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Objective retinal image quality with four multifocal IOLs (ReSTOR SN6AD1, ReSTOR SN60D3, ReZoom NXG1 and Tecnis ZMA00) and a monofocal IOL (Tecnis ZA9003) 3 months after cataract intervention

Session Details

Session Title: Quality of vision evaluation techniques

Session Date/Time: Tuesday 08/10/2013 | 14:00-16:00

Paper Time: 15:54

Venue: Elicium 2 (First Floor)

First Author: : M.Gil SPAIN

Co Author(s): :    C. Varón   G. Cardona   J. Gispets   N. Roselló   J. Buil  

Abstract Details


A prospective, randomized, double masked, clinical trial was designed to evaluate objective retinal image quality in 184 patients symmetrically, and randomly, implanted with four different multifocal IOL designs (ReSTOR SN6AD1, ReSTOR SN60D3, ReZoom NXG1 and Tecnis ZMA00) and one monofocal IOL (Tecnis ZA9003), three months after cataract intervention.


Ophthalmology Department of Santa Creu and Sant Pau Hospital, Barcelona, Spain.


Patients were symmetrically and randomly implanted with ReSTOR SN6AD1 (n=35), ReSTOR SN60D3 (n=39), ReZoom NXG1 (n=40), Tecnis ZMA00 (n=40) and Tecnis ZA9003 (n=30). Following a complete optometric and ophthalmologic examination, which included best corrected distance visual acuity (BCVA) and best distance corrected near visual acuity (BCNVA), objective quality of vision was assessed with a double pass instrument, (Ocular Quality Assessment System, OQAS™ Visiometrics, S.L., Terrassa, Spain), three months after lens implantation. MTF Cut-off values, Strehl ratio, and OQAS values 100, 20 and 9 were evaluated for 2 and 4 mm artificial entrance pupils and with experimental configurations consisting of a focus of 0 D, -1.5 D and -2.5 D to simulate distance, intermediate and near vision, respectively.


No statistically significant between-group differences were disclosed in terms of age, male versus female ratio, postoperative binocular BCVA and BCNVA. For a pupil of 2 mm and distance focus, statistically significant differences were found in Strehl ratio between NXG1 and SN6AD1 (p=0.027) and SN60D3 (p=0.002), and between SN60D3 and ZMA00 (p=0.009), as well as in OQAS value 20 between SN60D3 and NXG1 (p=0.016) and ZMA00 (p=0.024). SN60D3 and NXG1 were also different in terms of OQAS Value 9 (p=0.046). For the intermediate focus, statistically significant differences were found for all OQAS parameters between NXG1 and SN6AD1 and SN60D3, as well as between ZA9003 and SN6AD1 and SN60D3 (all p<0.05). In addition, ZMA00 and ZA9003 also displayed statistically significant differences in OQAS value 20 and 9 (all p<0.05). Finally, for the near focus, statistically significant differences were found only between NXG1 and SN60D3 and ZMA00 for all OQAS parameters (all p<0.05). Similar statistically significant differences between lens types were encountered for an entrance pupil of 4 mm, particularly between NXG1 and all the other lens types at near focus conditions and for all OQAS parameters.


The present results, which reflect IOL characteristics in optics, profile and add power, may contribute to help surgeons decide on the type of IOL most suitable for each patient. The evaluation of objective retinal image quality may be considered a sensitive technique to disclose differences in performance between lens types, particularly between refractive and hybrid designs, which in turn were found to be influenced by pupil diameter and observation distance.

Financial Interest:


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