Visual outcome

1
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)
2

• 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
3
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.

4
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

5
Objective

• To evaluate the visual outcome, subjective visual
  symptoms and patient satisfaction in patients who
  had implantation of the Tecnis multifocal
  intraocular lens (IOL)

6
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 post-operatively

7
Results

• 72 eyes
• Mean age 62.6 yrs (range, 40 78)
• Mean postop SE 0.11D (range, -1.00 to 1.00)

8
Distance VA
9
Distance near VA
100 had unaided near VA of N5
10
Patients satisfaction
11
Visual symptoms
12
Contrast sensitivity
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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
  distance-corrected 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
14
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
15
Conclusion

• The Tecnis multifocal IOL achieves good distance
  and near vision with minimal visual symptoms in
  Asian eyes