<h4>PURPOSE</h4><p>To compare visual performance of the refractive Array SA40N and the diffractive CeeOn 811E multifocal intraocular lenses (IOLs) and to evaluate the potential benefits of combining both multifocal IOLs in the same patient. </p> <h4>METHODS</h4><p>Two groups of cataract patients were unilaterally implanted with either the CeeOn diffractive (n=10) or the Array refractive multifocal IOL (n=10). Another group was bilaterally implanted with one of each multifocal IOLs (mix & match group, n=10). Visual acuity, spectacle independence, depth of focus, contrast sensitivity, presence of photic phenomena, and patient satisfaction were assessed postoperatively.</p> <h4>RESULTS</h4><p>All eyes achieved good distance visual acuity but better uncorrected near vision was achieved with the CeeOn diffractive design. Contrast sensitivity with either multifocal IOL was at the lower limit of the normal range but when multifocal IOLs were combined in the same patient, contrast sensitivity was not significantly different from phakic controls. Defocus curves revealed a superiority of CeeOn diffractive design for near and Array refractive design for intermediate but mix & match patients performed better overall than the other patients, particularly for intermediate distances, which was reflected by total independence from spectacles in 90% of patients compared to 60% in the other groups. Visual outcomes remained unchanged over time (1 month vs 6 month vs >3 years).</p> <h4>CONCLUSIONS</h4><p>Bilateral implantation with a diffractive multifocal IOL in one eye and a refractive multifocal IOL in the fellow eye is safe and could provide patients with better intermediate vision, increased depth of focus and contrast sensitivity, and also less dependence on spectacles. [<cite>J Refract Surg</cite>. 2008;24:233-242.]</p> <h4>ABOUT THE AUTHORS</h4> <p>From the Department of Ophthalmology, Dokuz Eylül University School of Medicine, Izmir, Turkey.</p> <p>The authors have no proprietary interest in the materials presented herein. </p> <p>Correspondence: Uzeyir Gunenc, MD, Dokuz Eylül Universitesi Tip Fakultesi, Göz Hastaliklari A.D., 35330 Inciralti, Izmir, Turkey. Tel: 90 532 342 37 36; Fax: 90 232 465 11 55; E-mail: <a href="mailto:ugunenc@deu.edu.tr">ugunenc@deu.edu.tr</a></p> <p>Received: November 13, 2006</p> <p>Accepted: March 12, 2007</p>

Staining of the vitreous material with triamcinolone acetonide during vitrectomy and phacofragmentation surgery for luxated nuclei helped in total removal of the vitreous body, thus preventing the aspiration of peripheral vitreous fibrils by the phaco tip, which might induce retinal detachment intraoperatively or postoperatively.

Sedation requirements were similar for cataract surgery under topical and retrobulbar anesthesia.

Based on the limited data in the literature and in this study, it is not possible to make concrete decisions about the benefits and disadvantages of the ThinOptx IOL for longer durations. Intraoperatively, this IOL apparently eliminates the need for enlargement of the corneal incision during implantation. However, the statistical insignificance of induced astigmatisms after microincisions and classical phacoincisions should also be taken into consideration. We conclude that ThinOptx IOL is a pioneering intraocular lens implant that will contribute to the exciting future of cataract refractive surgical procedures. However, both clinical and laboratory investigations are needed to clearly describe the long-term effectiveness of this new rollable IOL.

Neodymium:YAG laser haptic fracturing can be a viable option to cut the fibrosed haptic before explanting any IOL. It was demonstrated in vitro that it is easier to fracture hydrophilic acrylic and PMMA haptics than hydrophobic acrylic and polyvinylidene fluoride haptics.