Mixing multifocal IOLs results in better overall vision

SAN FRANCISCO — Combining two different multifocal IOLs in one patient can result in a high rate of spectacle freedom and patient satisfaction, said Frank A. Bucci, Jr., MD.

Dr. Bucci initiated a study where one cohort received the ReSTOR IOL (Alcon) in both eyes and a second cohort received the ReSTOR lens in one eye and the ReZoom lens (Advanced Medical Optics) in the contralateral eye. The ReSTOR-only group comprised 55 patients with a mean follow-up of 27 weeks. The mixed group comprised 39 patients with a mean follow up of 12 weeks.

In the ReSTOR-only group, 21 patients had cataracts and 24 had lensectomies. “Implanting the ReSTOR in the second eye improved reading and caused no added halos,” he said here at the American Society of Cataract and Refractive Surgery meeting.

The first group had a visual acuity of J1, while the mixed-lens group had a VA of 1.07, Dr. Bucci said. There was no statically significant difference at near, he said.

No statistically significant differences in bilateral uncorrected near vision were observed, he said.

For near vision, ReSTOR was excellent in bright light for small pupils, while the ReZoom was very good in moderate light for medium pupils, Dr. Bucci said. For intermediate vision, ReZoom was excellent, while ReSTOR sacrificed intermediate for fine detail at near, he said. For distance, ReZoom had excellent bright daylight, while ReSTOR had less light phenomenon at night.

“Why are we mixing technologies? Because it works,” Dr. Bucci said.

At the discussion following his paper presentation, Dr. Bucci said that he had started using ReZoom in the nondominant eye but switched to using ReZoom in the dominant eye and ReSTOR in the nondominant eye because he had heard too many complaints from patients about unilateral issues.

He called ReZoom a “viable” option and said if ReSTOR did not exist, he would use ReZoom in both eyes.

“ReZoom is rescuing the ReSTOR instead of the other way around,” he said.