1. The Effect of the Restor Multifocal IOL on Frequency Doubling Perimetry Elizabeth Yeu, MD1, Elizabeth Woznak, BS2, Nicole Kesten, BS2, Steven VL Brown, MD, FACS1,2 1 Rush University Medical Center, Chicago, IL 2Chicago Glaucoma Consultants, Chicago, IL and Evanston, IL * NO FINANCIAL INTERESTS

2. ABSTRACT PURPOSE: To determine the effect of ReSTOR Multifocal IOL lenses on FDT Visual Field Perimetry in patients with glaucoma. PURPOSE: To determine the effect of ReSTOR Multifocal IOL lenses on FDT Visual Field Perimetry in patients with glaucoma. SETTINGS: Private Practice - Chicago Glaucoma Consultants: Chicago, IL SETTINGS: Private Practice - Chicago Glaucoma Consultants: Chicago, IL METHODS: This prospective study included 13 patients (25 eyes): Patients had varied ocular history (3 with glaucoma, 3 glaucoma suspects, and 7 without "high risk" for glaucoma). All with phacoemulsification with AcrySof ReSTOR Natural IOL (Alcon) implantation. Participants underwent Frequency-doubling perimetry (FDT) Humphrey Matrix 24-2 (Carl Zeiss Meditec Inc.) testing before and after cataract extraction. The MD and the PSD were recorded along with considerations for accurate test taking. Changes in visual acuity using LogMAR, IOP, and visual complaints post ReSTOR intraocular lens implantation were also noted. METHODS: This prospective study included 13 patients (25 eyes): Patients had varied ocular history (3 with glaucoma, 3 glaucoma suspects, and 7 without "high risk" for glaucoma). All with phacoemulsification with AcrySof ReSTOR Natural IOL (Alcon) implantation. Participants underwent Frequency-doubling perimetry (FDT) Humphrey Matrix 24-2 (Carl Zeiss Meditec Inc.) testing before and after cataract extraction. The MD and the PSD were recorded along with considerations for accurate test taking. Changes in visual acuity using LogMAR, IOP, and visual complaints post ReSTOR intraocular lens implantation were also noted. RESULTS: No significance with data. RESULTS: No significance with data. CONCLUSIONS: Patients with well controlled glaucoma can enjoy the benefits of the ReSTOR lens without compromising their treatment. FDT visual field testing remains consistent and accurate after placement of the ReSTOR IOL. CONCLUSIONS: Patients with well controlled glaucoma can enjoy the benefits of the ReSTOR lens without compromising their treatment. FDT visual field testing remains consistent and accurate after placement of the ReSTOR IOL.

3. Methods and Materials Retrospective Review Patient Demographics Past Ocular Hx: # eyes Normal 14 GLC suspect 5 NTG2 ACG 4 Past Ocular Sx: LPI 4 ALT 2 SLT 1 * One eye had both ALT and SLT. 7 laser treatments for 6 eyes. Mean Age74.77 Age Range 64-83 2 Males, 11 Females : All Caucasian Patients underwent preoperative and postoperative automated visual fields analyzed via the Humphrey FDT 24-2 perimetry (Carl Zeiss Meditec Inc.). Mean deviation (MD) and pattern standard deviation (PSD) were evaluated between the pre- and post-operative visual fields.

4. Results Pre-opPost-op p value Va Mean -.36 logMAR -.08 logMAR MD: FDT -2.25 + 2.60 -2.39 + 2.39 p=0.81 PSD: FDT 4.17 + 2.05 4.06 + 1.69 p=0.69 IOP (mm Hg) 14.47 + 3.55 14.58 + 5.61 SUMMARY VaPre-Op Post-op Mean-.36-.08 MDPre-OpPost-op FDT-2.25 + 2.60-2.39 + 2.39

5. DISCUSSION Prospective study design Prospective study design Prior studies examined pre- and post- cataract surgery patients  MD improved, but PSD unchanged Prior studies examined pre- and post- cataract surgery patients  MD improved, but PSD unchanged This study showed that the post-operative changes in MD and PSD were insignificant This study showed that the post-operative changes in MD and PSD were insignificant Trend of slightly worse MD  secondary to reduced contrast sensitivity Trend of slightly worse MD  secondary to reduced contrast sensitivity The reliability of test taking is unaffected by the Restor IOL The reliability of test taking is unaffected by the Restor IOL Limited incidence of glare and increased halos Limited incidence of glare and increased halos Small sample size Small sample size Only 2 VF were compared Only 2 VF were compared Likely valid results since all patients were experienced in perimetry and the tests were reliable Likely valid results since all patients were experienced in perimetry and the tests were reliable

6. Conclusion PSD values of the FDT Matrix are not affected by the Restor IOL implant. PSD values of the FDT Matrix are not affected by the Restor IOL implant. Glaucoma may be appropriately followed after Restor implantation Glaucoma may be appropriately followed after Restor implantation Reduced contrast sensitivity post ReStor Reduced contrast sensitivity post ReStor Highlighted by the slight depression in MD Highlighted by the slight depression in MD Patients with well controlled glaucoma can enjoy the benefits of the ReSTOR lens without compromising their treatment. FDT visual field testing remains consistent and accurate after placement of the ReSTOR IOL

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