Multifocal lens combo may trump bilateral diffractive IOL implantation

November 1, 2007

Implantation of two different multifocal IOLs-an apodized diffractive lens (AcrySof ReSTOR, Alcon Laboratories) and a refractive lens (ReZoom, Advanced Medical Optics)-may provide increased ranges of near and intermediate vision for a patient undergoing refractive lens exchange compared with bilateral implantation of the diffractive IOL, according to a study of 20 patients.

Key Points

Overland Park, KS-Implantation of two different multifocal IOLs-an apodized diffractive lens (AcrySof ReSTOR, Alcon Laboratories) and a zonal refractive lens (ReZoom, Advanced Medical Optics)-may provide increased ranges of near and intermediate vision for a patient undergoing refractive lens exchange (RLE) compared with bilateral implantation of the apodized diffractive IOL.

Jason E. Stahl, MD, an ophthalmologist practicing at Durrie Vision, Overland Park, KS, and colleagues studied 20 patients, 10 who received the apodizedc diffractive lens in each eye and 10 who received the combination of lenses.

The mean age of the patients was 58.4 years in the combination lens group and 60.1 years in the diffractive lens group. Mean follow-up was shorter in the combination group, at 4.3 months, compared with 9.3 months for the apodized diffractive lens group.

Binocular visual outcomes were determined using ETDRS (distance); an MN read card at 32 inches (intermediate), and an ETDRA near card at 16 inches (near). Patients were not allowed to move the reading card to their "sweet spots" for intermediate and near testing.













Results

"When we looked at binocular uncorrected distance, we found vision in 90% of the combination group eyes at 20/16 or better, compared with 30% of the binocular diffractive group," Dr. Stahl said (Figure 1). "The combination group also did better at intermediate vision compared with those who underwent binocular implantation of the diffractive lens (See Figure 2) , whereas the binocular diffractive lens group performed better than the combination group at uncorrected near vision."

"Looking at the defocus curve for these lenses individually, we found a significantly greater curve for the zonal refractive lens eyes-because of the increased intermediate vision-and this translated into a significantly greater defocus curve for the combination group compared with the bilateral diffractive lens group," he said (See Figure 3).