Purchase this article with an account.
P. J. Buckhurst, J. S. Wolffsohn, S. Shah, S. A. Naroo, L. N. Davies; Visual Function in Patient’s Implanted Binocularly With Refractive or a Combination of Diffractive-Refractive Intraocular Lenses. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5621.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To examine the performance of patients implanted binocularly with refractive or a combination of diffractive-refractive intraocular lenses (IOL) in photopic and mesopic conditions.
Fifteen patients implanted with ReZoom refractive IOL in one eye and Tecnis ZM900 diffractive IOL in the other were examined 3 months after surgery. A further five patients implanted binocularly with ReZoom IOLs were assessed. Best distance corrected visual acuity at distance and near (logMAR chart), contrast sensitivity (Pelli-Robson chart) and binocular defocus curves from +1.5D to -5.0D in 0.5D randomised steps were measured in both photopic (85cd/m2) and mesopic (3cd/m2) conditions. In addition, monocular defocus curves were measured to assess binocular summation and binocular reading speed was assessed (MNRead) in photopic conditions.
The visual performance (acuity, contrast sensitivity and reading speed) of implanted binocular refractive IOLs was similar to a refractive / diffractive combination in both photopia and mesopic conditions (p>0.05). Binocular summation of defocus curves in the two eyes implanted with multifocal IOLs increased visual acuity as expected (by 0.06±0.03logMAR binocular refractive; by 0.10±0.03logMAR refractive/diffractive combination). However, this increase was greater for the refractive/diffractive combination (p<0.001). Overall range-of-clear-focus was also increased with the refractive/diffractive combination, whereas the defocus profiles were similar between each eye and binocular vision in patients implanted binocularly with a refractive intraocular lenses; this improvement was not evident in mesopic conditions.
A ‘mix and match’ approach to multifocal IOL implantation enhances binocular summation and increases the range-of-clear-focus. This strategy is therefore recommended when implanting multifocal IOLs to minimise the effects of presbyopia.
This PDF is available to Subscribers Only