Visual Function Following Bilateral Implantation of Refractive or Diffractive

Multifocals versus Combination of Refractive and Diffractive Multifocal IOLs

James S WolffsohnSunil Shah, Shehzad A Naroo, Phillip J Buckhurst

The authors have no financial interest in the subject matter of this poster

P140P140

Tecnis ZM900 (Advanced Medical Optics, Inc., Santa Ana, CA) •Diffractive pupil-independent multifocal IOL•+4.00D near addition (~3.50 D at spectacle plane)•Prolate aspheric anterior surface•Diffractive posterior surface

•Diffractive pupil-independent multifocal IOL•+4.00D near addition (~3.50 D at spectacle plane)•Prolate aspheric anterior surface•Diffractive posterior surface

ReZoom (Advanced Medical Optics, Inc., Santa Ana, CA)

•2nd generation refractive multifocal IOL•6 mm acrylic optic and PMMA haptic•Five refractive zones (centre distance)•Near addition +3.50D (~2.57D at spectacle plane)

•2nd generation refractive multifocal IOL•6 mm acrylic optic and PMMA haptic•Five refractive zones (centre distance)•Near addition +3.50D (~2.57D at spectacle plane)

Tecnis ZM900 and ReZoom IOLsTecnis ZM900 and ReZoom IOLs

Methods

Setting: Midland Eye Institute, Solihull, United Kingdom

• 15 subjects ReZoom / Tecnis ZM900 combination• 15 subjects bilateral ReZoom• 15 subjects bilateral Tecnis

• Examined 3- 6 months post surgery• Defocus curves measured under photopic (85cd/m2) and

mesopic (3cd/m2) conditions.

Defocus curve testing

Defocus curves evaluate pseudoaccommodative function

Trial lenses of varying power used to assess impact on visual acuity

Maintenance of good acuity with negative lenses indicates near vision capability

Obtained randomly from -5.00 to +1.50 DS, in 0.50 D steps

Chart letters randomised between steps

Results

Distance visual acuities were similar for all groups

Bilateral ReZoom: -0.07 ± 0.08LogMAR

Bilateral Tecnis: -0.04 ± 0.08LogMAR

Mix and Match: -0.09 ± 0.08LogMAR

Tecnis ZM900 performs better for near vision and the ReZoom provides clearer intermediate vision

Defocus (D)-5-4-3-2-1012

Vis

ua

l Acu

ity (

Lo

gMA

R) -0.2

0.0

0.2

0.4

0.6

0.8

1.0

Binocular ReZoomBinocular Tecnis

Mixing and matching the ReZoom and Tecnis IOL provided clear distance and near vision

Defocus (D)-6-5-4-3-2-1012

Vis

ua

l Acu

ity (

Lo

gMA

R) -0.2

0.0

0.2

0.4

0.6

0.8

1.0

Binocular TecnisBinocular mix and matchBinocular ReZoom

• Mix and match results in highest peaks in acuity at 0.0 and -3.0 D of defocus: better distance and near vision.

• Mix and match provides extended ranges of clear vision: peaks around 0 and -3.0 D are wider.

Despite having a pupil dependent design the ReZoom IOL exhibits pupil independent visual properties

Defocus (D)-5-4-3-2-1012

Vis

ual A

cuity

(Lo

gMA

R) -0.2

0.0

0.2

0.4

0.6

0.8

1.0

ReZoom PhotopicReZoom Mesopic

The Tecnis IOL has a pupil independent design and exhibits this pupil independence in the defocus curve profiles

Defocus (D)-5-4-3-2-1012

Vis

ua

l Acu

ity (

Lo

gMA

R) -0.2

0.0

0.2

0.4

0.6

0.8

1.0

Tecnis PhotopicTecnis Mesopic

A mix and match combination provides pupil independent vision

Defocus (D)-5-4-3-2-1012

Vis

ual A

cuity

(Lo

gMA

R) -0.2

0.0

0.2

0.4

0.6

0.8

1.0

Mix and Match PhotopicMix and Match Mesopic

A ‘mix and match’ approach can enhance binocular summation and increase range-of-clear-focus. It is important to consider this strategy when implanting multifocal IOLs to minimize the effects of presbyopia.

A ‘mix and match’ approach can enhance binocular summation and increase range-of-clear-focus. It is important to consider this strategy when implanting multifocal IOLs to minimize the effects of presbyopia.

ConclusionsConclusions

Visual Function Following Bilateral Implantation of Refractive Multifocals versus

Combination of Refractive and Diffractive Multifocal IOLs

James S WolffsohnSunil Shah, Shehzad A Naroo, Phillip J Buckhurst

The authors have no financial interest in the subject matter of this poster

P140P140