Combining multifocal IOL styles can improve presbyopic correction

BOSTON — Using two types of multifocal IOLs in combination in bilateral refractive lens exchange reduces intermediate vision complaints and provides high rates of spectacle independence and patient satisfaction, according to a surgeon speaking here.

Frank A. Bucci Jr., MD, discussed strategies for using multifocal IOLs to treat presbyopic patients at the American Society of Cataract and Refractive Surgery Summer Refractive Congress. In particular, he addressed the benefits and limitations of presbyopia-correcting lenses, including the eyeonics crystalens, the Advanced Medical Optics ReZoom and the Alcon AcrySof ReSTOR.

In a study, Dr. Bucci and colleagues compared the postoperative visual results in 110 eyes of 55 patients implanted bilaterally with ReSTOR IOLs to 150 eyes of 75 patients implanted with a combination of one ReZoom and one ReSTOR IOL. The researchers found that patients implanted with the ReZoom/ReSTOR lens combination achieved better intermediate vision.

Patients implanted with bilateral ReSTOR lenses achieved J1 bilateral near visual acuity (VA), J3.81 bilateral intermediate VA and J4.49 unilateral intermediate VA.

Patients who received a ReZoom lens in one eye and a ReSTOR lens in the other eye also achieved bilateral near VA of J1. However, these patients had significantly better results in the two other measurements, achieving J2.39 bilateral intermediate VA and J3.03 unilateral intermediate VA, Dr. Bucci said.

The ReZoom and ReSTOR lenses work together to counterbalance each other's weaknesses, he said. The ReZoom lens provides strong intermediate vision, but patients can experience reduced near vision and light phenomena at night. The ReSTOR lens, on the other hand, provides less intermediate vision, but patients have stronger reading vision in bright light and fewer halos at night.

"The unique optical characteristics of each multifocal IOL appears to be complementary," Dr. Bucci said.