That’s the finding of researchers in France and Spain who conducted a study of 304 patients with an average age of 65.6 years who underwent bilateral implantation of the multifocal lens. The surgery was performed to treat cataracts or to reduce the need for eyeglasses via refractive lens exchange.

The researchers had three goals:

1. To determine how many patients would be glasses-free 18 months after surgery.
2. To determine the degree of satisfaction patients had with the multifocal IOL.
3. To identify psychological factors most likely to predict independence from glasses after surgery.

At 18 months after surgery, the researchers found:

• Uncorrected distance visual acuity was 20/25 or better for 88.6 percent of patients.
• Uncorrected near visual acuity was 20/25 or better for 93.3 percent of patients.
• 87.2 percent of patients reported being glasses-free throughout the day.
• 88.2 percent of patients said their vision had improved and 78.0 percent considered their sight problems to be resolved.

In addition, the researchers found that patients who said that wearing glasses was bothersome and also said they preferred their appearance without glasses were three times more likely not to wear glasses after the ReSTOR surgery.

The researchers concluded that bilateral implantation of ReSTOR multifocal IOLs provides patients with good vision at distance and near without glasses, a high rate of spectacle independence and a high degree of satisfaction with their vision after surgery.

A full report of the study appears Clinical Ophthalmology (Vol 4), published online February 2010.

Ed. note:  ReSTOR is one of several brands of multifocal IOLs approved by the U.S. FDA for use in cataract surgery performed in the United States. Discuss your vision correction options with your refractive surgeon during your pre-surgical consultation.

With modern refractive cataract surgery and the use of multifocal intraocular lenses (IOLs), that’s beginning to change.

In a study published in this month’s American Journal of Ophthalmology, researchers report the results of 1-year study that evaluated the safety and effectiveness of the new Tecnis ZM900 multifocal IOL designed to restore vision at all distances after cataract surgery.

The lens is manufactured and sold by Abbott Medical Optics (AMO), based in Santa Ana, California.

The study evaluated the outcomes of 125 patients who underwent cataract surgery in both eyes with bilateral implantation of the Tecnis ZM900 multifocal IOL and 123 patients who underwent the same bilateral procedure with implantation of a conventional monofocal IOL (CeeOn 911A, also made by AMO) in both eyes.

The surgeries were performed at multiple eye surgery centers across the country by cataract surgeons who agreed to participate in the FDA study.

At the end of the 1-year study period, results included:

• 84 percent of patients receiving the Tecnis multifocal IOL achieved the combination of binocular uncorrected distance visual acuity of 20/25 and binocular uncorrected near visual acuity of 20/32, compared with only 6.2 percent of patients receiving the monofocal IOL.
• Visual acuity for reading and reading speed were significantly better among patients receiving the Tecnis multifocal IOL compared with those receiving the monofocal IOL.
• 96 percent of those receiving the Tecnis multifocal IOL reported being able to see comfortably at near without reading glasses, compared with 30 percent of those receiving the monofocal IOL.
• 85 percent of those receiving the Tecnis multifocal IOL in both eyes reported being free from wearing glasses throughout the day, compared with only 5.2 percent of those receiving the monofocal IOL.

The researchers concluded that the Tecnis multifocal IOL provided enhanced near vision, reading visual acuity and speed, depth of focus and spectacle independence compared with a conventional monofocal IOL.

SOURCE:  Evaluation of the aspheric Tecnis multifocal intraocular lens: One-year results from the first cohort of the Food and Drug Administration clinical trial. American Journal of Ophthalmology. April 2010.

Also, the new multifocal IOL has received “presbyopia-correcting IOL” status by the Centers for Medicare and Medicaid Services (CMS), giving Medicare beneficiaries the option to receive the Tecnis Multifocal IOL during cataract surgery for an additional fee to cover the extra cataract surgery cost.

“With this approval, Medicare cataract patients have a new opportunity to enjoy near, intermediate and distance vision without needing glasses,” said Jim Mazzo, senior vice president, Abbott Medical Optics (AMO), in a press release issued by the company on March 10.

According to the company, nearly 9 out of 10 patients undergoing cataract surgery and receiving the one-piece Tecnis Multifocal IOL in clinical trials reported never needing glasses after surgery.

Abbott has begun shipping the new multifocal IOL to cataract surgeons in select markets and plans for full commercial release beginning in April 2010.

More information about the new one-piece Tecnis Multifocal IOL, including important safety information, is available at www.abbottmedicaloptics.com.

SOURCE: Abbott receives U.S. FDA approval for new cataract multifocal intraocular lens. Abbott Medical Optics press release. March 10, 2010.

Researchers in Spain and Portugal evaluated the stereoacuity of 15 farsighted subjects who elected to undergo RLE in both eyes for the correction of farsightedness and presbyopia. None of the participants in the study had cataracts prior to surgery.

Stereoacuity, a sensitive measure of a person’s 3-dimensional vision and ability to perceive depth, was measured with a standard clinical test (Titmus stereotest) before and after RLE surgery.

All participants in the study had excellent stereoacuity scores prior to surgery. After bilateral RLE surgery, 95 percent of patients receiving AcrySof ReSTOR multifocal IOLs in both eyes maintained the same level of stereoacuity they had prior to surgery.

The authors of the study concluded that refractive lens exchange with bilateral AcrySof ReSTOR multifocal IOLs does not affect the depth perception of farsighted patients with normal binocular vision prior to surgery.

SOURCE:  Stereoacuity after refractive lens exchange with AcrySof ReSTOR intraocular lens implantation. Journal of Refractive Surgery. November, 2009.

Acri-LISA bifocal IOL: Study design and methods

The researchers implanted the Zeiss Acri.LISA multifocal intraocular lens (IOL) in both eyes of 85 farsighted cataract patients.

The patients were divided into two groups, based on their amount of pre-operative hyperopia: a low-to-moderate hyperopia group and a high hyperopia group.

At six months after surgery, the following measurements were taken:

• Best spectacle-corrected distance visual acuity (BSCVA)
• Best distance-corrected near visual acuity (BCNVA)
• Best distance-corrected intermediate visual acuity (VA)
• Distance contrast sensitivity (CSF) under bright and medium-low light conditions

Acri-LISA bifocal IOL: Study results

Results of the study from data gathered six months after surgery included:

• Mean monocular BSCVA was between 20/20 and 20/25 in both the low-to-moderate hyperopia group and the high hyperopia group.
• Mean binocular BSCVA was 20/20 in both groups.
• Mean monocular BCNVA was 20/20 in both groups.
• Both groups had similar post-operative contrast sensitivity in both bright and medium-low light conditions.

Conclusions

The researchers concluded that bilateral implantation of the Zeiss Acri.LISA 366D multifocal IOL in patients with low, moderate and high hyperopia produces a full range of vision and satisfactory visual acuity at distant, intermediate and near reference points.

Further studies are needed to confirm these results and to determine the degree of spectacle independence achieved by people who receive bilateral implantation of this and other multifocal IOLs.

SOURCE:  Visual and refractive outcomes in hyperopic pseudophakic patients implanted with the Acri.LISA 366D multifocal intraocular lens. American Journal of Ophthalmology. August 2009.

Tecnis Multifocal IOL: Study design and methods

In a one-year multi-center study, the safety and effectiveness of the Tecnis Multifocal IOL was compared to that of a conventional monofocal IOL also produced by Abbott Medical Optics (AMO).

In the study, 125 patients had the multifocal IOL implanted in both eyes and 125 patients had bilateral implantation of the monofocal IOL, based on the patients’ preference. The study was later expanded to include an additional 225 patients who received bilateral implantation of the Tecnis Multifocal IOL.

One-year results

In a recent issue of EyeWorld, surgeon and researcher Farrell Tyson, MD, reported the one-year results of 118 patients receiving the Tecnis Multifocal IOL and 116 patients receiving the monofocal IOL.

An analysis of the data for these patients revealed:

• Mean uncorrected visual acuity (UCVA) for distance vision for the two groups was essentially the same.
• Mean UCVA for near vision was significantly better (four to five lines smaller on a near vision test card) for the group receiving the Tecnis Multifocal IOL compared to the UCVA of patients receiving the conventional monofocal IOL.
• 84 percent of the Tecnis Multifocal IOL patients attained simultaneous binocular UCVA of 20/25 in the distance and 20/32 at near, compared to only 6 percent of the monofocal IOL patients.
• Although the Tecnis Multifocal IOL patients had lower mean contrast sensitivity scores than the monofocal IOL patients, the difference was not considered clinically significant.
• Halos and glare around street lights and headlights were more common among Tecnis Multifocal IOL patients, but reading vision and speed were significantly better.
• 85 percent of the Tecnis Multifocal IOL patients reported having no need for eyeglasses after surgery, compared to only 5 percent of patients receiving the monofocal IOL.
• 96 percent of the Tecnis Multifocal IOL patients said they functioned comfortably at near without glasses, compared to 30 percent of the monofocal IOL group.

Tecnis Multifocal IOL study: Conclusions

The Tecnis Multifocal IOL enables patients to see significantly better at near after cataract surgery without causing a significant loss of distance vision, concluded Dr. Tyson.

Although the Tecnis Multifocal IOL caused some glare and halos at night, patient satisfaction scores were very high, presumable due to the improved reading ability, reduced need for eyeglasses and large range of functional vision the lens provides.

Based on the one-year results of the study and his surgical experience with the Tecnis Multifocal IOL, Dr. Tyson is convinced bilateral implantation of the new multifocal IOL is the best surgical option for patients who desire the greatest freedom from eyeglasses after cataract surgery.

SOURCE:  Clinical study outcomes of the Tecnis Multifocal. EyeWorld. May 2009. (Supplement: Premium Clinical Options for Cataract and Refractive Surgery, sponsored by Abbott Medical Optics.)