A clinical assessment of visual performance of combining the TECNIS^® Symfony Extended Range of Vision IOL (ZXR00) with the +3.25 D TECNIS Multifocal 1-piece IOL (ZLB00) in subjects undergoing bilateral cataract extraction

Abstract

PurposeTo combine the increased depth of focus of the TECNIS® Symfony intraocular lens (IOL) with a TECNIS Multifocal (MF) low-add IOL (+3.25) to enable a patient to be less dependent on corrective lenses.SettingClinic in Canada.DesignSingle-center, prospective, open-label.Materials and methodsFifty patients were enrolled for bilateral surgery. Patients were implanted with TECNIS Symfony Extended Range of Focus lens in the dominant eye, and TECNIS low-add +3.25 MF IOL in the non-dominant eye. Patients were ≥18 years of age and had best-corrected visual acuity >20/30 in both eyes, pupil size >3.5 mm, and <1.5 D of corneal astigmatism. Patients were evaluated preoperatively, operatively, and postoperatively on Day 1, Day 7, Month 1, and Month 3. Postoperative evaluations at Month 3 were completed by 32 of 50 patients enrolled, and included distance, intermediate and near visual acuity (VA), and subjective outcomes.ResultsThree months postoperatively, binocular results without correction revealed 97% (29/30) of patients had distance VA of 20/20 or better, 97% (29/30) had intermediate VA of 20/25 or better, and 94% (28/30) had near VA of 20/25 or better. At Month 3, the majority of patients reported “none” for visual symptoms of glare (30/30, 100%), halo (29/30, 96.6%), starbursts (29/30), or other – blur (30/30, 100%).ConclusionThree months postoperatively, the combination of the increased depth of focus of the TECNIS Symfony IOL with a TECNIS MF low-add (+3.25) IOL may provide excellent uncorrected VA at near, intermediate, and far distances with minimal ocular symptoms.

<p>Evaluation of Visual and Subjective Outcomes with Mix-and-Match of Three One-Piece Tecnis Multifocal IOLs of Varying Add Powers</p>

“…Another recent study evaluated blended vision in 30 patients with implantation of the Symfony IOL (ZXR00) in the dominant eye and a +3.25 D (ZLB00) in the nondominant eye. 5 At 3 months, binocular results showed excellent uncorrected VA across distances, and very low incidence of visual symptoms such as glare, halo, and starbursts. The primary dysphotopsia seen with this study was halos, and by the 90-day mark, this symptom was tolerable for an overwhelming majority of study patients.…”

“…[1][2][3][4] Mixing different power MIOLs is an emerging trend that has shown promising outcomes. 4,5 Previous research has shown that MIOLs or monovision techniques can provide patients with good visual acuity at various distances and spectacle freedom. [7][8][9][10] Mix-and-match of IOLs with different add powers is an approach that has been used to individualize visual correction.…”

<p>Multivariate Regression Analysis Identifying Predictors of Patient Satisfaction with Multifocal IOLs: +4.00/+4.00 vs +3.25/+3.25 vs +3.25/EDOF</p>

“…A small number of other authors 6-10 have described successful outcomes when mixing different types of presbyopic IOLs. Black 6 reported the binocular results of 50 patients receiving an EDOF (Symfony) in the dominant eye and a Tecnis +3.25 multifocal IOL in the nondominant eye. Patients achieved high levels of uncorrected acuity at all focal distances with 97% 20/25 or better at distance, 97% 20/ 25 or better for intermediate, and 94% had 20/25 or better at near.…”

Comparison of the Clinical Outcomes between Echelette Extended Range of Vision and Diffractive Bifocal Intraocular Lenses

“…Clinical trials have demonstrated the presbyopia-correcting effect in bifocal IOL [5] and ERV IOL [6], respectively, but direct comparison between diffractive echelette ERV IOL and diffractive bifocal IOL, which would be helpful to highlight the design of echelette apart from other confounding factors, remains to be rare. Although Black [7] and de Medeiros et al [8] reported visual outcomes after blended implantation of diffractive echelette ERV IOL and diffractive bifocal IOL, thorough evaluations including visual acuity, defocus curve, CS, modulation transfer function (MTF), Strehl ratio, and subjective evaluation that stress the difference between these 2 IOLs were necessary to provide optimal IOL-selection strategies.…”