Presbyopia-correcting IOLs do well; not all alike

Fort Worth, TX-Results from quality of life and vision surveys provide insight on patient-based subjective outcomes after bilateral implantation of presbyopia-correcting IOLs, according to Richard Chu, DO.

In a masked study, 73 patients were randomly assigned to bilateral implantation of either the Crystalens AO accommodating IOL (AT-50AO, Bausch + Lomb), the AcrySof IQ ReSTOR +3.0 D add Multifocal IOL (SN6AD1, Alcon), or the Tecnis Multifocal Aspheric IOL (ZMA00, Bausch + Lomb). Patients were asked to complete the 42-item National Eye Institute-Refractive Error Quality of Life survey and the Subjective Vision Questionnaire at 1 and 3 months following second eye surgery. These particular surveys were chosen because they are geared toward refractive surgery patients, said Dr. Chu, medical director, Chu Eye Associates, Fort Worth, TX.

“These three presbyopia-correcting IOLs provide an extended range of functional vision, allowing less dependency on spectacles. However, while studies show they are associated with good performance according to objective measures, little has been studied about patient-based subjective measures,” he noted, explaining the background.

“In our study, the three FDA-approved presbyopia-correcting IOLs have comparably favorable satisfaction scores and seem to offer better spectacle independence than monovision,” he said. “However, our study also helps to highlight the inherent strengths and weaknesses of the three lenses.”

Dr. Chu collaborated with Jay Pepose, MD, PhD, and Mujtaba Qazi, MD, of the Pepose Vision Institute, St. Louis, to conduct the two-center study.

Its results showed that distance vision at 3 months was best with the ReSTOR IOL, followed by the Crystalens and then the Tecnis multifocal. On the other hand, the Tecnis multifocal group had the best near vision scores, followed by the ReSTOR group.

For glare, the Crystalens outperformed both multifocal IOLs at both 1 and 3 months.

“However, it is interesting to see the glare scores improved between 1 and 3 months for all three lenses, which suggests that glare improves over time with neuroadaptation,” Dr. Chu said.

Both multifocal IOLs outperformed the accommodating IOL for ratings of spectacle independence at both 1 and 3 months, but all three IOL groups outperformed monovision, which was compared using historical data.

Dr. Chu receives lecture fees from Bausch + Lomb.

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