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Session Title: Multifocal Technology and Comparative studies
Session Date/Time: Tuesday 08/10/2013 | 08:00-10:30
Paper Time: 09:00
Venue: Auditorium (First Floor)
First Author: : R.Ruiz Mesa SPAIN
Co Author(s): : A. Aramburu Del Boz
To assess clinical outcomes and subjective experience after implantation of three different types of diffractive intraocular lens (IOL), the FineVision trifocal (PhysIOL), Tecnis-One-Multifocal (Abbot) and the AcrySoft Restor +3,0 D (Alcon).
Clķnica Oftalvist CIO Jerez, Jerez de la Frontera, Spain.
Twenty-eight eyes of fourteen patients were implanted consecutively with the FineVision trifocal IOL. This IOL is fully diffractive over the entire optic and presents a decrease of the diffractive step height from the center towards the periphery to improve distance vision in mesopic conditions. Fourty-eight eyes of twenty-four patients were implanted with the pseudoaccomodative Tecnis-One-MF IOL. This IOL has been designed with pupil-independent full diffractive posterior surface. The amount of near addition that incorporates is +4.00 diopters (D) at the lens level, an amount that is equivalent to 3.00D at the spectacle plane. Thirty-six eyes of eighteen patients after implantation of pseudoaccomodative AcrySoft Restor +3 D IOL were also evaluated. This IOL has a central apodized refractive and peripheral diffractive optic profile, to provide a full range of quality vision, neart to distant. Outcomes recorded 6 months postoperatively were uncorrected and distance-corrected (far, near, intermediate) visual acuities, contrast sensitivity (under photopic and mesopic condition), patients" quality of life (visual function questionnaire, halos and glare presence, overall satisfaction) and posterior capsular opacification (PCO).
The mean binocular visual acuity was 0.032 logMAR in the patients with FineVision IOL implantation, 0.026 logMAR in the group of Tecnis-One-MF and 0.003 logMAR in the AcrySoft Restor patients. The mean intermediate and near visual acuity were 0.098 and 0.072 logMAR in the FineVision group, 0.162 and 0.040 logMAR in the Tecnis-One-MF patients and 0.143 and 0.057 logMAR in the AcrySoft Restor group. In the patients with FineVision IOL we observed grade 0 (absent) PCO in 95% and 5% of grade 1 (mild). In the group of Tecnis-One-MF we odetected 94% of grade 0 and 6% of grade 1. In the patients with AcrySoft Restor IOL implantation an 88% of grade 0 and 12% of grade 1 opacification was detected. The photopic contrast sensitivity was within the standard normal range with the FineVision IOL und slightly reduced with the other lenses. Under scotopic condition it was inferior in all the patients. In the three groups about 70% of patients manifist the presence of dysphotopsias but these were bearable in all cases. Also, 90% of AcrySoft Restor patients noted reading difficulty with dim light while 72% of Tecnis-One-MF patients reported difficulties when working with computers.
The Acrysoft Restor and Tecnis-One-MF IOLs consistently improves near and far visual acuity and, in a lesser degree, the intermediate vision. We have obtained the best uncorrected intermediate vision with the FineVision lens, maintaining suitable distance and near vision performance. This lens, implanted binocularly show very good visual acuity at all evaluated distances. The third focal point is usable by the patient and does not create more dysphotopsias than other difractive IOLs. Diffractive trifocal IOLs give high rates of spectacle freedom and overall patient satisfaction.
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