Comparison of 2 Models of Aspheric Diffractive Multifocal IOL Dr. Magda Rau, Augenklinik Cham Germany PRESBYOPIA AND REFRACTIVE SURGERY WITH LENSECTOMY AND TECNIS TM ZM900 MULTIFOCAL FOLDABLE IOL AuthorM. Rau    GERMANY Co Authors  

Tecnis ZM900 silicon Tecnis ZMA00 acrylic

Clinical study prospective case study from July 2008 until December 2008 40 diffractive MIOLs in 40 eyes of 20 patients Tecnis ZM900 silicon in one eye, Tecnis ZMA00 acrylic in the other eye of the same patient -mean age 76

Material and Methods Selection criteria Exclusion criteria: Cataract bilateral Strong desire to achieve spectacle independence Willingness to accept potential optical side effects and longer optical adaptation period after surgery No retinal and optic nerve pathology Exclusion criteria: Patients with astigmatism of more than 1.25 D Patients who had never been satisfied with prescription of multifocal glasses Patients with overly high expectations for postoperative vision, anxious or demanding persons

Similarities ZMA00 : ZM900 Biconvex 6.0 mm optic Wavefront-designed aspheric anterior surface Full diffractive posterior surface pupil-independent Light distribution 50/50 +5D to +34D in 0.5D increments OptiEdge™ design Optical power add +4.0D to optimize acuity at preferred reading distance of 33 cm

Differences: ZMA00 : ZM900 ZM900 ZMA00 ZMA00 Hydrophobic Acrylic Silicone Haptics: 13.0 mm Modified C Blue PMMA 5° Haptics: 12.0 mm Cap C Clear PVDF 6°

Video implantation of Tecnis ZMA00

Results Mean BCVA for distance (3 months post-OP) Mean correction: ©Rau

Mean UCVA for distance (3 months post-OP) ©Rau

Mean UCVA for intermediate (3 months post-OP) ©Rau

Mean UCVA for near (3 months post-OP) ©Rau

contrast sensitivity Tecnis ZMA00 acrylic Tecnis ZM900 silicon test with functional acuity contrast method – developed by B.P. Ginsburg ©Rau

Are you satiesfied with the achieved optical results? ©Rau

Do you experience glare? ©Rau

Do you notice halos? ©Rau

contrast sensitivity using Pelli-Robson-charts ©Rau

contrast sensitivity Tecnis ZMA00 acrylic Tecnis ZM900 silicon test with functional acuity contrast method – developed by B.P. Ginsburg Tecnis ZMA00 acrylic Tecnis ZM900 silicon ©Rau

reading speed and reading quality in comparison result reached using Radner Charts under photopic (100 cd/m2) conditions and 40cm distance ©Rau

Conclusion The acrylic IOL is easier to implant because the haptics are more stable and provide better centration. Both MF IOL provide comparable distance, intermediate and near visual acuity. Halos and glare are also comparable. The contrast sensitivity examined with Peli-Robson charts was better for multifocal Tecnis acrylic, the contrast sensitivity curve of Guinsburg box better for acrylic as well. Faster reading speed was achieved in acrylic group. In our study the MF Tecnis acrylic in comparison to the MF Tecnis silicon showed improvement in contrast sensitivity and reading speed. The acrylic lens achieved also higher patient satisfaction.