Tecnis Multifocal Intraocular Lens Research Articles

How does the world appear to patients with multifocal intraocular lenses?: a mobile model eye experiment

BackgroundTo show how the world appear to patients with multifocal intraocular lens (IOL) using a novel mobile model eye.MethodsThe mobile model eye was composed of an artificial cornea, IOL, IOL chamber, and a camera. A monofocal IOL (Tecnis monofocal IOL) and two diffractive multifocal IOL (ReSTOR, Tecnis multifocal IOL) were used in the study. We went outside to take a picture of the scenery. At night, we stood on a road and took pictures to see how the traffic lights and headlights of cars looked. For an indoor analysis, we approached the Early Treatment Diabetic Retinopathy Study (ETDRS) chart to the model eye from a distance of 95 cm to check the multifocal function of the lenses. In the car, we took pictures of the street and a cell phone in turn to check the multifocal function of the lenses.ResultsTwo multifocal IOLs showed definite multifocal function. Far objects appeared either similarly clear or slightly hazier (depending on the IOL model) than those with the monofocal IOL. In the night vision, there was a mild or severe halo around light sources compared to those with the monofocal IOL.ConclusionWe believe that this mobile model eye can be used to evaluate how the real world appear to a patient with a multifocal IOL, to explain multifocal function of the IOLs, and possible complications in the patients, before performing a surgery.

Objective electrophysiological contrast sensitivity with monofocal and multifocal intraocular lenses: a prospective clinical study

Background: To compare objective electrophysiological contrast sensitivity function (CSF) in patients implanted with either multifocal intraocular lenses (MIOLs) or monofocal intraocular lenses (IOLs) by pattern reversal visual evoked potentials (prVEP) measurements. Methods: Fourty-five cataract patients were randomly allocated to receive bilaterally: apodized diffractive-refractive Alcon Acrysof MIOL (A), full diffractive AMO Tecnis MIOL (B) or monofocal Alcon Acrysof IOL (C). Primary outcomes: 1-year differences in objective binocular CSF measured by prVEP with sinusoid grating stimuli of 6 decreasing contrast levels at 6 spatial frequencies. Secondary outcomes: psychophysical CSF measured with VCTS-6500, photopic uncorrected distance (UDVA), and mesopic and photopic uncorrected near and intermediate visual acuities (UNVA and UIVA respectively). Results: Electrophysiological CSF curve had an inverted U-shaped morphology in all groups, with a biphasic pattern in Group B. Group A showed a lower CSF than group B at 4 and 8 cpd, and a lower value than group C at 8 cpd. Psychophysical CSF in group A exhibited a lower value at 12 cpd than group B. Mean photopic and mesopic UNVA and UIVA were worse in monofocal group compared to the multifocal groups. Mesopic UNVA and UIVA were better in group B. Conclusions: Electrophysiological CSF behaves differently depending on the types of multifocal or monofocal IOLs. This may be related to the visual acuity under certain conditions or to IOL characteristics. This objective method might be a potential new tool to investigate on MIOL differences and on subjective device-related quality of vision.

Spectacle plane add power of multifocal intraocular lenses according to effective lens position

ObjectiveTo evaluate the accuracy of predicting the spectacle plane add power of multifocal intraocular lenses (MIOLs) based on the effective lens position (ELP) using the Haigis formula. DesignRetrospective cross-sectional study. ParticipantsA total of 26 eyes from 18 consecutive patients who underwent phacoemulsification with Tecnis MIOL (Z*B00) implantation. MethodsThe postoperative spectacle plane add power of MIOLs was determined from the monocular defocus curve. The predicted add power error was defined as the difference between the predicted and postoperatively measured spectacle plane add power. The median absolute predicted add power error determined by the preoperatively estimated ELP using the Haigis formula was compared with power error calculated using the value presented by the manufacturer. The correlations among predicted add power error, postoperative spectacle plane add power, and back-calculated ELP were analyzed. ResultsThe median absolute predicted add power error calculated using the Haigis formula (0.13 D) was significantly smaller than that calculated using the value presented by the manufacturer (0.26 D). The predicted add power error determined by the value presented by the manufacturer was negatively correlated with back-calculated ELP. The postoperative spectacle plane add power was negatively correlated with back-calculated ELP in the ZKB00 IOL (n = 21). ConclusionsThe predicted spectacle plane add power of MIOLs using the ELP of the Haigis formula was more accurate than that using the value presented by the manufacturer. The spectacle plane add power of MIOLs decreased as ELP increased.

The importance of angle kappa evaluation for implantation of diffractive multifocal intra‐ocular lenses using pseudophakic eye model

To determine the critical value of the angle kappa in connection with a higher risk of photic phenomena for the AcrySof ReSTOR and Tecnis multifocal intra-ocular lens (MIOL) on a standardized pseudophakic eye model. To analyse the impact of biometric value changes on the critical angle kappa. Geometrical optic rules applied to a suitable optical model of the pseudophakic eye were used to calculate the critical value of the angle kappa for the Tecnis and three types of the AcrySof ReSTOR MIOLs. The angle kappa was defined as critical if the incident ray passed through the first ring's edge area. The influence of different positive optical corneal power (K), effective lens position (ELP) and axial length (AL) on the critical angle kappa (κc) was investigated. The dependence of κc on one of the parameters was studied for standardized values of the remaining parameters. The highest value of the critical angle kappa was evaluated for the Tecnis MIOL. The increase in ELP and K caused an increase in κc under the given conditions. On the contrary, an increase in AL led to lower values of κc. We demonstrated the dependence of the critical angle kappa on the central part of the MIOL and on biometric parameters of the eye, especially on the effective lens position. According to these results, we conclude that shallow anterior chamber depth in connection with a higher angle kappa is an important risk factor for pronounced photic phenomena after implantation of a diffractive MIOL.

Clinical evaluation of a multifocal aspheric diffractive intraocular lens

AimTo evaluate the performance of an aspheric diffractive multifocal acrylic intraocular lens (IOL), ZMB00 1-Piece Tecnis.SettingFive sites across Europe.MethodsFifty-two patients with cataracts (average age 68.5±10.5 years, 35 female) were bilaterally...

Inadvertent implantation of a reversed-optic Tecnis ZM900 multifocal intraocular lens: case report

A 51-year-old woman with age-related cataract had an uneventful phacoemulsification and a Tecnis ZM900 multifocal intraocular lens (IOL) implantation in both eyes. During IOL implantation in the left eye, the optic was unintentionally reversed in the bag and left that way. The refraction surprise was not significant and six months postoperatively the corrected distance visual acuity in both eyes was 20/20 and neither complained of visual discomfort. In conclusion, we found that a reversed-optic Tecnis multifocal IOL in the present case resulted in good final visual acuity without significant differences in aberrations compared to the other eye, and a conservative management can be taken as a safe option.

Two-year follow-up after implantation of diffractive aspheric silicone multifocal intraocular lenses

To evaluate the stability of visual performance after implantation of a diffractive aspheric silicone multifocal intraocular lens (MIOL). Thirty eyes of 15 patients received the Tecnis MIOL ZM900 (Abbot Medical Optics) after cataract extraction at Tokyo Dental College Suidobashi Hospital. The uncorrected and best-corrected distance visual acuities (UCDVA, BCDVA); uncorrected, distance-corrected and best-corrected near VAs (UCNVA, DCNVA and BCNVA); spherical equivalent refraction, spectacle independence, contrast sensitivity and posterior capsule opacification (PCO) were measured at 1 week; 1, 3 and 6 months; and 1 and 2 years postoperatively. Two years postoperatively, the UCDVA was 0.01 logMAR, BCDVA -0.09 logMAR, UCNVA 0.19 logMAR, DCNVA 0.1 logMAR and BCNVA 0.04 logMAR. There was no significant change from 1 week through 2 years. The percent of spherical equivalent refraction error within ± 0.5 diopter was 63.4% at 2 years. No patient required spectacles for reading; two patients have used spectacles for intermediate vision when necessary. One eye underwent Nd:YAG laser posterior capsulotomy because of PCO. The visual performance after implantation of the Tecnis MIOL was stable for 2 years. A low rate of PCO contributed to the long-term visual performance.

Imaging Quality of Bifocal Piggyback Intraocular Lens versus ReSTOR and TECNIS Multifocal Lenses

The imaging quality provided by a piggyback integrated by a monofocal intraocular lens (IOL) + a bifocal IOL of zero power and +3.75 diopters of addition is compared with the optics quality of a simple multifocal IOL of the same power and addition. The imaging quality was evaluated by determining the modulation transfer function (MTF), using an artificial eye simulating in vivo conditions of the anterior chamber, including an artificial cornea and a wet cell containing physiologic solution where the IOL was positioned. The MTFs of the bifocal piggyback for near and distance vision were measured, with pupil diameters of 3 and 5 mm, and compared with the MTFs of an equivalent power of ReSTOR and TECNIS multifocal IOLs measured under the same conditions. The MTFs for distance and near focus of the bifocal piggyback are similar to the MTFs of the ReSTOR and TECNIS multifocal IOLs with the two diameters of pupil. A more accurate comparison, values of average modulation, and Strehl ratio show a greater similitude with ReSTOR than with TECNIS. The bifocal piggyback system provides a similar imaging quality to that obtained with a ReSTOR multifocal IOL and, like the ReSTOR, provides better performance in distance vision than in near vision, whereas the TECNIS multifocal IOL provides the best performance.

Optical Performance Measurement and Night Driving Simulation of ReSTOR, ReZoom, and Tecnis Multifocal Intraocular Lenses in a Model Eye

To measure the optical properties of multifocal intraocular lenses (IOLs) for different pupil sizes. An artificial eye was fabricated that had both the average spherical aberration and chromatic aberration levels found in the human eye. This model eye contained a saline-filled wet cell into which various IOLs can be mounted. Pupil sizes of 3 and 6 mm were explored with the system. Using the model eye, the following IOLs were examined: Alcon ReSTOR apodized diffractive, AMO ReZoom zonal refractive, and Tecnis ZM900 full-aperture diffractive. The modulation transfer function (MTF) for the lenses was calculated. The model eye was also used as a portable device to photograph nighttime driving scenes. For 3-mm pupils, the apodized and full-aperture diffractive IOLs balance contrast between near and distance vision, whereas the zonal refractive IOL performs poorly for near vision. For 6-mm pupils, the apodized diffractive shifts performance from near vision to distance vision, whereas the zonal refractive and full-aperture diffractive IOLs continue to balance performance between distance and near. Subjectively, the night driving photographs showed much more stray light artifacts for the zonal refractive and the full-aperture and apodized diffractive IOLs. Under dark conditions, the shift of optical performance of the apodized diffractive lens towards distance vision reduces artifacts that appear under night driving conditions. These artifacts remain for the zonal refractive and full-aperture diffractive lenses.

Postoperative Changes in Refraction and Anterior Chamber Depth in Different Multifocal Intraocular Lenses

To investigate the axial shift of multifocal intraocular lenses (IOLs) during the first months after implantation and to determine its potential effect on uncorrected distance visual acuity. This study comprised 8 patients (16 eyes) who received the Tecnis multifocal IOL and 8 patients (16 eyes) who received the ReSTOR multifocal IOL. Anterior chamber depth was measured with a Scheimpflug camera, and visual acuity and subjective manifest refraction were determined at 1 day, 1 week, and 1 and 3 months after surgery. The spherical equivalent refraction in the ReSTOR and Tecnis eyes, respectively, was +0.125 +/- 0.412 diopters (D) and +0.306 +/- 0.481 D at day 1, -0.375 +/- 0.280 D and -0.188 +/- 0.438 D at 1 week, -0.475 +/- 0.337 D and -0.018 +/- 0.512 D at 1 month, and 0.297 +/- 0.267 D and -0.036 +/- 0.393 D at 3 months. Anterior chamber depth in the ReSTOR and Tecnis eyes, respectively, was 3.18 +/- 0.1 mm and 3.16 +/- 0.17 mm at day 1, 3.18 +/- 0.10 mm and 3.17 +/- 0.20 mm at 1 week, 3.29 +/- 0.22 mm and 3.18 +/- 0.25 mm at 1 month, and 3.14 +/- 0.19 mm and 3.20 +/- 0.14 mm at 3 months. The change in axial position did not correlate with the change in refraction. Multifocal IOLs change their axial position slightly during the first postoperative months. The ReSTOR IOL showed a myopic change of approximately -0.50 D during this time period, which did not correlate with the change in axial position.

Visual performance and biocompatibility of 2 multifocal diffractive IOLs: Six-month comparative study

To evaluate the distance and near functional capacity, wavefront error and biocompatibility in patients with 2 diffractive multifocal intraocular lenses (MIOLs). Ophthalmology Department of Chieti-Pescara University (Italy). This prospective study comprised 28 eyes of 28 senile cataract patients having phacoemulsification and implantation of the Tecnis ZM900 MIOL (Group 1) and the AcrySof ReSTOR MIOL (Group 2). The main outcome measures, over a 6-month follow-up period, were spherical equivalent, distance visual acuity at high and low contrast, near visual acuity, and defocus curve. Wavefront error was evaluated in both groups. Capsule opacification was also assessed. The high and low contrast uncorrected and best corrected visual acuity for distance did not show statistically significant differences between the 2 groups. The distance corrected near visual acuity was 1.86 +/- 1.66 in Group 1 and 1.93 +/- 1.12 in Group 2. The depth of focus was 4.5 diopters in both groups. The root mean square of total aberration and of spherical and coma aberrations were significantly lower in Group 1 than in Group 2. A higher percentage of patients with Tecnis MIOLs showed a more severe grade of anterior fibrosis. Posterior opacification was minimal and not significantly different between the 2 groups. Diffractive MIOLs were effective in improving functional capacity for distance and near and provided a good quality of vision due to a significant reduction in spherical aberration, particularly in the Tecnis MIOLs. The higher capsular biocompatibility of the ReSTOR MIOL compared with the Tecnis MIOL could ensure long-term stability.

Functional outcomes after implantation of Tecnis ZM900 and Array SA40 multifocal intraocular lenses

To evaluate the functional outcome after implantation of the Tecnis ZM900 multifocal intraocular lens (IOL) (AMO) and the Array SA40 multifocal IOL (AMO). Department of Ophthalmology, Bundesknappschaft s Hospital, Sulzbach, and the Department of Ophthalmology, Marienhospital, Aachen, Germany. In a prospective comparative 2-center trial, Tecnis ZM900 and the Array SA40 multifocal IOLs were bilaterally implanted in 50 patients (50 eyes Tecnis, 50 eyes Array) by 1 surgeon at each center. The following parameters were assessed 30 to 60 days and 120 to 180 days after surgery in both eyes: refraction, pupil size, uncorrected and best corrected visual acuities for distance and near at different contrast levels, and photopic and mesopic contrast sensitivity at different spatial frequencies. Patient satisfaction (spectacle independence, photic phenomena, overall satisfaction) was assessed by a questionnaire. The main differences between the 2 multifocal IOLs were the better uncorrected near visual acuity (P<.001), distance-corrected near visual acuity (P<.001), the mesopic contrast sensitivity at high spatial frequencies (P<.05) as well as greater independence from spectacles in patients with the Tecnis multifocal IOL, resulting in higher levels of patient satisfaction. The aspherical diffractive Tecnis multifocal IOL gave better outcomes than the Array multifocal IOL.