Evolution of visual performance in 250 eyes implanted with the Tecnis ZM900 multifocal IOL.

摘要

PURPOSE: To evaluate visual performance in relation to time after implantation of the multifocal Tecnis intraocular lens (IOL) in patients with cataract. METHODS: This prospective case series involved 250 eyes of 137 patients with cataract aged 68.5+/-9.9 years. Monocular uncorrected and corrected near visual acuity (NVA and DCNVA) and distance visual acuity (UCVA and BCVA), occurrence of visual symptoms, and patient satisfaction were evaluated at 1-3 days, 30-90 days, and 150-210 days after surgery. Posterior capsule opacification and contrast sensitivity under photopic conditions were also assessed. RESULTS: At the last follow-up visit, mean NVA and DCNVA was 0.215+/-0.082 and 0.189+/-0.045 logMAR, respectively. The majority of eyes (96.8%) could read J2 without correction, including 83.2% reading J1. With best distance correction, 95.6% of eyes were able to read J1. Mean UCVA and BCVA was 0.144+/-0.101 and 0.09+/-0.03 logMAR, including 77.6% and 98.4% of eyes that achieved 20/30 or better, respectively. The majority of patients (>90%) ranked their near, distance, and global vision as good or excellent and 88.4% were free from spectacles. A significant improvement of uncorrected and corrected distance and near VA as well as a decrease in the intensity of subjective photic phenomena was observed over time. At the last follow-up visit, the rate of posterior capsule opacification (grade 1) was 4.4% and mean monocular contrast sensitivity was 1.44+/-0.26. CONCLUSIONS: The multifocal Tecnis IOL provides excellent near vision and good distance vision in patients with cataract. However, most patients required a neuroadaptation period of approximately 6 months to experience full visual benefits of the lens.