Posters

Comparison of multifocal intraocular lenses (Tecnis ZMB00&trade) and multifocal contact lenses (Biofinity Multifocal&trade) in terms of visual performance and spectacle independence

Poster Details

First Author: N.Quesnel CANADA

Co Author(s):    M. Boileau   L. Lalonde   M. Alarie   K. Gilbert   J. Dufour  

Abstract Details

Purpose:

To determine if there is a difference between a group of patients implanted with the diffractive Tecnis ZMB00&trade multifocal intraocular lens (MFIOL) and another group fitted with the progressive multiple zones Biofinity Multifocal&trade contact lens (MFSCL) in terms of visual performance, incidence of visual disturbances (halos / glare) and spectacle independence as assessed by a questionnaire.

Setting:

Laurentian Eye Institute, Boisbriand (Quebec), Canada University of Montreal, Montreal (Quebec), Canada

Methods:

This prospective study included patients aged 58.8± 8.2 years implanted with MFIOL (n=18) or fitted with MFSCL (n=12). All patients were free of ocular pathology and contact lens patients had no sign of cataracts. Uncorrected binocular visual acuities (UCVA) expressed in LogMar at different distances (far, intermediate and near), contrast sensitivity function (CSF) as well as the near range of clear vision were compared. The subjective appreciation was assessed by a self-administered psychometric questionnaire consisting of 5 questions related to their quality of vision and spectacle independence more than 3 months after the surgery or adaptation with MFSCL. For UCVA, CSF, near range of clear vision and 3 questions related to visual disturbances the statistical significance was tested by the student t test for independent samples. For questions regarding the need for glasses at different distances the non-parametric Mann-Whitney test was used for statistical analysis.

Results:

The results are considered statistically significant if p < 0, 05. There was no statistically significant difference between the 2 groups for the range of clear near vision and distance UCVA. On the other hand, the CSF is better (p = 0, 00) in the MFIOL group (CS = 1.90) than in the MFSCL group (CS = 1.72). The UCVA at intermediate distance is better (p = 0, 00) with MFSCL (UCVA = 0.15) than MFIOL (UCVA = 0.33) but the near UCAV is better (p = 0. 010) in MFIOL patients (UCVA = 0.19) than MFSCL group (UCVA = 0.34). These differences are statistically significant. Patients implanted with MFIOL report more visual disturbances like glare and halos at night than those adapted with MFSCL (p = 0. 01). At near, 42% of patients in MFSCL believe that glasses could improve their vision, while 6% of patients in MFIOL have the same opinion. The reported need for glasses at far (6% in the MFIOL group compared to 8% in the MFSCL group) and intermediate (44% in the MFIOL group compared to 42% in the MFSCL group) was similar with both lenses.

Conclusions:

In this small preliminary study, the MFSCL group seems to perform better at intermediate distance while the MFIOL group has better results for near vision. This result is not surprising because the optical designs of the 2 test lenses differ. Contrary to the Tecnis IOL, the Biofinity uses a zonal aspheric progressive design with a focal point for intermediate distance. Furthermore, for MFSCL patients it is possible to favor voluntarily their distance vision at the expense of their near vision. Our results are in accordance with previous studies showing that the Tecnis MFIOL provided good near vision and spectacle independence. We suggest to ophthalmologists that they adequately assess their patient's needs for intermediate vision before proposing MFIOL to refractive lens exchange or to cataract patients already adapted with progressive multiple zones MFSCL. Further studies should include a greater number of patients and more multifocal intraocular and contact lens types and designs. FINANCIAL INTEREST: NONE