Comparison of Angle Kappa and Visual Outcomes in Pseudophakic Patients with Monofocal and Multifocal Intraocular Lenses

Anum Sarfaraz; Asad Ullah; Sudais Ahmad; Sumaira Shakoor Qaisrani; Izma Mamoon; Ammara Affi; Firza Naz

doi:10.71177/jcco.v3i02.86

Authors

Anum Sarfaraz The University of Faisalabad, Faisalabad, Pakistan https://orcid.org/0009-0009-8234-9102
Asad Ullah Timergara Teaching Hospital, Timergara, Pakistan https://orcid.org/0000-0002-8714-7915
Sudais Ahmad The University of Faisalabad, Faisalabad, Pakistan https://orcid.org/0009-0005-9399-2612
Sumaira Shakoor Qaisrani The University of Faisalabad, Faisalabad, Pakistan https://orcid.org/0009-0007-3279-3905
Izma Mamoon The University of Faisalabad, Faisalabad, Pakistan https://orcid.org/0009-0009-3289-6984
Ammara Affi The University of Faisalabad, Faisalabad, Pakistan https://orcid.org/0000-0003-3210-2450
Firza Naz The University of Faisalabad, Faisalabad, Pakistan https://orcid.org/0009-0003-1119-0508

DOI:

https://doi.org/10.71177/jcco.v3i02.86

Keywords:

Intraocular Lenses, Angle Kappa, Pseudophakia, Visual Acuity, Cataract Surgery, Phacoemulsification

Abstract

Aim: To compare angle kappa and visual outcomes in pseudophakic patients implanted with monofocal versus multifocal intraocular lenses (IOLs) and to evaluate postoperative changes in angle kappa.

Study Design: Pre- and post-interventional study.

Duration and Settings of the Study: Conducted over 9 months, starting from September 2023 to May 2024, at Frontier Institute of Ophthalmology, Peshawar.

Methods: Patients undergoing uneventful phacoemulsification included through purposive sampling were randomly divided into two groups. One group (23 participants) received monofocal IOLs (Alcon AcrySof SA60 AT) and the second group (23 participants) received multifocal IOLs (Alcon AcrySof ReSTOR SN6AD1). Best-corrected distance visual acuity was measured using the LogMAR chart at baseline, one week, and one month. Angle kappa was assessed using Oculus Pentacam AXL. Data were analyzed in SPSS v25. Normality was tested using Shapiro-Wilk. Intra-group comparisons used the Friedman test (BCDVA) and repeated measures ANOVA (angle kappa); between-group comparisons used the Mann–Whitney U and independent t-tests (angle kappa).

Results: A total of 46 patients were included. The mean age of the monofocal group was 55.96 ± 9.52 years, and of the multifocal group, it was 48.95 ± 6.39 years. Both groups showed significant improvement in BCDVA (p < 0.001). At one month, the multifocal group achieved better BCDVA (p < 0.05). Angle kappa significantly decreased in both groups postoperatively (p < 0.05). No significant intergroup difference existed at baseline and one week, but the multifocal group had a higher residual angle kappa at one month (p < 0.05).

Conclusion: Both IOLs improved vision and reduced angle kappa postoperatively. Multifocal IOLs provided superior acuity but retained higher angle kappa, potentially increasing dysphotopsia risk. Preoperative angle kappa evaluation may help guide IOL selection.