Multifocal IOL mixing, matching provides excellent visual outcomes
May 13, 2009
Multifocal intraocular lenses (IOLs) are implantable lenses designed to provide clear vision at all distances after cataract surgery or refractive lens exchange (RLE).
But no multifocal IOL is perfect and will satisfy all the vision needs of all patients. European ophthalmologists performing refractive cataract surgery are finding that "mixing and matching" multifocal IOLs — using one type of multifocal IOL for one eye and a different type for the other eye — may be a superior alternative to implanting the same type of lens in both eyes.
Multifocal IOL mixing: Study design
In a recent multi-center study, a total of 240 patients received a ReZoom multifocal IOL (Abbott Medical Optics) in their distance-dominant eye and a diffractive aspheric multifocal IOL (Tecnis ZM900, Abbott Medical Optics) in their other eye.
The choice of lenses was based on data indicating that the ReZoom multifocal IOL provides very good distance and intermediate vision, but may not provide adequate uncorrected near vision for some patients; and that the aspheric diffractive multifocal IOL (Tecnis ZM900) provides very good near vision, but may provide more limited intermediate and distance vision.
The study was launched in June 2006 at 12 surgical centers in Belgium, Spain, Italy and Germany. Patients enrolled in the study had a median age of 64 years and underwent either bilateral cataract surgery or a combination of cataract surgery on one eye and RLE on the other eye.
Follow-up visits were scheduled at three intervals: one to two days, 30 to 60 days, and four to six months after surgery. A total of 90 patients appeared for their final follow-up visit.
During the post-surgical exams, measurements of uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) were taken, and patients were interviewed about visual symptoms and their overall satisfaction.
Multifocal IOL mixing: Results
Analysis of data gathered at the final follow-up visit revealed the following results:
- Mean binocular UCVAs were: 20/20 (distance), between 20/30 and 20/40 (intermediate) and between 20/20 and 20/25 (near).
- 96.5 percent of patients did not need to wear prescription eyeglasses or reading glasses.
- 100 percent said they would undergo the same procedure again.
- 98 percent said they would recommend the procedure to a friend.
Data on visual symptoms was available for 90 eyes and revealed that 39 percent of these patients reported halos (nearly always mild), 7.8 percent reported glare at night, and 4.4 percent reported glare daytime glare.
Multifocal IOL mixing: Conclusions
The researchers concluded that the mix-and-match approach to the use of multifocal IOLs provides excellent functional vision with very high rates of patient satisfaction and spectacle independence after surgery.
They also noted that the results of this study are consistent with other investigators' reports of favorable results using this approach.