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Pruthvi Kothari, Mitul Vakharia, Kayeromi Gomez; A Clinical Comparison of Visual Outcomes for Tecnis Multifocal +2.75 (ZKB00) and ReSTOR Multifocal +3.00 (SN6AD1). Invest. Ophthalmol. Vis. Sci. 2018;59(9):2203.
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© ARVO (1962-2015); The Authors (2016-present)
Modern surgical techniques have made it possible to replace lenses affected by cataracts with multifocal intraocular lens (IOL) implants, allowing nearly complete restoration of normal visual function and high levels of satisfaction. We performed a retrospective and prospective comparative study in order to examine whether the newer ZKB00 provides improved objective and subjective visual outcomes compared with the older SN6AD1.
A total of 126 patients (252 eyes) aged 28-84 (mean age 65 ± 9) were involved, 64 (128 eyes) with SN6AD1 and 62 (124 eyes) with ZKB00. Patients were part of a consecutive case cohort, only receiving SN6AD1 from 4/2009-12/2014 and ZKB00 from 3/2015-8/2016. Selection criteria were age 18+, cataract in both eyes or refractive error opting for clear lens exchange, corneal astigmatism ≤ 1.0 diopter, and lack of other ophthalmological diseases. All patients had standard phacoemulsification with IOL implantation into lens capsular bag performed by a single surgeon. One month postoperative uncorrected and best-corrected distance and near visual acuities (VA) were obtained from the medical records. Spectacle dependence, photic phenomena, and satisfaction with vision were assessed with a modified visual function index (VF-14). Statistical analysis was done using the Mann-Whitney U and Pearson χ2 tests.
Mean logMAR 1 month postoperative uncorrected distance VA for ZKB00 and SN6AD1 patients was 0.10 ± 0.01 and 0.11 ± 0.01, respectively (p = 0.05). Mean logMAR 1 month postoperative uncorrected near VA for ZKB00 and SN6AD1 patients was 0.04 ± 0.01 and 0.02 ± 0.01, respectively (p = 0.08). Spectacle use was reported by 64% of ZKB00 patients and 39% of SN6AD1 patients (χ2 (1, N = 115) = 7.27, p = 0.007). Sixty one percent of ZKB00 patients and 66% of SN6AD1 patients noted halos or glares (χ2 (1, N = 115) = 0.32, p = 0.57). Overall VF-14 score ranged from 32-100% (average score 88.28%). Mean VF-14 score (%) for ZKB00 and SN6AD1 patients was 87.16 ± 1.74 and 89.46 ± 1.85, respectively (p = 0.06).
ZKB00 did not provide better visual outcomes compared with SN6AD1. More patients with ZKB00 reported dependence on glasses than patients with SN6AD1. These findings might be explained by various factors, including the lower add power in ZKB00 or the longer time period between IOL implantation to VF-14 response for SN6AD1, allowing more time to adapt.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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