Three to 6-month follow-up after bilateral implantation of ReSTOR aspheric +3D Thomas Kohnen, MD Department of Ophthalmology Goethe University Frankfurt am Main, Germany Visiting Professor, Cullen Eye Institute Baylor College of Medicine, Houston, TX, USA This research was supported by Alcon Laboratories, Inc., but Dr Kohnen has no financial interest in the products presented.

Methodology Twenty candidates for bilateral implantation of multifocal IOLs Expressed interest in presbyopic correction Need for intermediate vision Evaluations Preoperatively and at 1, 3 and 6 months postoperative Objective measures Visual acuity Distance (high and low contrast) Intermediate (50, 60, 70 cm) Near (40 cm and near at preferred distance) Defocus curve Subjective measures Patient questionnaires

ReSTOR +3 D Multifocal IOL Central 3.6-mm apodized diffractive disk Adds +3 D at lens plane, yielding +2.5 D at the spectacle plane Of available light energy, half to near focus half to distance focus Outer refractive annulus, devoted to distance focus

Mean Uncorrected Visual Acuity 6 month postoperative 20/20, J1+ 20/25, J1 Visual acuity, Snellen & Jaeger n=17 20/32, J2 Preferred near distance = 37 ± 4 cm

Intermediate UCVA at 50cm 6 month postoperative

Intermediate UCVA at 60cm 6 month postoperative

Intermediate UCVA at 70cm 6 month postoperative

Mean Combined UCVA 6 months postopereative Combined UCVAs: Distance Intermediate: 50 cm, 60 cm, 70 cm Near at preferred distance n=17

Low Contrast Acuity 3 months postoperative photopic Conditions mesopic Conditions n=19 n=19

Visual Disturbances average difficulty score Preop 5 halo glare 4 night vision 3 average difficulty score 2 1 Preop 3 6 Postoperative time, months For the same 17 patients at all time points Based on a 5-point scale: 1 = no difficulty, 5 = severe difficulty

Conclusion Bilateral implantation with ReSTOR SN6AD1 IOLs provided patients with good vision on all measures: Near vision Preferred near focus was ~37 cm Average UCVA was <0.1 logMAR, J1 or better Depth of optimal focus spread from 40 cm to 50 cm Intermediate vision Average UCVAs for all intermediate distances were 0.18 logMAR or better (equivalent to 20/30 Snellen, J2) Distance vision Good high-contrast and low-contrast visual acuity Visual disturbances generally decreased preop to postop