Transcript Visual outcome & subjective visual symptoms of the Tecnis

Visual outcome & subjective visual
symptoms of the
Tecnis ZM900 multifocal intraocular
lens in Asian eyes
Dr Colin S.H. Tan
MBBS, MMed (Ophth), FRCSEd (Ophth)
Co-investigators
• Dr Hung Ming Lee
• Dr Han Bor Fam
• Dr Alex K.H. Lau
The authors have no financial or proprietary interests in the subject of
this presentation
Outcomes of cataract surgery
• Patients expect:
– Good functional vision & contrast sensitivity
– Increasingly, good distance, intermediate & near
vision
• There is a decrease in image quality with age, which has
been attributed to increasing optical aberration
• An IOL designed to produce negative spherical
aberration may theoretically compensate for the
positive spherical aberration of the cornea, much like the
crystalline lens in a young person.
The IOL
Tecnis multifocal intra-ocular lens (IOL)
• Advanced Medical Optics, Santa Ana, CA
• Based on Tecnis Z9000 IOL
• Wavefront designed, modified prolate anterior
surface to produce negative spherical
abberration
• Diffractive multifocal optic to the posterior
surface of the lens
Objective
• To evaluate the visual outcome, subjective
visual symptoms and patient
satisfaction in patients who had
implantation of the Tecnis multifocal
intraocular lens (IOL)
Methods
• Retrospective clinical study
• Main outcome measures:
•
•
•
•
Distance and near visual acuities (VA)
patient satisfaction with vision
visual symptoms
spectacles dependence
• Parameters were assessed 6 months postoperatively
Results
• 72 eyes
• Mean age: 62.6 yrs (range, 40 – 78)
• Mean postop SE 0.11D (range, -1.00 to
+1.00)
Distance VA
100
100
95.8
87.5
Percentage
80
65.3
60
Uncorrected
Best corrected
40
20
0
20/30 or better
20/20
Distance & near VA
100
100
Percentage
95.8
Best corrected
80
20/20 & N5
20/25 & N5
* 100% had unaided near VA of N5
Patients’ satisfaction
70
Percentage
60
50
40
Very satisfied
Satisfied
Dissatisfied
30
20
10
0
Far
Intermediate
Near
Visual symptoms
60
Percentage
50
40
none
mild
moderate
severe
30
20
10
0
Glare
Halo
Contrast sensitivity
1.8
1.6
1.4
1.2
1
Contrast
0.8
0.6
0.4
0.2
0
A
B
C
D
E
Discussion
• Tecnis MF comparable to Array SA401
• Tecnis Z9000 (monofocal) had better distance VA and
contrast compared to SI402
• Tecnis MF achieved better uncorrected and distancecorrected near vision vs. Array SA401
• 82.6% reported total spectacle independence for near,
compared to 100% for our study
1
Mester et al. JCRS 2007
2
Mester et al. JCRS 2002
Contrast sensitivity & visual
symptoms
• Tecnis MF had similar photopic contrast sensitivity vs.
Array SA401
• Contrast sensitivity at 12 & 18 cpd higher under
mesopic conditions
• 70% had mild to moderate glare; 43.3% had halos
• Halos reported in 39% of patients with Tecnis ZM900
and in 39.1% - 58.3% of patients with Array SA401
1
Mester et al. JCRS 2007
Conclusion
• The Tecnis multifocal IOL achieves good
distance and near vision with minimal
visual symptoms in Asian eyes