james s wolffsohn sunil shah, shehzad a naroo, phillip j buckhurst
DESCRIPTION
Visual Function Following Bilateral Implantation of Refractive or Diffractive Multifocals versus Combination of Refractive and Diffractive Multifocal IOLs. James S Wolffsohn Sunil Shah, Shehzad A Naroo, Phillip J Buckhurst - PowerPoint PPT PresentationTRANSCRIPT
Visual Function Following Bilateral Implantation of Refractive or Diffractive
Multifocals versus Combination of Refractive and Diffractive Multifocal IOLs
James S WolffsohnSunil Shah, Shehzad A Naroo, Phillip J Buckhurst
The authors have no financial interest in the subject matter of this poster
P140P140
Tecnis ZM900 (Advanced Medical Optics, Inc., Santa Ana, CA) •Diffractive pupil-independent multifocal IOL•+4.00D near addition (~3.50 D at spectacle plane)•Prolate aspheric anterior surface•Diffractive posterior surface
•Diffractive pupil-independent multifocal IOL•+4.00D near addition (~3.50 D at spectacle plane)•Prolate aspheric anterior surface•Diffractive posterior surface
ReZoom (Advanced Medical Optics, Inc., Santa Ana, CA)
•2nd generation refractive multifocal IOL•6 mm acrylic optic and PMMA haptic•Five refractive zones (centre distance)•Near addition +3.50D (~2.57D at spectacle plane)
•2nd generation refractive multifocal IOL•6 mm acrylic optic and PMMA haptic•Five refractive zones (centre distance)•Near addition +3.50D (~2.57D at spectacle plane)
Tecnis ZM900 and ReZoom IOLsTecnis ZM900 and ReZoom IOLs
Methods
Setting: Midland Eye Institute, Solihull, United Kingdom
• 15 subjects ReZoom / Tecnis ZM900 combination• 15 subjects bilateral ReZoom• 15 subjects bilateral Tecnis
• Examined 3- 6 months post surgery• Defocus curves measured under photopic (85cd/m2) and
mesopic (3cd/m2) conditions.
Defocus curve testing
Defocus curves evaluate pseudoaccommodative function
Trial lenses of varying power used to assess impact on visual acuity
Maintenance of good acuity with negative lenses indicates near vision capability
Obtained randomly from -5.00 to +1.50 DS, in 0.50 D steps
Chart letters randomised between steps
Results
Distance visual acuities were similar for all groups
Bilateral ReZoom: -0.07 ± 0.08LogMAR
Bilateral Tecnis: -0.04 ± 0.08LogMAR
Mix and Match: -0.09 ± 0.08LogMAR
Tecnis ZM900 performs better for near vision and the ReZoom provides clearer intermediate vision
Defocus (D)-5-4-3-2-1012
Vis
ua
l Acu
ity (
Lo
gMA
R) -0.2
0.0
0.2
0.4
0.6
0.8
1.0
Binocular ReZoomBinocular Tecnis
Mixing and matching the ReZoom and Tecnis IOL provided clear distance and near vision
Defocus (D)-6-5-4-3-2-1012
Vis
ua
l Acu
ity (
Lo
gMA
R) -0.2
0.0
0.2
0.4
0.6
0.8
1.0
Binocular TecnisBinocular mix and matchBinocular ReZoom
• Mix and match results in highest peaks in acuity at 0.0 and -3.0 D of defocus: better distance and near vision.
• Mix and match provides extended ranges of clear vision: peaks around 0 and -3.0 D are wider.
Despite having a pupil dependent design the ReZoom IOL exhibits pupil independent visual properties
Defocus (D)-5-4-3-2-1012
Vis
ual A
cuity
(Lo
gMA
R) -0.2
0.0
0.2
0.4
0.6
0.8
1.0
ReZoom PhotopicReZoom Mesopic
The Tecnis IOL has a pupil independent design and exhibits this pupil independence in the defocus curve profiles
Defocus (D)-5-4-3-2-1012
Vis
ua
l Acu
ity (
Lo
gMA
R) -0.2
0.0
0.2
0.4
0.6
0.8
1.0
Tecnis PhotopicTecnis Mesopic
A mix and match combination provides pupil independent vision
Defocus (D)-5-4-3-2-1012
Vis
ual A
cuity
(Lo
gMA
R) -0.2
0.0
0.2
0.4
0.6
0.8
1.0
Mix and Match PhotopicMix and Match Mesopic
A ‘mix and match’ approach can enhance binocular summation and increase range-of-clear-focus. It is important to consider this strategy when implanting multifocal IOLs to minimize the effects of presbyopia.
A ‘mix and match’ approach can enhance binocular summation and increase range-of-clear-focus. It is important to consider this strategy when implanting multifocal IOLs to minimize the effects of presbyopia.
ConclusionsConclusions
Visual Function Following Bilateral Implantation of Refractive Multifocals versus
Combination of Refractive and Diffractive Multifocal IOLs
James S WolffsohnSunil Shah, Shehzad A Naroo, Phillip J Buckhurst
The authors have no financial interest in the subject matter of this poster
P140P140