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James S Wolffsohn Sunil Shah, Shehzad A Naroo, Phillip J Buckhurst

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

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James S Wolffsohn Sunil Shah, Shehzad A Naroo, Phillip J Buckhurst

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  1. 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 The authors have no financial interest in the subject matter of this poster P140

  2. Tecnis ZM900 and ReZoom IOLs 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 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)

  3. 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.

  4. 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

  5. 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

  6. Tecnis ZM900 performs better for near vision and the ReZoom provides clearer intermediate vision

  7. Mixing and matching the ReZoom and Tecnis IOL provided clear distance and near vision • 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.

  8. Despite having a pupil dependent design the ReZoom IOL exhibits pupil independent visual properties

  9. The Tecnis IOL has a pupil independent design and exhibits this pupil independence in the defocus curve profiles

  10. A mix and match combination provides pupil independent vision

  11. Conclusions 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.

  12. Visual Function Following Bilateral Implantation of Refractive Multifocals versus Combination of Refractive and Diffractive Multifocal IOLs James S Wolffsohn Sunil Shah, Shehzad A Naroo, Phillip J Buckhurst The authors have no financial interest in the subject matter of this poster P140

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