Long-term Experience With Mixing and Matching Refractive Array and Diffractive CeeOn Multifocal Intraocular Lenses

Abstract

<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>

Long-term Visual Function and Patient Satisfaction After Bilateral Implantation and Combination of Two Similar Multifocal IOLs

“…Studies have shown how the concept of mixing and matching multifocal IOLs allows a wide range of vision at different distances with a high level of patient satisfaction. 15,17,18 However, the main shortcoming of refractive multifocal IOLs seems to be the higher rate of photic phenomena compared to the diffractive multifocal IOLs. 19 This drawback can penalize the mix and match technique in terms of quality of vision and patient satisfaction.…”

Visual outcome comparison of unilateral versus bilateral implantation of apodized diffractive multifocal intraocular lenses after cataract extraction

“…The aforementioned longitudinal study found that 9.8% of an elderly population sample (n Z 6199) had only one IOL at the 2002 time pointdseveral years before AcrySof ReSTOR IOLs were available. Several studies [23][24][25][26] are available to guide the surgeon in mixing or matching multifocal technologies; however, many patients present with 1 monofocal IOL and 1 phakic cataractous eye. This study shows that a monofocal-multifocal IOL combination can produce good near UCVA (0.09 logMAR), better than might be expected by matching IOLs to produce bilateral monofocal IOLs, which yielded 0.41 logMAR in 1 study.…”

Short‐term outcomes of combined implantation of diffractive multifocal intraocular lenses with different addition power

“…). Previous studies revealed that patients who underwent combined implantation of refractive and diffractive types of MIOLs had better near or intermediate visual acuity (VA) than patients who underwent bilateral implantation of monofocal IOLs or unilateral MIOL implantation (Gunec & Celik ; Chen et al. ; Yoon et al.…”