Multifocal IOLs

1

• Multifocal IOLs
• Frank A. Bucci, Jr., M.D.
• Bucci Laser Vision Institute
• Wilkes Barre, PA - USA

2
Presbyopic Correcting IOLs

• 2005 RELEASE OF REZOOM RESTOR
• CMS ruling
• Renewed interest
• presbyopic correcting IOLs (PCIs)
• cataract patients
  lensectomy patients
• Since June 1, 2005
• Implanted 570 ReZoom ReSTOR IOLs

BUCCI ASCRS 2007
3
Methods ReSTOR / ReSTOR

• Cohort I
• 55 bilateral ReSTOR / ReSTOR
• Mean F/U 19 mos.
• Cohort II
• 145 bilateral ReZoom/ReSTOR
• Mean F/U 13 mos.

BUCCI ASCRS 2007
4
Results Summary Bilat. Near Vision

• Cohort I Cohort II
• ReSTOR/ReSTOR ReZoom/ReSTOR
• (n55) (n110)
• Near Near
• J 1.00 J 1.07
• No Statistically Significant Difference
• at Near

BUCCI ASCRS 2007
5
Results Summary Bilat. Intermediate

• Cohort I Cohort II
• ReSTOR/ReSTOR ReZoom/ReSTOR
• (n55) (n145)
• Mean F/U 19 mos. Mean F/U 13 mos.
• Intermediate Intermediate
• J 3.81 J 2.39
• Statistically Significant Difference
  (p.0001)
• at Intermediate

BUCCI ASCRS 2007
6
ReZoom/ReSTOR vs. ReSTOR/ReSTOR Bilateral
Intermediate
RESULTS
3.81
2.39
RS/RS 71 (39/55) J 4
RZ/RS 21 (23/110) J 4
n 55
n 110
Stat. sign. difference p .0001
BUCCI ASCRS 2007
7
Cohort I Unilateral Bilateral
INTERMEDIATE ReSTOR/ReSTOR
RESULTS
Unilateral
n110
x 4.49
8
14
12
Bilateral
x 3.81
n55
4
4
5
3
1
BUCCI ASCRS 2007
8
Complaints By Procedure and
Age 13/17 were Lensectomy
Patients 11/13 of the Lensectomy
complaints lt 60 y.o.
RESULTS

BUCCI ASCRS 2007
9
Internet Use the Aging Population

Source AARPs 2006 The State of 50America
BUCCI ASCRS 2007
10
ReSTOR/ReSTOR vs. ReZoom/ReSTOR
DISCUSSION

• Brazil - Feb 06 World Cornea
  Congress

RS/RS (n100)
RZ/RS (n88)
BUCCI ASCRS 2007
Akaishi Fabri Brazilian
Experience 2006
11
Diffractive Refractive Technolgies

BUCCI ASCRS 2007
12
Diffractive Refractive Technolgies

• Tecnis MF ReZoom
• 45 Pts Authors initial
  observations vs. RS/RZ
• Less halos and glare than ReSTOR ReZoom
• Less light needed for bilateral near
  vision
• Greater pupil independence esp. with near
  vision
• More comfortable reading distance
• Less loss of contrast sensitivity

BUCCI ASCRS 2007
13
Conclusions RZ/RS vs. RS/RS

• 1. 1 out of 4 (25.5) RS/RS pts. volunteered an
  intermed. complaint
• 2. 1 out of 3 (32.4) RS/RS lensectomy pts.
  volunteered an intermed. complaint
• 3. The RZ/RS mitigate intermediate complaints
• 4. RZ/RS bilat. intermed. vision (J 2.39) vs.
  RS/RS
• (J 3.81) (p.001)
• 5. The relative risk of an intermed. complaint
• occurring with a RS/RS pt. with
  age and
• with RL
• 6. The unique optical characteristics are
  synergistic complimentary resulting in
  spec. indepedence
• patient satisfaction

BUCCI ASCRS 2007