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R. E. Evans, F. A. Bucci, Jr.; Visual Outcomes and Patient Satisfaction of Cataract and Refractive Lensectomy Patients Receiving Bilateral ReZoom Multifocal Implants. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5280.
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To evaluate the visual outcomes and patient satisfaction of cataract (KPE) and refractive lensectomy (RL) pts. receiving bilateral ReZoom (RZ) IOLs when excluding patients with mesopic pupils ≤ 4.0mm and who expressed an extreme need to achieve fine detailed near vision.
A retrospective, single center review of 71 pts. (142 eyes) who received bilateral RZ IOLs was completed. 49 females (69%) and 22 males (31%) underwent 78 KPEs (55%) and 64 RLs (45%). The mean age was 57 yrs. (27 to 87). Visual and refractive outcomes were assessed including UCVA, BCVA, unilateral near and intermediate VAsc, bilateral near and intermediate VAsc, spherical equivalent (SE), and astigmatism. Patients were asked if they would repeat the same course of surgery, and rates of spectacle independence were assessed. Surgery was performed on the dominant eye first with a target refraction of plano to -0.12. If after 2-3 wks. pts. were satisfied with their near vision, the same (pl to -0.12) refractive outcome was targeted in the nondominant eye. If the pt. sought stronger near vision, -0.50 was targeted in the nondominant eye. Patients with mesopic pupils ≤ 4.0mm and those having an extreme need for fine detailed near vision were excluded.
142 eyes had a mean preop VAsc of 20/285 (20/20 to 20/4000). Mean preop BCVA was 20/27 (20/15 to 20/400) and the mean preop SE was -1.06 (-15.87 to +6.62). Preop refractive cylinder was 0.91D. The mean postop VAsc was 20/24, (KPE: 20/25- / RL: 20/22) after all Yags (45%) and refractive surgeries for residual refractive error (33% ),12 LASIK, 2 PRK and 23 microRK/AK were completed. The mean SE and refractive astigmatism postop were -0.22D and 0.37D respectively. The mean bilateral near vision (best focal point) was J1.32 (J1.79 unilateral). The mean bilateral intermediate vision (arm’s length) was J1.88 (J2.79 unilateral). At near bilaterally, 80% (RL) and 75% (KPE) were J1, 95% (RL) and 87% (KPE) were ≥ J2, and 99% (RL) and 97% (KPE) were ≥ J3. At intermediate bilaterally, 80% (RL) and 75% (KPE) were ≥ J2, and 95% (RL) and 86% (KPE) were ≥ J3. Mean follow up was 43 wks (11-96). Eighty-four percent of pts. claimed they never use glasses, and 67 patients (94.4%) said they would have this same surgery again. No pts. received or discussed having an explantation.
High levels of pt. satisfaction were achieved with bilateral RZ resulting from 1) proper pt. selection, 2) aggressive correction of residual refractive error, and 3) an effective combination of functional uncorrected near and intermediate vision (RL: 80% J1 at near & 80% ≥ J2 at intermediate / KPE: 75% J1 at near & 75% ≥ J2 at intermediate).
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