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VIDEO: Combination of high and low add IOLs improve visual acuities, increase patient satisfaction

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NEW ORLEANS — The combination of Tecnis ZKB00 +2.75 and ZMB00 +4.00 multifocal IOLs improved near, intermediate and distance visual acuities and increased overall patient satisfaction, according to a study presented here.

“In absence of a real trifocal in the U.S., we’re offering multifocality, but in true effect, it’s really only bifocal lens implants that we’re putting in,” Barry A. Schechter, MD, said at the American Society of Cataract and Refractive Surgery meeting. “In order to improve spectacle independence and improve the range of vision in our patients, I’ve decided to mix and match lower and high power IOLs.”

Barry A. Schechter

The prospective, nonrandomized study included patients who received a Tecnis ZKB00 +2.75 D multifocal IOL (Abbott Medical Optics) in the dominant eye and a Tecnis ZMB00 +4.00 D multifocal IOL (Abbott Medical Optics) in the nondominant eye.

Patients had corneal astigmatism of at least 1.25 D at baseline.

Schechter evaluated patients using bilateral uncorrected reading acuity under two different illumination conditions of 33 cm and 50 cm.

Patients were administered the NEI VFQ-25 questionnaire, a survey used to measure emotional well-being and daily social and daily vision functioning for patients who have chronic eye diseases.

Researchers collected patient data at 3 months after IOL implantation.

In eyes implanted with ZMB00, baseline monocular uncorrected visual acuity (UCVA) under 50 cm and 33 cm photopic lighting was 20/80 (P = .3) and 20/63 (P = .376), respectively, compared with 20/40 at 3 months. Binocular UCVA under 50 cm and 33 cm photopic lighting was 20/70 (P = .19) and 20/45 (P = .25), respectively, compared with 20/25 and 20/28, respectively, at 3 months.

In eyes implanted with ZKB00, baseline monocular UCVA under 50 cm and 33 cm photopic lighting was 20/100 (P = .058) and 20/50 (P = .16), respectively, compared with 20/25 and 20/32, respectively, at 3 months. Binocular UCVA under 50 cm and 33 cm photopic lighting was 20/50 (P < .001) and 20/72 (P < .14), respectively, compared with 20/24 and 20/30, respectively, at 3 months.

At 3 months, a majority of patients reported an improvement over baseline in general vision and in near and distance vision activities.

“We are still enrolling patients, so these are interim results for our study,” Schechter said. – by Nhu Te

Reference:

Schechter B. Mixing higher and lower multifocal IOL add powers in patients having uncomplicated cataract surgery to improve spectacle independence. Presented at: American Society of Cataract and Refractive Surgery meeting; May 6-10, 2016; New Orleans.

Disclosure: Schechter reports he has financial interests with Abbott Medical Optics, Alcon, Bausch + Lomb and Omeros.