Preliminary Results after Cataract Surgery with the Aspheric Acrysof ReSTOR IOL to Correct Presbyopia

Meeting of the ASCRSChicago

8-10 February 2007

R.M.M.A. Nuijts1, N.E. De Vries, and J. De Brabander

University Hospital Maastricht The Netherlands

1Author receives travel expenses from ALCON

AcrySof® ReSTOR™

Model SN60D3• Apodized diffractive

structure 3.6 mm center• Refractive in periphery• Incorporates +4.0 add at

lens plane equaling +3.2 at spectacle plane

1.3 micronstep

larger steps: more light to near at centersmaller steps: more light to distance at edge

AcrySof Aspheric IOL Design

PosteriorAspheric Optic

Symmetric Biconvex

6.0 mm

Anterior Aspheric Optic

AnteriorApodizedDiffractiveOptic

Symmetric Biconvex

6.0 mm

SN6AD3* SN60WF*

The ReSTOR Aspheric IOL (SN6AD3) is designed with negative spherical aberration

Patients and Methods

• Prospective study aspheric ReSTOR– 15 patients, 30 eyes with cataract– Bilateral implantation within 2 weeks– 8-14 weeks follow-up– Mean age: 67 ± 8.0 years (range 52-81)

• Comparison with historical standard ReSTOR (SN60D3) group

Outcome Measures

• Patients were examined monocularly and binocularly

• ETDRS visual acuity charts• logMAR visual acuity transferred to

Snellen UCDVA and BCDVA• Near visual acuity transformed into

Snellen values• Contrast sensitivity CSV-1000

Refractive OutcomeComparative data

StandardReSTOR (%)

AsphericReSTOR (%)

Number of eyes 65 30

Mean SE (D) 0.06 ± 0.28 0.14 ± 0.49

SE ± 1.0 D (%) 100 100

Mean Refractive Astigmatism (D) -0.78 ± 0.62 -0.86 ± 0.60

Uncorrected Distance VA Aspheric vs Standard ReSTOR

0.5

0.63

0.8

1.0

-0,1

0

0,1

0,2

0,3

Mea

n Lo

gMA

R V

A

Aspheric ReSTOR Standard ReSTOR

monocular binocular 1.25

0.79

0.89

0.68

0.85

Monocular Near VAStandard vs Aspheric ReSTOR

0,870,831,010,96

00,20,40,60,8

11,2

UCNVA DCNVA

Standard ReSTOR Aspheric ReSTOR

Aspheric vs. Standard ReSTOR IOL

Monocular Mesopic Contrast Sensitivity

0

0,3

0,6

0,9

1,2

1,5

1,8

2,1

3 cpd 6 cpd 12 cpd 18 cpd

Mea

n C

ontra

st S

ensi

tivity

(log

units

+/-

SD)

Standard ReSTOR

Aspheric ReSTOR

Largest difference = 0.29 log units

Clinical Significance 0.3 log units at 2 or more Spatial Frequencies

P=0.001

Vector Vision CSV-1000

P=0.04

Use of SpectaclesAspheric ReSTOR IOL

• Reading glasses: 0/15

• Distance glasses: 0/15– 3/30 eyes scheduled for LASEK

• Computer glasses: 2/15

Adverse Effects

• 3/30 eyes scheduled for YAG capsulotomy

• 3/30 eyes scheduled for LASEK• 1/30 re-operated for decentration• 1/30 IOL exchange for postoperative

ametropia• No disturbing glare or halo’s

Conclusions

• Preliminary data of the aspheric ReSTOR IOL (SN6AD3):– Provides excellent near and distant VA– Mean monocular UCNVA: 0.96– No glasses for near or distant vision

• 2/15 patients computer glasses– No disturbing glare or halos– Higher contrast sensitivity as compared to

standard ReSTOR