LogMAR-Analysis of multifocal intraocular lenses: Clinical performance A. Mannsfeld, I.-J. Limberger, A. Ehmer, M.P. Holzer, G. U.Auffarth International Vision Correction Research Centre University of Heidelberg, Department of Ophthalmology, Germany; Acting-chairman: G.U. Auffarth, MD Dr. Holzer receives research and travel reimbursement from 20/10 Perfect Vision, AMO, Haag-Streit, Oculus and WaveLight. None of the authors have a financial interest in the subject matter of this poster.

The implantation of multifocal intraocular lenses is gaining more and more importance by offering patients spectacle-independence postoperatively. Purpose of this clinical prospective trial was to compare two diffractive and refractive multifocal intraocular lenses (MIOLs) in terms of postoperative functional results. Moreover it should be tested if there is a difference between subjective and objective refraction between those two optical principles. Background Annett Mannsfeld, Msc

TECNIS® ZM 900 (AMO) 3-piece, silicone, 6 mm optic diameter, 12 mm total diameter diffractive posterior surface  two focal points between near and distance vision near addition +4.0 D pupil size independent prolate anterior surface to compensate for corneal spherical aberrations ReZoom™ (AMO) 3-piece, acrylic, 6 mm optic, 13 mm total diameter five refractive zones: 100% light transmission over all five optical zones transitions are supposed to provide intermediate vision pupil size dependent total near addition D Background Multifocal intraocular lenses Annett Mannsfeld, Msc

Tecnis ZM 900 age ± 9.24 years ( ) 20 patients (14 female, 6 male) 39 eyes were examined ReZoom age ±15.73 years ( ) 23 patients (17 female, 6 male) 36 eyes were examined Patients and Methods After a mean follow-up time of ± months (range 3 to 41 months after surgery), the patients were re-examined evaluating functional results: Un- and best-corrected distance visual acuity was evaluated using the Nidek CP 690 DIN/ISO chart projector (OCULUS). Un-, distance- and best- corrected near visual acuity was tested using the Zeiss near reading charts in 33 cm distance with logarithmic increments. Furthermore, subjective and objective refraction data measured with the Nidek AR-660A autorefractor was compared. Annett Mannsfeld, Msc

The postoperative monofocal uncorrected distance visual acuity (UCDVA) was 0.12 ± 0.14 logMAR (ReZoom) and 0.17 ± 0.12 logMAR (Tecnis). Bestcorrected monofocal distance visual acuity (BCDVA) was 0.0 ± 0.11 logMAR with ReZoom and 0.04 ± 0.08 logMAR with Tecnis. Results Distance visual acuity Comparison UCDVA Comparison BCDVA Annett Mannsfeld, Msc

UCNVA was 0.05 ± 0.20 logMAR with Tecnis and 0.29 ± 0.23 logMAR with ReZoom (monocular). Both IOLs achieved a very good bestcorrected visual acuity of 0.0 vs logMAR (Tecnis vs. ReZoom). The ReZoom patients required an additional correction of ± 1.01 D in average to improve UCNVA, the Tecnis patients needed only ± 0.08 D near addition Results Near visual acuity ReZoomZM 900 Mean value near addition (D) ±Standard deviation Comparison near additon Annett Mannsfeld, Msc

Results Comparison autorefractor – subjective refraction Autorefractor revealed a bestcorrected visual acuity of 0.16 ± 0.18 (ReZoom) and 0.05 ± 0.08 (Tecnis), while subjective BCDVA was 0.04 ± 0.08 logMAR with Tecnis and 0.0 ± 0.11 logMAR with ReZoom objective distance visual acuity ReZoom subjective distance visual acuity ReZoom objective distance visual acuity ZM 900 subjective distance visual acuity ZM 900 mean value visual acuity (logMAR) ± standard deviation Comparison BCDVA Annett Mannsfeld, Msc

Results Comparison autorefractor – subjective refraction The ReZoom eyes showed a statistically significant difference (P = 3.86E-13, t-Test) with a mean spherical equivalent of ± 0.83 D (objective) vs ± 0.49 D (subjective) % of eyes showed a spherical equivalent between -1.0 and -1.5 D with the autorefractor. Subjectively evaluated % of eyes were within ± 0.5 D. In the Tecnis group, subjective and objective refraction were comparable with only slight differences being not statistically significant. Objectively, a mean spherical equivalent of 0.32 ± 0.83 D was calculated compared to 0.51 ± 0.2 D subjectively Spherical equivalent (D) Frequency objective SE ReZoom subjective SE ReZoom Spherical equivalent (D) Frequency objective SE ZM 900 subjective SE ZM 900 Annett Mannsfeld, Msc

The Tecnis MIOL showed better near visual acuity results while ReZoom offers better distance visual acuity results and reading glasses are often necessary postoperatively. Autorefractor measurements in diffractive multifocal lenses are possible with a high accuracy between objective and subjective refraction. In refractive lenses autorefractor measurements are not reliable with differences of -1 D compared to the subjective refraction. Conclusions Annett Mannsfeld, Msc

G.U. Auffarth, MD A. Ehmer, MSc M.P. Holzer, MD I.J. Limberger, MD A. Mannsfeld, Msc T.M. Rabsilber, MD M.J. Sanchez, MD I. Schmack, MD