Visual outcome subjective visual symptoms of the Tecnis
Visual outcome & subjective visual symptoms of the Tecnis ZM 900 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 Z 9000 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. 11 D (range, -1. 00 to +1. 00)
Distance VA
Distance & near VA * 100% had unaided near VA of N 5
Patients’ satisfaction
Visual symptoms
Contrast sensitivity
Discussion • Tecnis MF comparable to Array SA 401 • Tecnis Z 9000 (monofocal) had better distance VA and contrast compared to SI 402 • Tecnis MF achieved better uncorrected and distancecorrected near vision vs. Array SA 401 • 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 SA 401 • 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 ZM 900 and in 39. 1% - 58. 3% of patients with Array SA 401 1 Mester et al. JCRS 2007
Conclusion • The Tecnis multifocal IOL achieves good distance and near vision with minimal visual symptoms in Asian eyes
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