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Combination of high and low add multifocal IOLs improves useful visual acuity
Patients were satisfied with the lenses, and the majority said they would have them implanted again.
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The implantation of two different multifocal IOL add powers improved near, intermediate and distance visual acuities and was well tolerated by patients, a speaker said at the American Society of Cataract and Refractive Surgery meeting in New Orleans.
“We noted a significant improvement in visual acuities,” Barry A. Schechter, MD, told Ocular Surgery News in a follow-up interview. “Patients’ acuities improved from an average of 20/100 preoperative to the 20/25 range at distance and at near and intermediate.”
Ten patients had been enrolled and included in the study when 3-month data were collected, Schechter said.
“Enrollment is still ongoing and will be fully reported upon in the near future,” he said.
Patients
The prospective, nonrandomized study included patients who received a Tecnis ZKB00 +2.75 D multifocal IOL in the dominant eye and a Tecnis ZMB00 +4.00 D multifocal IOL (both Abbott Medical Optics) in the non-dominant eye.
“It’s not really monovision, but we tended to leave the non-dominant eye more myopic to target a near point of 33 cm,” Schechter said.
Patients selected for inclusion had no significant astigmatism preoperatively. “We specifically did that so we wouldn’t have to do LRIs or LASIK correction on them. We wanted to enroll people with less than 0.75 D of astigmatism,” Schechter said.
Schechter evaluated patients using bilateral uncorrected reading acuity under two different illumination conditions at 33 cm and 50 cm.
Patients were administered the NEI VFQ-25 questionnaire to measure emotional well-being and daily social and vision functioning preoperatively and postoperatively.
Researchers collected patient data at 1 week, 1 month and 3 months after IOL implantation.
Results
In eyes implanted with the ZMB00 lens, baseline monocular uncorrected visual acuity was 20/80 under 50 cm photopic lighting and 20/63 under 33 cm photopic lighting. At 3 months, UCVA was 20/40 under both lighting conditions.
In eyes implanted with the ZKB00 lens, baseline monocular UCVA was 20/100 under 50 cm photopic lighting and 20/50 under 33 cm photopic lighting. At 3 months, UCVA was 20/25 under 50 cm lighting and 20/32 under 33 cm lighting.
Baseline binocular UCVA was 20/70 under 50 cm photopic lighting and 20/45 under 33 cm lighting. At 3 months, binocular UCVA was 20/25 under 50 cm photopic lighting and 20/28 under 33 cm lighting.
Baseline binocular best corrected visual acuity was 20/50 under 50 cm photopic lighting and 20/72 under 33 cm photopic lighting. At 3 months, binocular BCVA was 20/24 under 50 cm photopic lighting (P < .001) and 20/30 under 33 cm photopic lighting.
On the NEI VFQ-25 questionnaire, general vision scores improved from 70 at baseline to 85 at 3 months. Pain scores decreased from 84.4 at baseline to 81.3 at 3 months. Near activities scores increased from 77.1 at baseline to 89.6 at 3 months. Distance activities scores increased from 87.5 at baseline to 100 at 3 months.
Most other scores on the questionnaire increased or remained consistent.
“One hundred percent of the people said that they noted halos at night, which could be tolerated, especially by the 3-month visit, because neuroadaptation eventually takes place,” he said. “The vast majority of patients stated that they would have the same lenses implanted again given a choice.” – by Matt Hasson
- Reference:
- Schechter B. Mixing higher and lower multifocal IOL add powers in patients having uncomplicated cataract surgery to improve spectacle independence. Presented at: American Society of Cataract and Refractive Surgery meeting; May 6-10, 2016; New Orleans.
- For more information:
- Barry A. Schechter, MD, can be reached at Florida Eye Microsurgical Institute, 1717 Woolbright Road, Boynton Beach, FL 33436; email: baschechter@gmail.com.
Disclosure: Schechter reports he has financial interests with Abbott Medical Optics, Alcon, Bausch + Lomb, Omeros, Shire and Sun Ophthalmics.