AcrySof ReSTOR Research Articles

Visual outcomes after cataract surgery with implantation of a +3.00 D or +4.00 D aspheric diffractive multifocal intraocular lens: Comparative study

To compare the visual performance after cataract surgery with implantation of +3.00 diopter (D) or +4.00 D aspheric multifocal intraocular lenses (IOLs). Department of Ophthalmology, Maastricht University Medical Center, The Netherlands. This prospective study compared the results of bilateral cataract surgery with implantation of a +3.00 D AcrySof ReSTOR SN6AD1 IOL or a +4.00 D AcrySof ReSTOR SN6AD3 IOL. The main outcome measures were binocular uncorrected (UDVA) and corrected distance visual acuities, binocular uncorrected (UNVA) and corrected near visual acuities, binocular uncorrected (UIVA) and corrected intermediate visual acuities, preferred working distance, straylight and contrast sensitivity levels, and wavefront aberrometry measurements. The +3.00 D IOL was implanted in 68 eyes and the +4.00 D IOL, in 46 eyes. The UIVA was significantly better in the +3.00 D IOL group than in the +4.00 D IOL group at 40, 50, 60, and 70 cm. The preferred working distance for near tasks was significantly lower in the +3.00 D IOL group (38.9 cm) than in the +4.00 D IOL group (31.0 cm). The UDVA was better in the +3.00 D IOL group; the UNVA at the preferred working distance was similar in the 2 groups. Contrast sensitivity and intraocular straylight levels were also similar. The mean levels of higher-order and spherical aberrations were lower in the +3.00 D IOL group. Cataract surgery with the +3.00 D IOL resulted in better intermediate vision than with the +4.00 D model without compromising distance and near visual acuity. No author has a financial or proprietary interest in any material or method mentioned.

Wavefront aberration and accommodation power in eyes with aspheric multifocal intraocular lens implantation

目的 评价白内障超声乳化摘出联合非球面衍射型多焦点人工晶状体(MIOL)植入术后患者的波前像差及拟调节力.方法 将进行白内障超声乳化联合人工晶状体植入术且年龄45～70岁的36例50眼患者随机分为2组,MIOL组患者17例25眼植入Acrysof ReSTOR MIOL,单焦点人工晶状体(SIOL)组患者19例25眼植入Acrysof SIOL.术后3个月检查裸眼及矫正远近视力,最佳矫正远视力下的近视力(DCNVA)、波前像差、调制传递函数(MTF)、拟调节力,并比较脱近用镜率.结果 术后3个月,2组患者术后裸眼远视力和最佳矫正远视力差异均无统计学意义(P＞0.05);MIOL组术后裸眼近视力和DCNVA明显优于SIOL组(P＜0.05);球面像差Zernike C12、4阶高阶像差及总体高阶像差比较MIOL组与SIOL组间差异均无统计学意义(P＞0.05);MTF值在各空间频率2组间差异均无统计学意义(P＞0.05).视近拟调节力:MIOL组为(0.925±0.549)D,SIOL组为(0.390±0.235),差异有统计学意义(P＜0.05).脱近用镜率:MIOL组(80%)优于SIOL组(24%)(P=0.000).结论 ReSTOR衍射型MIOL眼能提供良好的远近视力,拟调节幅度较SIOL大,能有效改善白内障患者术后的视觉质量。

Клинико-функциональные результаты хирургического лечения катаракты и пресбиопии с использованием дифракционнорефракционных ИОЛ AcrySof ReSTOR

Клинико-функциональные результаты хирургического лечения катаракты и пресбиопии с использованием дифракционнорефракционных ИОЛ AcrySof ReSTOR

Neodymium:YAG laser rates after bilateral implantation of hydrophobic or hydrophilic multifocal intraocular lenses: Twenty-four month retrospective comparative study

To compare 2-year neodymium:YAG (Nd:YAG) laser capsulotomy rates after bilateral implantation of hydrophobic or hydrophilic multifocal intraocular lenses (IOLs). Private practice, southwest France. This retrospective study included patients with cataract or clear lenses who had bilateral implantation of AcrySof ReSTOR hydrophobic or Acri.LISA hydrophilic acrylic multifocal IOLs between May 2004 and June 2009 by the same surgeon at 1 clinic. Data were extracted from patients' files maintained by the surgeon and ophthalmologists involved in postoperative care. Time from IOL implantation to Nd:YAG laser capsulotomy was analyzed with Kaplan-Meier survival curves. Imbalances in confounding variables were adjusted with a Cox model. The hydrophobic IOL group comprised 80 patients and the hydrophilic IOL group, 76 patients. There were significantly more men in the hydrophobic group (51.3%) than in the hydrophilic group (30.7%) and patients were significantly younger in the hydrophobic group (63.0 years versus 65.8 years) (both P<.01). Eighteen months postoperatively, 4.4% of eyes in the hydrophobic group and 14.6% of eyes in the hydrophilic group required Nd:YAG laser capsulotomy. After 24 months, the respective rates were 8.8% and 37.2% (P<.0001). Eyes in the hydrophilic group had a 4.50-fold (2.28 versus 8.91) higher risk for Nd:YAG laser capsulotomy (P<.0001) that persisted after adjusting for age (relative risk 4.64, 2.32 to 9.29) (P<.0001). Patients younger than 63.5 years in the hydrophilic group were more likely to require Nd:YAG laser capsulotomy. Capsulotomy was significantly less frequent after hydrophobic IOL implantation than after hydrophilic IOL implantation 24 months postoperatively. No author has a financial or proprietary interest in any material or method mentioned. An additional disclosure is found in the footnotes.

Development of a New Subjective Questionnaire: The Freedom from Glasses Value Scale (FGVS)

To develop a patient self-administered questionnaire assessing the added value of complete independence from spectacles (hereafter referred to as glasses) after multifocal intraocular lens (IOL) surgery. Exploratory interviews with five cataract patients and six presbyopic patients with AcrySof ReSTOR IOLs (Alcon Laboratories Inc) implanted in both eyes for at least 6 months were conducted. The questionnaire's conceptual framework was developed after interview analysis. Based on the identified concepts, items were generated simultaneously in French and Spanish using patients' own words, and comprehension tested with six French patients; the Spanish questionnaire underwent clinician review and was further tested with four Spanish patients. French and Spanish versions were accordingly refined. The questionnaire was linguistically validated in UK English and Danish. Interview analysis resulted in the identification of 9 global concepts: global vision, practical constraints related to wearing glasses, impact of eye surgery on the patient's life, improvement of practical issues without glasses, improvement of psychological constraints without glasses, physical appearance/aesthetic aspect, self-image and in the eyes of others, eyesight problems left behind after surgery, and recommendation of surgery to others. The initial version of the test questionnaire contained 23 items; 2 items were deleted and changes were made after clinician review and patient testing. The final questionnaire named Freedom from Glasses Value Scale (FGVS) contained 21 items and four general additional questions. Beyond functional aspects, this qualitative study identified additional benefits in cataract and presbyopic patients living free of glasses after receiving multifocal IOLs. The FGVS now needs to be psychometrically validated (eg, construct validity and reliability).

Intermediate visual function with different multifocal intraocular lens models

To compare visual acuity at different distances after bilateral implantation of 1 of 4 multifocal intraocular lenses (IOLs). Fernández-Vega Ophthalmological Institute, Oviedo, Spain. This study evaluated consecutive patients who had bilateral implantation of a spherical multifocal IOL with a +4.00 diopter (D) addition (add) (AcrySof ReSTOR SN60D3) or an aspheric multifocal IOL with a +4.00 D add (AcrySof ReSTOR SN6AD3), +3.75 D add (Acri.LISA 366D), or +3.00 D add (AcrySof ReSTOR SN6AD1). Six months postoperatively, binocular measurement of corrected distance visual acuity (CDVA) at 4 m, corrected near visual acuity (CNVA) at 40 cm, and corrected intermediate visual acuity (CIVA) at 50, 60, 70, and 80 cm were performed; the defocus curve was also measured. Each IOL model was implanted in 20 eyes (10 patients). All IOL models resulted in good distance vision, with no statistically significant differences between models. Patients with the +3.00 aspheric IOL had statistically better binocular CIVA at 50, 60, and 70 cm (P<.0001) and binocular CNVA at 40 cm (P = 3 x 10(-3)) than patients with the other IOL models. Patients with bilateral multifocal aspheric IOLs with a lower add had better intermediate and distance near visual acuity than patients with bilateral multifocal spherical IOLs or bilateral aspheric IOLs with a higher add.

Differences in Visual Performance of Acrysof ReSTOR IOL in High and Low Myopic Eyes

To determine the differences in refractive and visual results obtained in eyes with high and low myopia after multifocal intraocular lens (IOL) implantation. Monocular visual acuity for distance and near, with and without distance correction, and photopic and mesopic contrast sensitivity were measured at 6 months after surgery in 152 myopic eyes implanted with the AcrySof ReSTOR Natural (SN60D3) IOL. Two groups were created: high and low myopia (76 eyes in each). Monocular best distance-corrected visual acuity was 0.02+/-0.06 logMAR for low myopes and 0.05+/-0.09 logMAR for high myopes. Monocular best distance-corrected near visual acuity was 0.04+/-0.05 and 0.07+/-0.08 logMAR for low and high myopes, respectively. Contrast sensitivity for high myopic eyes under photopic conditions was lower, primarily at high spatial frequencies, in relation to low hyperopic. Differences between both groups were statistically significant for 6 and 18 cycles per degree (cpd) spatial frequencies (p<0.006). At mesopic level, high myopic eyes showed lower values compared to low myopic eyes for all spatial frequencies. However, these differences were only statistically significant for 3, 6, and 12 cpd (p<0.003). The AcrySof ReSTOR IOL provided good visual acuity and contrast sensitivity for both distance and near, with and without distance correction; however, better results were found in low myopic eyes compared to those obtained in eyes with high levels of myopia.

Limbal relaxing incisions at the time of apodized diffractive multifocal intraocular lens implantation to reduce astigmatism with or without subsequent laser in situ keratomileusis

To evaluate the visual and refractive outcomes of limbal relaxing incisions (LRIs) to reduce astigmatism at the time of apodized diffractive multifocal intraocular lens (IOL) implantation. University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA. This retrospective review comprised consecutive patients who had LRIs at the time of lens extraction and AcrySof ReSTOR IOL implantation. A subgroup of patients had subsequent laser in situ keratomileusis (LASIK) for residual refractive error correction. The study evaluated 73 eyes (59 patients); 21 eyes (28.7%) of 59 patients had further LASIK (LRI+LASIK). The mean follow-up was 13.2 months +/- 6.4 (SD). The mean keratometric astigmatism decreased from 1.49 +/- 0.71 diopters (D) preoperatively to 0.56 +/- 0.57 D at the last follow-up (P<.001). Although the LRI+LASIK group had significantly greater corneal astigmatism than the LRI-only group preoperatively (P = .005) and 1 month (P = .030) and 6-months (P = .014) postoperatively, there was no statistically significant difference between the 2 groups at the last follow-up (P = .528). At the last follow-up, the uncorrected distance visual acuity was 20/25 or better and the uncorrected near visual acuity was J1 or better in 32 (76%) of 42 eyes in the LRI-only group and in 17 (81%) of 21 eyes in the LRI+LASIK group. Limbal relaxing incisions at the time of apodized diffractive multifocal IOL implantation, with or without subsequent LASIK, were effective and safe in reducing astigmatism.

Evaluating visual quality of an aspheric multifocal intraocular lens

To evaluate visual quality of patients implanted with the AcrySof IQ ReSTOR multifocal aspheric intraocular lens. Retrospective study of patients who had implantation of an AcrySof IQ ReSTOR SN6AD3 IOL (Group test) or an AcrySof ReSTOR SN60D3 IOL (Group control). Group test comprised 30 patients (35 eyes) and Group control, 40 patients (56 eyes). Three months postoperatively, uncorrected and best corrected distance visual acuity, uncorrected and best corrected near visual acuity, best corrected intermediate visual acuity, the focus depth, higher order aberration, contrast sensitivity and glare sensitivity were measured in both IOL groups. Patients were orally administered a visual function questionnaire including questions about glare, halos, and other visual discomfort. The percentage of patients with uncorrected near, far and intermediate visual acuity > or = 0.5 in test group was 80% (20/35), 82.9% (29/35) and 45.7% (16/35) respectively, and that of the control group was 76.8% (43/56), 80.4% (45/56) and 39.3% (22/56) respectively. There was no statistical difference of uncorrected visual acuity between two groups (P > 0.05). When compare the best distance corrected near, far and intermediate visual acuity between two groups, we can get the same results (P > 0.05). The contrast sensitivity and glare sensitivity in all frequency sect of group test have been more obviously improved postoperatively than that of group control (P < 0.05). The Z(4, 0), Z(4, 2), S3 + S4 and total S of Zernike coefficients was statistically different (P < 0.05). The other Zernike coefficients and higher order aberration did not differ significantly between the two groups (P > 0.05). There were no statistical difference between two groups in focus depth (P > 0.05). Both groups had no serious glare. Though three eyes felt discomfort of halos in group control, only one eye felt the same phenomenon in group test. AcrySof IQ ReSTOR SN6AD3 intraocular lens has negative spherical aberration by an aspherical design in front surface, which makes it could counteract the positive spherical aberration of cornea. Consequently, IQ ReSTOR IOL gave good high-contrast visual acuity at distance, near and intermediate visual acuity.

Visual function after monocular implantation of apodized diffractive multifocal or single-piece monofocal intraocular lens: Randomized prospective comparison

To compare visual function after phacoemulsification with implantation of a multifocal intraocular lens (IOL) or a monofocal IOL. Department of Ophthalmology, Affiliated Hospital of Qingdao University Medical College, Qingdao, Shandong, China. This study comprised patients with unilateral cataract who had phacoemulsification with implantation of an AcrySof ReSTOR SA60D3 multifocal IOL (multifocal group) or an AcrySof SA60AT single-piece monofocal IOL (monofocal group). Postoperative visual function, including uncorrected (UDVA) and corrected (CDVA) distance visual acuity; uncorrected (UNVA), corrected (CNVA), and distance-corrected near visual acuity; and contrast sensitivity were evaluated 1 week, 1 month, and 6 months postoperatively. Patient-reported vision and spectacle independence in the 2 groups were also compared. Of the 161 eyes, 72 were in the multifocal group and 89 were in the monofocal group. The multifocal group had statistically significant better UNVA than the monofocal group from 1 week postoperatively to the final follow-up and statistically significant better CNVA at 6 months (both P<.05). There were no statistically significant differences in UDVA or CDVA between the 2 groups over the 6-month follow-up. The multifocal group had statistically significantly better pseudoaccommodation than the monofocal group; the monofocal group had significantly better contrast sensitivity (both P<.05). Patients with the multifocal IOL reported being more satisfied than those with the monofocal IOL. The multifocal IOL provided better near visual acuity and more spectacle independence than the monofocal IOL.

Outcomes and Patient Satisfaction After Presbyopic Bilateral Lens Exchange with the ResTOR IOL in Emmetropic Patients

To assess efficacy, safety, predictability, stability, and patient satisfaction after presbyopic lens exchange in emmetropic patients. A prospective, nonrandomized, masked, observational case series (self-controlled) of 46 emmetropic eyes of 23 consecutive patients (age range: 50 to 60 years) after presbyopic lens exchange with bilateral AcrySof ReSTOR Natural (SN60D3) intraocular lens (IOL) (Alcon Laboratories Inc) implantation were evaluated. Mean spherical equivalent refraction (SE) was -0.04±0.14 diopters (D) (range: +0.25 to -0.25 D). Monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA), and patient satisfaction were recorded preoperatively and 6 months after surgery. At 6 months postoperative, efficacy index at distance was 1.00. No eye lost ≥2 lines of CDVA, 5 eyes lost 1 line, 24 eyes did not change after surgery, 14 eyes gained 1 line, and 3 eyes gained 2 lines of visual acuity. Safety index at distance was 1.03. All eyes had a manifest SE within ±0.50 D of emmetropia. Mean postoperative SE was +0.14±0.22 D (range: -0.25 to +0.37 D). No eye lost >2 lines of DCNVA, 1 eye lost 2 lines, 3 eyes lost 1 line, 34 eyes did not change after surgery, and 8 eyes gained 1 line of visual acuity. Uncorrected near visual acuity was 0.95±0.07. Safety and efficacy indexes at near were 1.01 and 1.03, respectively. A patient satisfaction questionnaire showed that patients had a high level of satisfaction after presbyopic lens exchange surgery. Presbyopic lens exchange with implantation of the ReSTOR multifocal IOL in emmetropic eyes is an effective and safe procedure for presbyopia correction.

Spheric, Aspheric ReSTOR Intraocular Lens: Three-month Results and Preoperative Clinical Factors Influencing Patient's Satisfaction

Purpose: To evaluate results at three months postoperatively on patient satisfaction and preoperative clinical factors affecting patient satisfaction after implantation of an AcrySof ReSTOR intraocular lens (IOL). Methods: Thirty-three eyes of 33 patients who underwent implantation of spheric/aspheric AcrySof ReSTOR IOL at the Samsung Medical Center of Korea were enrolled in the present study. The uncorrected distance visual acuity (UCDVA), best corrected distance visual acuity (BCDVA), and refractive error were recorded preoperatively and three months after surgery. A questionnaire to assess patient satisfaction was created (score range: 1-5, 5 being the maximum score). Patient age, preoperative UCDVA, BCDVA, corneal astigmatism, and asphericity of IOL were selected as preoperative factors influencing patient satisfaction. Results: One hundred percent and 93.9% of the patients achieved UCDVA and BCDVA of 20/25 or better, respectively. The overall patient satisfaction score was 3.91.0/4.50.7 (p=0.073) and the score of intent to recommend ReSTOR IOL to others was 3.71.0/4.50.6 (p=0.013) with the spheric/aspheric IOL, respectively. The age of patients was negatively correlated with the score of overall satisfaction and the intent to recommend the procedure to others (p=0.024, 0.031). The overall patient satisfaction and intent to recommend of the patients who were less than 55 years old were significantly higher than those of the older patients (p=0.032, 0.039). Conclusions: High UCDVA and BCDVA resulted from the implantation of ReSTOR IOL. The younger the patients were, the higher the resulting patient satisfaction. Implantation of ReSTOR IOL in young patients is recommended.

Intraocular Omni-focal Lens With Increased Tolerance to Decentration and Astigmatism

To measure the optical performance of an extended depth of focus (EDOF) intraocular lens (IOL), which provides an imaging solution for near, intermediate, and distance ranges, and to compare its optical performance to available bifocal IOLs with various extents of decentration and astigmatism aberrations. A special profile that performs interference principle-based focal extension is engraved on the top of a monofocal rigid IOL. An optical bench based on the L&B eye model was used to test the performance in comparison with the bifocal AcrySof ReSTOR SA60D3 lens (Alcon Laboratories Inc). The imaging performances at near, intermediate, and distance ranges were mapped. Different decentration parameters and amount of astigmatism aberration were tested. In numerical simulations and the experimental bench, the EDOF IOL was demonstrated to have good visual acuity in near, intermediate, and distance ranges as well as reduced sensitivity to decentration of up to 0.75 mm and the capability of correcting astigmatism aberrations of up to 1.00 diopter. Extended depth of focus technology is capable of providing clear and focused vision at near, intermediate, and distance ranges. Its high quality imaging is obtained under large decentration conditions and residual astigmatism. This capability broadens the potential use of the technology beyond its application as a simultaneous multifocal lens.

Does the apodized diffractive intraocular lens Acrysof ReSTOR NaturalTM interfere with FDT Matrix perimetry results?

To compare the effect of an apodized diffractive intraocular lens (IOL) (Acrysof ReSTOR Natural) and its yellow counterpart (Natural IQ) on frequency doubling technology (FDT) perimetry results. This study included 37 eyes from 22 patients at the 'Centro Oftalmológico Tranjan' who had undergone uncomplicated phacoemulsification and intraocular lens implantation (17 Acrysof ReSTOR Natural, 20 Natural IQ) performed by the same surgeon, at least three months prior to the study. Patients were subject to frequency doubling technology Matrix Perimeter testing. The patients were between 41 to 79 years old (mean, 70.78 +/- 9.83) in the Natural IQ and 49 to 81 years old (mean, 67.11+/- 11.48) in the Acrysof ReSTOR Natural group, and the mean IOP was 13.64 +/- 2.02 mmHg in the Natural IQ 12.94 +/- 1.39 mmHg in the Acrysof ReSTOR Natural group. The mean pupillary diameter under scotopic conditions was 6.63 +/- 1.16 mm in the Natural IQ group and 7.20 +/- 1.8 mm in the Acrysof ReSTOR Natural group (p=0.20). The mean deviation was -1.83 +/- 3.46 dB in the Natural IQ group and -1.77 +/- 3.94 dB in the Acrysof ReSTOR Natural group (p=0.28). The pattern standard deviation was 3.49 +/- 0.79 dB in the Natural IQ group and 3.20 +/- 0.86 dB in the Acrysof ReSTOR Natural group (p=0.27). There was no difference in the results of FDT Matrix perimetry in eyes that received apodized diffractive IOLs implant or eyes that received monofocal intraocular lens implant.

Outcomes of the AcrySof ReSTOR IOL in Myopes, Emmetropes, and Hyperopes

To evaluate the influence of preoperative ocular parameters on various parameters of postoperative outcome after implantation of the AcrySof ReSTOR intraocular lens (IOL) in myopic, hyperopic, and emmetropic patients. Phacoemulsification and IOL implantation was performed in 56 eyes of 32 patients. According to axial length, 28 eyes were classified as emmetropic, 16 as myopic, and 12 as hyperopic. Patients were examined after 8.2+/-1.8 months (range: 5.7 to 10.5 months) for uncorrected and best distance-corrected visual acuity for far, intermediate, and near vision. A defocus profile was recorded and individual reading distance and distance for lowest intermediate visual acuity were determined. The predictability of three different calculation formulas was evaluated. Patients were interviewed for photic phenomena, quality of night vision, spectacle independence, and satisfaction with visual outcome. Predictability of IOL calculation was not statistically significant among groups using the SRK-T formula, but was significantly different with the Haigis (P=.01) or Holladay I (P=.02) formulas. Uncorrected and best distance-corrected visual acuity for near, intermediate, and far vision were not significantly different among groups. Mean uncorrected far visual acuity was 20/23+/-5.5 letters, 20/25+/-6 letters, and 20/25+/-4.5 letters and uncorrected near visual acuity was 20/25+/-5.5 letters, 20/26+/-4.5 letters, and 20/26+/-7.5 letters for the emmetropic, myopic, and hyperopic groups, respectively. The defocus profile significantly varied among groups; patients of the hyperopic group showed a closer reading distance (29.5 cm) than patients of the emmetropic (32.8 cm) and myopic (34.6 cm) groups. Reading distance was statistically significantly correlated to axial length and anterior chamber depth and thus can be estimated preoperatively. Our data show that preoperative refractive status is a relevant factor influencing postoperative outcome after implantation of a ReSTOR IOL. Predictability of IOL calculation and defocus profile were significantly different for myopic, emmetropic, and hyperopic patients.

Stereoacuity After Refractive Lens Exchange With AcrySof ReSTOR Intraocular Lens Implantation

To evaluate stereoacuity before and after refractive lens exchange (RLE) with AcrySof ReSTOR intraocular lens (IOL) implantation. Stereoacuity was measured using the Titmus stereotest at 40 cm under photopic conditions (85 cd/m(2)) before and after RLE with bilateral AcrySof ReSTOR Natural (SN60D3 model) implantation in 30 hyperopic eyes of presbyopes with low astigmatism (< or =1.00 diopter [D]). Stereoacuity measurements after implantation were compared with those found before surgery. Stereoacuity was unchanged after RLE with pseudoaccommodative IOL implantation. In this population of non-cataractous hyperopes with excellent preoperative stereoacuity (46.42+/-1.36 sec arc), 95% maintained the same level of stereoacuity (48.67+/-1.13 sec arc) after surgery (P=.223). Further calculations predict that this ability to discriminate objects in depth extends to approximately 2 m. Beyond this distance, depth discrimination does not help the visual system. Refractive lens exchange with AcrySof ReSTOR IOL implantation does not affect the binocular ability of the human eye regarding depth perception, the best evidence of binocular function in hyperopic individuals.

Evaluation of long-term visual performance following AcrySof ReSTOR lens implantation

Background Multifocal lens has become popular in cataract surgery. Short-term outcome after AcrySof ReSTOR Lens implantation had been reported by many studies, but long-term visual performance and the effect of posterior capsular opacification (PCO) on visual performance need further investigation. Methods This retrospective study involved 54 eyes from 41 cataract patients implanted with ReSTOR lens, with a follow-up period of 12 to 31 months. Manifest refraction spherical equivalence (MRSE), monocular uncorrected and best-corrected distance visual acuity, uncorrected and distance-corrected near and intermediate visual acuity, contrast sensitivity were assessed. The effect of PCO on visual performance was evaluated by comparing visual parameters between pre and post-capsulotomy. Results Uncorrected distance visual acuity of eyes with MRSE within ±0.5 diopter (D) was better than those with MRSE greater than ±0.5 D (P &lt;0.05). Uncorrected distance and near visual acuity (LogMAR) was 0.10 and 0.17 respectively. Best corrected distance visual acuity and best distance-corrected near visual acuity (LogMAR) was 0.00 and 0.16, a significant improvement was noted after correction (P=0.000, P=0.001, respectively). Contrast sensitivity logarithm was comparable with the normal value at difference spatial frequencies except at 12 cpd. In 5 eyes with mild PCO, post-capsulotomy visual parameters were better than pre-capsulotomy (P &lt;0.05). Conclusion ReSTOR lens provides a good long-term distance and near vision, functional intermediate vision and contrast sensitivity. Mild PCO significantly affects visual performance and needs early intervention.

Implantation of the multifocal ReSTOR apodised diffractive intraocular lens in adult anisometropic patients with mild to moderate amblyopia

Aim:To assess subjective and objective parameters of visual function after implantation of the AcrySof ReSTOR in amblyopic patients.Methods:Phacoemulsification and IOL implantation were performed in six eyes of three patients with...

Refractive lens exchange with spherical diffractive intraocular lens implantation after hyperopic laser in situ keratomileusis

To assess the safety, efficacy, and predictability in eyes that had refractive lens exchange (RLE) with implantation of a spherical diffractive intraocular lens (IOL) after previous hyperopic laser in situ keratomileusis (LASIK). Fernández-Vega Ophthalmological Institute, Oviedo, Spain. This prospective study evaluated eyes that had RLE and implantation of an AcrySof ReSTOR SN60D3 IOL after hyperopic LASIK. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA), and residual refractive errors were analyzed using vector analysis and recorded preoperatively and 6 months postoperatively. The study evaluated 41 eyes of 23 patients. The mean UDVA was 0.189 logMAR +/- 0.175 (SD) preoperatively and 0.113 +/- 0.101 logMAR 6 months postoperatively (P = .009) and the mean CDVA, 0.049 +/- 0.071 logMAR and 0.046 +/- 0.063 logMAR, respectively (P = .44). At 6 months, the efficacy index was 0.87 and the safety index, 1.00. The mean UNVA was 0.014 +/- 0.026 logMAR, with an efficacy index of 1.00. There were no differences in corrected near visual acuity between preoperatively (with spectacle addition) and postoperatively (P = .3); the safety index was 1.01. All eyes were within +/-1.25 diopters (D) of the targeted refraction and 73.17% were within +/-0.50 D. The mean postoperative spherical equivalent was -0.064 +/- 0.513 D. Implantation of a spherical multifocal IOL after hyperopic LASIK was safe, effective, and predictable.

A comparative clinical study of the visual results between three types of multifocal lenses

To compare the patients' visual results after bilateral implantation of the multifocal intraocular lenses (MIOLs): ReZoom (NXG1, Abbott Medical Optics, Abbott Park, IL, USA), Acrysof ReSTOR (SA60D3, Alcon Laboratories, Fort Worth, TX, USA) and Tecnis MF (ZM900, Abbott Medical Optics). A prospective, nonrandomized, comparative trial of 30 patients (60 eyes) aged 46-71 (mean age 56.3 +/- 5.96) divided into three equal groups with implanted bilaterally multifocal lenses: ReZoom IOL, Acrysof ReSTOR IOL and Tecnis MF IOL. The patient selection criteria included no other eye disease besides cataract, and corneal astigmatism of 1.5 diopters or less. In each case, the patients were scheduled to have standard phacoemulsification surgery with IOL implantation into the bag. The postoperative target was emmetropia. The mean follow-up was 6 months in all eyes. The following parameters were assessed/carried out: slit-lamp examination, uncorrected and best spectacle-corrected far and near visual acuity, autorefractometry, intraocular pressure, contrast sensitivity and subjective satisfaction with vision using the VF-14 survey. After surgery, all eyes were within +/-2.0D of target refraction. The mean uncorrected distance visual acuity improved in all cases. The postoperative BCDVA was better than 20/30 at the sixth month in all eyes. Six months postoperatively, the mean uncorrected distance visual acuity (UCDVA) +/- standard error (SE) in the ReZoom, ReSTOR and Tecnis MF groups was 0.11 +/- 0.01, 0.17 +/- 0.02 and 0.14 +/- 0.02 (LogMAR) respectively. All results were significantly better compared to preoperative values (p < 0.001) but did not differ between the study groups (p > 0.05). At the final visit, 75% of eyes in the ReZoom group achieved J1 (Jaeger standard) in comparison to 85% in the ReSTOR and Tecnis MF groups. Eighty percent of patients with bilaterally implanted ReSTOR and Tecnis MF IOL were spectacle-independent, in comparison to 70% with implanted ReZoom IOL. Thirty percent of patients with implanted Rezoom and Acrysof Restor IOL and 20% with implanted Tecnis multifocal IOL reported little or moderate halo and glare. The patients' satisfaction after the procedure was excellent; the scoring on the VF-14 survey ranged from 70-100%, with an average of 93%. No patient was dissatisfied with the results of the surgery. The implantation of tested multifocal intraocular lenses provides good near and distance visual acuity. We did not observe any statistically significant differences between the tested multifocal intraocular lenses with regard to best-corrected distance visual acuity, presence of glare and halo, as well as satisfaction with vision.