Comparative Study of Visual Quality and Performance of 3 Diffractive Multifocal IOLs

Chaves, Mario Augusto

Comparative Study of Visual Quality and Performance of 3 Diffractive Multifocal IOLs

Friday, April 25, 2014

KIOSKS (Boston Convention and Exhibition Center)

Mario Augusto Pereira Dias Chaves, MD, Hospital Oftalmológico de Brasilia, Brasilia, Brazil

Wilson T. Hida, MD, Hospital Oftalmologico de Brasilia, Sao Paulo - SP, Sao Paulo, Brazil

Fernando De Bortoli Nogueira, MD, Hospital Oftalmologico de Brasilia, Brasilia, Brazil

André Gustavo Rolim de Araújo, MD, Hospital Oftalmologico de Brasilia, Brasilia, Brazil

Michelle R. Gonçalves, MD, Hospital Universitário Lauro Wanderley - CEROF, João Pessoa, Brazil

Celso T. Nakano, MD, Santa Cruz Eye Institute, Sao Paulo, Brazil

Antonio F. P. Motta, MD, Sao Paulo University, Salvador, Brazil

Narrative Responses:

Purpose
To compare the visual performance and optical quality between three different diffractive multifocal lenses, Tecnis three-piece model ZMA00, Tecnis one piece model ZMB00 and AcrySof ReSTOR one-piece model SN6AD1.

Methods
Prospective nonrandomized evaluation of 108 eyes in 54 patients referred for bilateral cataract surgery, candidates for multifocal lens implantation and less than 1.00 diopters corneal astigmatism in both eyes. Exclusion criteria were preoperative presence of other ocular diseases, ocular surgery, axial myopia, and systemic diseases, besides intraoperative complications, doubts of in the capsular bag implantation and decentralization greater than 0.5 mm from the visual axis. Ophthalmic examination included measurements of uncorrected and distance-corrected distance, intermediate, and near visual acuities; contrast sensitivity and defocus curvevisual acuity for distance; wavefront analysis, reading ability and the degree of patient satisfaction.

Results
Uncorrected distance Visual acuity (UDVA) was 0.09 logMAR to SN6AD1 group and 0.08 for ZMA00 and ZMB00 groups. Corrected distance visual acuity was 0.04 for SN6AD1 and 0.02 for ZMA00 and ZMB00 groups without significance. There was significant improvement of spherical equivalent and UDVA for all groups. SN6AD1 group had better contrast sensitivity at low frequencies but without difference in high frequencies. ZMB00 group obtained similar behavior for intermediate vision to SN6AD1 in Defocus curve but lower near reading distance. ZMA00 group showed worse deflection curve for intermediate vision. ZMB00 presented lower aberration profile compared to SN6AD1 but without significance.

Conclusion
The three lenses promoted excellent quality of vision for distance and near, with better intermediate vision with SN6AD1 and ZMB00 groups. The reading distance and intermediate vision habits are essential in selecting which the best addition choice is for each patient.