Visual Outcomes in 3-Year Randomized Clinical Comparison of Accommodating and 2 Multifocal IOLs

Monday, April 20, 2015: 8:46 AM
Room 3 (San Diego Convention Center)
Robert Edward T. Ang, MD

To evaluate visual outcomes at postoperative year 3 in patients implanted bilaterally with 1 of 3 types of presbyopia-correcting intraocular lenses (IOLs): the accommodative Crystalens AO IOL (Bausch + Lomb), the ReSTOR +3 multifocal IOL (Alcon), and the Tecnis Multifocal IOL (Abbott Medical Optics).

This was an open-label extension of a prospective, randomized, double-masked, 6-month study. Ninety-three patients (186 eyes) with <1.25 D of corneal astigmatism who were eligible for routine cataract surgery were randomized to bilateral implantation with Crystalens AO, ReSTOR +3, or Tecnis Multifocal IOLs during phacoemulsification. Patients who completed month 6 and agreed to enroll in the study extension were followed through postoperative month 36. Outcomes evaluated at postoperative month 36 included binocular high-contrast uncorrected distance visual acuity (UDVA), distance-corrected intermediate visual acuity (DCIVA) (80 cm), and distance-corrected near visual acuity (DCNVA) (40 cm).

The number of patients who participated in the study extension was 24, 26, and 25 in the Crystalens AO, ReSTOR +3, and Tecnis Multifocal groups, respectfully. Postoperative month 36 data were available for all patients except 2 in the ReSTOR +3 group who were lost to follow-up. At postoperative month 36, binocular high-contrast UDVA was similar among groups, binocular high-contrast DCIVA was significantly better with Crystalens AO than with ReSTOR +3 or Tecnis Multifocol (p = 0.003), and binocular high-contrast DCNVA was significantly better with ReSTOR +3 and Tecnis Multifocal than with Crystalens AO (p < 0.001).

Outcomes were stable across 1-year, 2-year, and 3-year follow-up. At postoperative year 3, UDVA was similar with the 3 lenses, DCIVA was better with the accommodative lens, and DCNVA was better with the multifocal lenses.