Mix and match combination of multifocal, aspheric IOLs yield excellent results

Implantation of a multifocal IOL (ReZoom, Advanced Medical Optics) in the dominant eye and an aspheric IOL (Tecnis, Advanced Medical Optics) in the nondominant eye is well-tolerated and a viable strategy for providing a full range of spectacle-free vision for patients undergoing bilateral cataract surgery, said Zainah Alsagoff, MD.

Dr. Alsagoff and colleagues from the Singapore National Eye Centre conducted a pilot study evaluating visual outcomes and subjective satisfaction in 15 patients who underwent bilateral cataract surgery. Patients were eligible to participate in the study if they were aged up to 80 years and had no more than 1 D of astigmatism. All patients underwent uncomplicated phacoemulsification by two surgeons with a 2-week interval between fellow eye procedures.

The comprehensive outcomes evaluations included binocular logMAR uncorrected visual acuity at distance, intermediate, and near with ETDRS charts under standardized lighting; mesopic and photopic contrast sensitivity with sine wave grating charts, stereopsis evaluated with the Titmus test at 30 cm; and reading ability and speed using the Wilkins rate of reading rest.

The results showed good visual function at all distances for most patients. The majority of patients had above the minimum contrast required except for some eyes with the aspheric IOL. The Titmus test showed no significant reduction in stereopsis with the implantation of this lens combination.

When asked about satisfaction, most patients indicated that they were satisfied or very satisfied; found their vision was improved at distance, intermediate, and near; and did not find night vision difficult or have problems with starbursts, ghosting, halos or glare. Two patients wore glasses occasionally and only for near vision. All patients said they would choose the combination again.

"We know from previous studies that the combination of the apodized diffractive IOL (ReSTOR, Alcon Laboratories) and [multifocal] IOLs works well. The results of this pilot study show that the multifocal IOL can also be combined with the [aspheric IOL] to give good results," Dr. Alsagoff said.