Retrospective Comparison of 3177 Eyes Implanted with Presbyopic IOLs

Carlos Buznego MDElizabeth A. Davis MD, FACS Guy M. Kezirian MD, FACS

William B. Trattler MD

Dr. Buznego is a consultant to Alcon, Allergan, Glaukos, Inspire, Ista, QLTI

Purpose

• Compare visual outcomes following cataract surgery with presbyopic IOLs at distance, intermediate and near– Tecnis Aspheric Multifocal +4 Add– Crystalens Accomodating HD– Restor Aspheric Multifocal +3 Add

SurgiVision® DataLink IOL Edition: Comparison

• IOL Results Registry: – Data not collected using a protocol, but reported

by surgeons into a registry – Administered by SurgiVision® Consultants, Inc.– Funded by Bausch + Lomb,

Methods: Data Filters

• Eyes evaluated: Best case scenario– No prior surgery– “Average” measurements • Mean K’s 41.00 – 46.50 • Axial length range 22 – 26.5 mm • Preop corneal astigmatism ≤ 1.00 D

– Postop results screened for best results • Postop spheroequivalent ± 0.50 D • Postop astigmatism ≤ 0.75 D

Methods: Analysis

• Used last reported postop exam in the 1-3 month interval

• Analysis based on Snellen visual acuities alone• Analysis does not consider visual quality: – Contrast– Glare

Results: IOL Counts

0500

10001500200025003000 2641

391 145

UCVA Distance: Mean Acuities

10

20

30

40

50

25.1 25.8 25.5

UCV

A (

20/X

)

p Not Significant

UCVA Intermediate: Mean Acuities

10

20

30

40

50

24.1

29.5

24.2

UCV

A (

20/X

)

HD v. Tecnis p Not SignificantEither HD/Tecnis v. ReSTOR p <0.05

UCVA Near: Mean Acuities

10

20

30

40

50

34.1

23.218.9U

CVA

(20

/X)

HD v. either ReSTOR or Tecnis p <0.01 ReSTOR v. Tecnis p <0.01

UCVA Distance

2020 20/25 20/30 20/400%

20%

40%

60%

80%

100%

Crsytalens HDReSTOR SN6AD1 (Aspheric Plus 3)Tecnis Multifocal (ZM900 and ZMA00)

UCVA Intermediate

2020 20/25 20/30 20/400%

20%

40%

60%

80%

100%

Crsytalens HDReSTOR SN6AD1 (Aspheric Plus 3)Tecnis Multifocal (ZM900 and ZMA00)

UCVA Near

2020 20/25 20/30 20/400%

20%

40%

60%

80%

100%

Crsytalens HDReSTOR SN6AD1 (Aspheric Plus 3)Tecnis Multifocal (ZM900 and ZMA00)

Results

• At distance, all lenses were equivalent.• At intermediate, Crystalens and Tecnis

Multifocal were statiscally better than Restor• At near, Tecnis was better than Restor which

was better than Crystalens

Comments and Conclusion

• Some sampling bias may be present • N different for each lens• Tecnis eyes contributed by a small number of surgeons

• This analysis does not control for pupil size – Pupil size may affect performance of presby-IOL’s

• Vision quality not evaluated (glare, mesopic visual function, low contrast acuity, etc.)

• Further evaluation is necessary

Thank you.