Intraocular Lens Multifocality Combined with the Compensation for Corneal Spherical Aberration:A New Concept ofPresbyopia-CorrectingIntraocular Lens

Abstract

The outcomes of a prospective consecutive study aimed at evaluating the visual and refractive benefit after cataract surgery with the implantation of the aspheric diffractive multifocal intraocular lens (IOL) Tecnis ZMB00 (Abbott Medical Optics) are reported. A total of 31 eyes of 19 patients (age range, 40 to 81 years) underwent phacoemulsification surgery with implantation of this aspheric multifocal IOL. At 6 months after surgery, postoperative spherical equivalent was within ±1.00 D in 96.8% of eyes, with 94.7% of patients presenting a postoperative binocular far LogMAR uncorrected visual acuity (UCVA) of 0.1 or better. Far best-corrected distance VA improved significantly (p < 0.01), with postoperative values of 0.1 or better in 96.8% of eyes. Postoperative near UCVA was 0.10 (equivalent to J1) or better in 93.55% of eyes. Furthermore, the IOL power was found to be very poorly correlated with the postoperative far LogMAR (r = 0.13) and near UCVA (r = 0.13). In conclusion, the aspheric diffractive multifocal IOL Tecnis ZMB00 provides a restoration of the far and near visual function after phacoemulsification surgery for cataract removal or presbyopia correction, which is predictable and independent from the optical power of the implanted IOL.

Clinical evaluation of a new pupil independent diffractive multifocal intraocular lens with a +2.75 D near addition: a European multicentre study

“…In agreement with this, the level of predictability of the achieved refractive correction was good, with 98.4% of eyes with a postoperative SE within ±1.0 D of emmetropia. These visual and refractive outcomes are consistent with those reported by previous authors for the ZMB00 IOL3–5 7 12 13 and for other modalities of diffractive multifocal IOLs 2 5 6 14–18…”

“…All of them agree on reporting good functional distance and near visual outcomes and therefore confirm the ability of this IOL platform and diffractive pattern to restore the visual function at such distances after cataract surgery 3–5 7 12 13. Lubin´ski et al 12 have recently reported mean values of logMAR UDVA and UNVA of −0.10±0.13 and −0.02±0.12, respectively, at 6 months after cataract surgery with implantation of the Tecnis ZMB00 IOL.…”

“…Several studies have evaluated the clinical outcomes of the multifocal IOL based on the same diffractive platform (Tecnis) but with a higher near addition (+4.00 D) (Tecnis ZMB00) 3–5 7 12 13. All of them agree on reporting good functional distance and near visual outcomes and therefore confirm the ability of this IOL platform and diffractive pattern to restore the visual function at such distances after cataract surgery 3–5 7 12 13.…”

“…The MIOL evaluated in this prospective, multicentre study is a diffractive, bifocal Tecnis MIOL (ZKB00, Abbott Medical Optics, Santa Ana, California, USA) with a near addition of +2.75 D on IOL plane. It is based on the Tecnis diffractive platform, an optimised diffractive optic, controlling and minimising the level of monochromatic ocular spherical aberration7 as well as chromatic aberrations 9. Multifocal IOLs using this technology provide compensation for the positive spherical aberration that is usually present in the cornea10 and also induce a low chromatic dispersion that can result in an improvement in contrast sensitivity 5…”

Grad der binokularen Pseudoakkommodation mit einer apodisierten, diffraktiven und trifokalen Multifokallinse

“…Diffraktive MIOL werden außerdem in der eingearbeiteten Struktur der Lichtverteilung unterschieden. Entweder wird das einfallende Licht auf der gesamten Optikfläche segmental aufgeteilt [9,15], wobei ein Teil der IOL das Licht für die Ferne und der andere für die Nähe bündelt, oder das Licht wird durch die Kombination einer zentralen diffraktiven Optik mit umgebender monofokaler Optik (für den Fernpunkt) verteilt [16]. Durch den zusätzlichen Einsatz der Apodisation lässt sich bei diffraktiven Designs das einfallende Licht zusätzlich in unterschiedlichen Intensitäten auf die einzelnen Brennpunkte verteilen [17].…”