Mixing multifocal IOLs can enhance outcomes, minimize photic phenomena, surgeons say

ATHENS — Combined implantation of different multifocal IOLs produces excellent distance, intermediate and near visual acuity, according to surgeons speaking here at the ESCRS Winter Meeting. Implanting combinations of IOLs also improves spectacle independence and can reduce photic phenomena, they said.

In a German clinic, 20 patients were implanted with the "mix and match" technique using the diffractive Tecnis and the refractive ReZoom IOLs (Advanced Medical Optics).

At 3 months follow-up, "The mean bilateral visual acuity was 20/25 or better at distance, 20/30 at intermediate and 20/25 at near," said Magda Rau, MD. "Only 15% of the patients used glasses some time during the day for limited tasks. All patients were satisfied with the results."

Although 30% of the patients experienced halos, only 10% found them disturbing, and only 5% complained about glare, she said.

"We've had good results with both of these lenses implanted individually, [but] the combination of them gives the surgeon the possibility of satisfying a larger share of patients," Dr. Rau said.

Similar conclusions were reported in a poster presentation by Melike Gedar, MD, and a Turkish group of surgeons who implanted nine refractive lens exchange patients and one cataract patient using the same IOL combination.

Dr. Gedar and colleagues also found a dramatic reduction in the occurrence and intensity of photic phenomena in these patients compared with patients implanted bilaterally with either lens alone.

The implantation of ReZoom and ReSTOR (Alcon) was also tried as an alternative to ReZoom and Tecnis in 20 eyes by a group of Polish surgeons. In their study, both combinations proved equally successful.

"The combination of different multifocal IOLs neutralizes the disadvantages of the implantation of only one type of multifocal lens," Stanislawa Gierek-Ciaciura wrote. "Accurate patient selection is necessary to optimize results."