in IOP (p< 0.0001) and IOP-lowering medication use (p< 0.0001) at POM1, POM3-6, and POM9-12.

Conclusions : ATIOL implantation, particularly in combination with MIGS, offers promising improvements in both visual and IOP outcomes for patients with glaucoma. Future analysis will expand to include patients who underwent ATIOL implantation between 2023 and 2024.

Rights

© 2025 The Authors.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Original Publication Citation

Wetsel, T. R., Drake, T. N., Goyal, A., Brown, S., Bhargava, S., Wu, P., Mason, L., & Okeke, C. (2025). Advanced technology intraocular lens implants (ATIOLs) and microinvasive glaucoma surgery (MIGS): Visual and intraocular pressure outcomes. Investigative Ophthalmology & Visual Science, 66(8), 5097. https://iovs.arvojournals.org/article.aspx?articleid=2807777

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