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Tecnis IOL – Correction for Cataracts and Reading Vision

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    Sandra Belmont, MD, FACS

    Belmont Eye Center
    121 East 61st Street
    New York, NY 10065
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    Gregory J. Pamel, MD

    Pamel Vision & Laser Group
    115 East 61st Street
    Suite 1B
    New York, NY 10021
    (888) 485-5688
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    Dean Dornic, MD

    Laser Eye Center of Carolina
    3701 NW Cary Parkway
    Suite 101
    Cary, NC 27513
    (800) 576-8978
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    Dean Dornic, MD

    Eye Specialists of Carolina
    1609 Booker Dairy Road
    Smithfield, NC 27577
    (800) 576-8978
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The Tecnis Multifocal Lens is the latest multifocal intraocular lens (IOL) to gain FDA approval for the cataract surgical procedure performed in the United States: It was approved in January 2009. The lens is marketed by Advanced Medical Optics (Santa Ana, CA) and competes with the company's own ReZoom Multifocal IOL, which received FDA approval in March 2005.

In addition to being approved for refractive cataract surgery, eye surgeons can also implant the Tecnis Multifocal in refractive lens exchange (RLE) surgery as an "off-label" use. Data suggests that, as with other multifocal IOLs, when the Tecnis lens is implanted during laser cataract surgery the results for presbyopia treatment are improved. Laser cataract surgery with a multifocal IOL should not be confused with other types of laser surgery for presbyopia, such as multifocal LASIK.

(As part of the FDA approval process, the manufacturer of an intraocular lens (IOL) or other medical device produces a "label" to explain its use. Once the device is approved by the FDA, physicians may use it "off-label" for other purposes if they are well-informed about the product, base its use on firm scientific method and sound medical evidence, and maintain records of its use and effects. Tecnis Multifocal IOLs are FDA-approved for use in cataract surgery. Their use in patients having refractive lens exchange surgery is considered an "off-label" use.)

Tecnis Multifocal IOL Design

The Tecnis Multifocal lens has an aspheric front surface and a diffractive multifocal surface on the backside of the lens. The diffractive surface consists of many concentric rings of very fine ridges that create focusing zones that bend light differently to provide a multifocal correction.

The central optical portion (the optic) of the Tecnis Multifocal IOL is available in two materials. One model (ZM900) has a silicone optic and a second model (ZMA00) has a soft acrylic optic. Both models of the lens are flexible and can be folded and introduced into the eye during small-incision phacoemulsification cataract surgery.

The Tecnis Multifocal IOL is designed to have roughly an equal amount of light-focusing ability for distance vision and near vision. (By comparison, many surgeons feel AMO's ReZoom Multifocal IOL tend to be a bit more distance-dominant.) The effective maximum add power in the lens for near vision is +3.00 diopters (D), according to the company.

Effectiveness of the Tecnis Multifocal IOL

According to Advanced Medical Optics (AMO), clinical studies of the Tecnis Multifocal IOL found:

  • Four to six months after surgery, 88 percent of patients receiving the Tecnis Multifocal IOL reported never needing eyeglasses, and nearly 12 percent said they needed eyeglasses only occasionally.
  • Six months and one year after surgery, mean uncorrected (monocular and binocular) distance visual acuity among patients receiving the Tecnis Multifocal IOL was comparable to the uncorrected distance vision among patients receiving a conventional monofocal control IOL.
  • Four to six months after surgery, over 97 percent of patients receiving the Tecnis Multifocal IOL had uncorrected visual acuity of 20/40 or better at both distance and near, compared to only 21 percent of patients receiving the monofocal control IOL.
  • One year after surgery, 95 percent of patients receiving the Tecnis Multifocal IOL implant said they would choose the Tecnis lens again.

Teaming Tecnis Multifocal IOLs with Other Premium IOLs

Though patient satisfaction with Tecnis Multifocal IOLs is very high, some people who have the lenses implanted may experience glare, halos or inadequate near vision. The distance vision may suffer due to the concentric rings in the Tecnis lens that bend light waves as they enter the eye. To overcome these issues and to give patients the best possible vision at all distances, some cataract surgeons choose to implant a Tecnis Multifocal IOL in one eye and a different IOL in the other eye.

Often during the cataract surgery recovery period, a patient's vision improves as he or she adjusts to the new multifocal lens. But, if distance vision seems too compromised with a Tecnis Multifocal IOL implanted in one eye after the recovery period, the surgeon may choose a premium monofocal IOL with aspheric optics in the other eye. The monofocal IOL with aspheric optics does not have the concentric rings that a Tecnis lens has and thus provides excellent distance vision, just like a pair of glasses or contact lenses that have been prescribed solely to correct distance vision. This technique is referred to as modified monovision, and is weighted toward better distance vision than near vision.

Or a cataract surgeon may choose to implant a Tecnis Multifocal IOL in one eye and a different brand of multifocal IOL in the other eye for optimum vision at all distances.

Tecnis Multifocal IOL Cost

According to a leading vision care industry analyst, most cataract surgeons in the U.S. charge approximately $3,500 to $5,000 per eye for Tecnis Multifocal IOL surgery. This total fee includes all aspects of the procedure, including the lens and follow-up exams after surgery.

If you currently have Medicare or other health insurance that covers cataract surgery cost, with a conventional monofocal IOL, you can expect your out-of-pocket contribution for upgrading to the Tecnis Multifocal IOL to be approximately $1,500 to $2,000 per eye.

You can lower your out-of-pocket costs for Tecnis Multifocal IOLs and other elective eye care procedures by setting up a Health Savings Account (HSA) at your bank or contributing to flexible health benefits program at work. Many refractive and cataract surgeons offer financing programs that allow you to pay for the procedure over time at attractive interest rates or interest-free over a limited time frame. These programs make the cost of LASIK surgery, including conventional LASIK, farsighted LASIK and presbyopia LASIK, more affordable for a wider range of patients.

Note: This information is for general education purposes only. It is not to be used as a substitute for medical advice from your eye doctor or refractive surgeon.

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