One-year Outcome of Monocular Implant of Aspheric Multifocal IOL

Mi Hyun Cheon; Joo Eun Lee; Jae Hyung Kim; Kyung Hoon Kim; Hee Gyung Lee; Jae Yong Kim; Myoung Joon Kim; Hung Won Tchah

doi:10.3341/jkos.2010.51.6.822

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Cheon, Lee, Kim, Kim, Lee, Kim, Kim, and Tchah: One-year Outcome of Monocular Implant of Aspheric Multifocal IOL

Original Article

J Korean Ophthalmol Soc 2010;51(6):822-828.

Published online: 3 June 2010

DOI: https://doi.org/10.3341/jkos.2010.51.6.822

One-year Outcome of Monocular Implant of Aspheric Multifocal IOL

Mi Hyun Cheon, MD, Joo Eun Lee, MD, Jae Hyung Kim, MD, Kyung Hoon Kim, MD, Hee Gyung Lee, MD, Jae Yong Kim, MD, Myoung Joon Kim, MD, Hung Won Tchah, MD

Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

Address reprint requests to Hung Won Tchah, MD, PhD Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center #388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea Tel: 82-2-3010-3680, Fax: 82-2-470-6440, E-mail: hwtchah@amc.seoul.kr

Received 31 December 2010 Accepted 14 April 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate near and far visual acuity, subjective visual symptoms, and patient satisfaction with a monocular implant of aspheric multifocal IOL (AMO Tecnis ZM900^®).

Methods

Thirty eyes of 30 patients received phacoemulsifications and monocular implantation of Tecnis ZM900 IOL. The main outcome measures at postoperative 1 week, 1 month, 3 months, and 1 year were uncorrected and corrected near and distant visual acuity, refractory errors, contrast sensitivity, subjective visual symptoms (glare and halo), spectacle independency, and satisfaction.

Results

At a 3 month postoperative visit, the mean uncorrected near and distant visual acuities were 0.29±0.17 (logMAR) and 0.16±0.12 (logMAR), respectively. At 1 year, the mean uncorrected near and distant visual acuities were 0.25±0.17 (logMAR) and 0.11±0.08 (logMAR). Glare and halo decreased, and contrast sensitivity increased upon 1-year follow-up after monocular implantation of ZM900. Most patients (87%) were satisfied with their visual outcome.

Conclusions

Monocular implantation of multifocal IOL Tecnis ZM900 shows stable surgical outcomes with a high satisfaction rate and enables a high rate of spectacle independency. Postoperative glare and halo, youth, and residual refractive error could be risk factors for dissatisfaction with monocular implantation of multifocal IOL Tecnis ZM900. Proper patient selection can lead to satisfying outcomes.

Keywords: Contrast sensitivity, Glare, Halo, Monocular multifocal intraocular lens, Patient satisfaction

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Figure 1.

Change in contrast sensitivity test at photopic condition (A) and mesopic condition (B) (*p<0.05).

Figure 2.

Spectacle independency, patient satisfaction, whether recommend or not.

Table 1.

Patient characteristics

Number of patients	30
Age	68.88±7.67
Sex (M:F)	7:23
Axial length (mm)	23.54±0.86
IOL power (diopter)	20.75±1.75
Target refraction	-0.04±0.13
Dominant : Non-dominant	19:11
BCVA of op. eye (logMAR)	0.33±0.27
SE of op. eye (diopter)	-0.11±1.57
BCVA of fellow eye (logMAR)	0.25±0.15
SE of fellow eye (diopter)	0.15±1.48

UCVA=uncorrected visual acuity;

BCVA=best corrected

visual acuity; SE=spherical equivalent.

Table 2.

Postoperative distant visual acuity

	Postop 1 week	Postop 1 month	Postop 3 months	Postop 1 year
UCVA (logMAR)	0.21±0.14	0.17±0.15	0.16±0.12	0.11±0.08
BCVA (logMAR)	0.14±0.11	0.11±0.12	0.08±0.08	0.06±0.09
SE (diopter)	0.01±0.59	-0.06±0.32	-0.04±0.27	-0.09±0.40
RE (diopter)	+0.05±0.60	-0.01±0.36	+0.01±0.31	-0.04±0.34

UCVA=uncorrected visual acuity; BCVA=best corrected visual acuity; SE=spherical equivalent; RE=refractive error (postoperative spherical equivalent-target refraction).

Table 3.

Postoperative near visual acuity

	Postop 1 week	Postop 1 month	Postop 3 months	Postop 1 year
NearVA (logMAR)	0.30±0.17	0.28±0.08	0.29±0.17	0.25±0.17
Distant-corrected NVA (logMAR)	0.20±0.17	0.23±0.06	0.13±0.10	0.12±0.10
20/40 or better	18 (60%)	18 (60%)	20 (66.7%)	22 (73.3%)

logMAR 0.2=0.63, logMAR 0.1=0.8 (logMAR 0.5, logMAR 0.3)

Table 4.

Postoperative aberrations (mean± standard deviation)

	Postop 1 month	Postop 3 months	Postop 1 year
RMS total (micron)	0.96±0.35	0.85±0.36	0.83±0.47
HOA (micron)	0.23±0.06	0.13±0.10	0.12±0.10

RMS=root mean square; HOA=higher-order averration

Table 5.

Postoperative glare and halo

	Postop 1week	Postop 1 month	Postop 3 months	Postop 1 year
Glare (≥ moderate)	6/30 (20%)	5/30 (16.6%)	3/30 (10%)	4/30 (13.3%)
Halo (≥ moderate)	7/30 (23.3%)	5/30 (16.6%)	6/30 (20%)	4/30 (13.3%)

Table 6.

Not unsatisfying but not recommendable group characteristics

Young age: 8 eyes (mean age : 56 years)
Male : Female=1 : 7
Postoperative astigmatism : 3 eyes (≥1.0 D)
Myopic shift : 1 eye (-3.8 D)
Previous ocular condition : 1 eye (DM)
General discomfort : 2 eyes (somatoform disorder)

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