SEP 18, 2012
The authors of this pilot study in the March issue of the Journal of Cataract & Refractive Surgery report the results of implanting a multifocal IOL with myopic postoperative targets in cataractous eyes with AMD. They targeted a spherical equivalent (SE) of -2.0 D, which yielded +5.2 D near addition. This improved or maintained near vision without severely compromising distance vision. However, it is incumbent upon surgeons to explain to patients that a multifocal IOL won't improve BCVA.
The study included 13 patients (20 eyes) who received the Acrysof Restor SN60D3 multifocal IOL. Six months after surgery, uncorrected near visual acuity improved in 18 eyes (90 percent) and was unchanged in two eyes. Corrected distance visual acuity (CDVA) improved in 14 eyes (70 percent), was unchanged in four eyes (20 percent) and decreased by three lines or less in two eyes (10 percent).
Patient-reported outcomes indicated significant improvements in vision, mental health symptoms due to vision, role difficulties due to vision and limitations with peripheral vision.
Since the study did not have a control group, the authors compared the results to the published results of a large relevant study. They found that the CDVA with the current study's multifocal-magnification strategy appears to be comparable to the CDVA for standard cataract surgery for AMD patients. The strategy also offers the potential for improvement in near vision not available with standard cataract surgery.
The preliminary results reported in this study suggest that the multifocal-magnification strategy the authors used holds promise for visual rehabilitation of AMD patients with cataract and may be useful in guiding researchers and manufacturers in the design of high-magnification IOLs for AMD patients.