Three to 6-month follow-up after bilateral implantation of
Three to 6-month follow-up after bilateral implantation of ReSTOR aspheric +3D Thomas Kohnen, MD Department of Ophthalmology Goethe University Frankfurt am Main, Germany Visiting Professor, Cullen Eye Institute Baylor College of Medicine, Houston, TX, USA This research was supported by Alcon Laboratories, Inc., but Dr Kohnen has no financial interest in the products presented. Methodology Twenty candidates for bilateral implantation of multifocal IOLs Expressed interest in presbyopic correction Need for intermediate vision Evaluations Preoperatively and at 1, 3 and 6 months postoperative Objective measures Visual acuity Distance (high and low contrast) Intermediate (50, 60, 70 cm)
Near (40 cm and near at preferred distance) Defocus curve Subjective measures Patient questionnaires ReSTOR +3 D Multifocal IOL Central 3.6-mm apodized diffractive disk Adds +3 D at lens plane, yielding +2.5 D at the spectacle plane Of available light energy, half to near focus half to distance focus Outer refractive annulus, devoted to distance focus Mean Uncorrected Visual Acuity 6 month postoperative 40 cm 50 cm 60 cm 70 cm
4m 20/20, J1+ Visual acuity, logMAR 0 20/25, J1 0,1 0,2 n=17 20/32, J2 0,3 Preferred near distance = 37 4 cm Visual acuity, Snellen & Jaeger Near @ Preferred Distance Intermediate UCVA at 50cm 6 month postoperative
Percent of patients 100 82 88 n=17 80 60 41 40 20 12 0 20/20 or better 20/30 or better 20/40 or better 20/>40
Intermediate UCVA at 60cm 6 month postoperative 94 Percent of patients 100 n=17 76 80 60 40 35 20 6 0 20/20 or better 20/30 or better
20/40 or better 20/>40 Intermediate UCVA at 70cm 6 month postoperative Percent of patients 80 65 71 n=17 60 40 29 20 6 0 20/20 or better 20/30 or
better 20/40 or better 20/>40 Mean Combined UCVA 6 months postopereative Combined UCVAs: Distance Intermediate: 50 cm, 60 cm, 70 cm Percent of patients Near at preferred distance 100 81 80 n=17 61 60 40 88
32 20 12 0 20/20 or better 20/25 or better 20/30 or better 20/40 or better 20/>40 Low Contrast Acuity 3 months postoperative photopic Conditions mesopic Conditions 12,50%
25% 0 0,1 0,2 0,3 Chart contrast level D is ta n c e v is u a l a c u ity , lo g M A R D is ta n c e v is u a l a c u ity , lo g M A R Chart contrast level 12,50% 25% 0 0,1 0,2
Postoperative time, months For the same 17 patients at all time points Based on a 5-point scale: 1 = no difficulty, 5 = severe difficulty Conclusion Bilateral implantation with ReSTOR SN6AD1 IOLs provided patients with good vision on all measures: Near vision Preferred near focus was ~37 cm Average UCVA was <0.1 logMAR, J1 or better Depth of optimal focus spread from 40 cm to 50 cm Intermediate vision Average UCVAs for all intermediate distances were 0.18 logMAR or better (equivalent to 20/30 Snellen, J2) Distance vision Good high-contrast and low-contrast visual acuity Visual disturbances generally decreased preop to postop
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