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First Author: F.Carones ITALY
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To present the clinical results over a one-year follow-up from a multifocal IOL with a +2.5 D add power (ReSTOR 2.5, Alcon Laboratories) that is intended to optimize performance at intermediate and far distances for patients in need of a lens for distant dominant lifestyles. The IOL has been implanted on patients either bilaterally or in one eye only, having the other one received a near-distance optimized multifocal IOL with a different add power (ReSTOR 3.0), according to patients needs and expectations.
Outpatient private ambulatory clinic, Carones Ophthalmology Center, Milan, Italy
After cataract or clear lens extraction, the ReSTOR 2.5 was implanted bilaterally in 14 patients, and in the dominant eye of 36 patients who received a ReSTOR 3.0 in the other (non-dominant) eye. Eyes where residual astigmatism after surgery was assessed to be greater than 0.50 D were implanted with the toric version of the two IOLs. Refraction, uncorrected (UCVA) and best corrected visual acuity (BCVA) were tested at 4 meters for distance, at 60 cm for intermediate, and at 40 cm for near. Assessments were performed before and the day after surgery, at 1 week, then at 1, 3 and 6 months after the procedure. A subjective evaluation questionnaire was used to determine spectacle dependence (scale 0= never use to 5= always use), light dependence for reading (scale 0= no dependent to 5= always dependent), patient satisfaction (scale 0= completely unsatisfied to 10= completely satisfied) and quality of vision (description of phenomena, and scale 0= none to 5= very bothering). The results here reported are referred to the longest follow-up available (3 to 6 months).
For all eyes implanted with the ReSTOR 2.5, BCVA was never worse than 20/15. Patients implanted bilaterally with the ReSTOR 2.5 had binocular distance UCVA 20/20 or better in all cases. UCVA at 60 cm was 20/20 or better for all patients when assessed bilaterally. At 40 cm, 5 patients (36%) could read 20/20 using both eyes and all of them were able to read at least 20/50. Spectacle dependence score was 1.8 (range 0 to 3). Light dependence score for reading purposes was 2.1 (range 1 to 4). Satisfaction score was 8.8 (range 5 to 10). No bothering visual symptoms were reported. Patients who received the ReSTOR 2.5 only in the dominant eye had binocular distance UCVA 20/20 or better in all cases. UCVA at 60 cm measured with both eyes was 20/20 or better for 32 patients (89%). At 40 cm, 27 patients (75%) could read 20/20 using both eyes and all of them could read at least 20/32. Spectacle dependence score was 0.8 (range 0 to 3). Light dependence score for reading purposes was 1.8 (range 0 to 4). Satisfaction score was 9.4 (range 7 to 10). No bothering visual symptoms were reported.
According to the subjective patient assessment, the ReSTOR 2.5 provides very good results in terms of vision sharpness and absence of meaningful night-vision problems. When implanted bilaterally, the ReSTOR 2.5 meets the expectations of those patients concerned about quality of vision but willing to gain some spectacle independence (particularly for intermediate tasks like computer and monitor use), who do not care occasionally using reading glasses for their activities at near. The mixed approach (ReSTOR 2.5 implanted in the dominant eye and ReSTOR 3.0 implanted in the non-dominant eye) seems to improve overall spectacle independence and therefore patient satisfaction, without significantly affecting quality of vision and night-time disturbances.
... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented