This is a clinical outcome assessment after cataract surgery with implantation of multifocal intraocular lens implant IOL with a lower near addition (+2.75D) of 143 eyes of 85 patients aged between 40 to 83 years of age. The type of lens implant used was multifocal IOL (MIOL) Tecnis ZKB00. The changes in uncorrected and corrected Log-MAR distance, intermediate visual acuity and near visual acuities, as well as manifest refraction were evaluated during a three month follow-up period. The patients were also asked about photic phenomena and spectacle dependence. The postoperative spherical equivalent was within ±0.5 dioptres and ±1 dioptre of emmetropia in 78.1% and 98.4% of eyes, respectively. The postoperative mean monocular uncorrected distance visual acuity, uncorrected near visual acuity and uncorrected intermediate visual acuity was 0.20 Log-MAR or better in 73.7%, 81.1% and 83.9% of eyes, respectively. All eyes achieved monocular corrected distance visual acuity of 0.30 Log-MAR or better. All patients were at least moderately happy with the outcomes of the surgery. Only 15.3% of patients required glasses correction postoperatively from daily activities. The postoperative complications include four eyes requiring Femto-LASIK re-treatment to correct the residual refractive error (2.8% 4/143 eyes). Regarding photic phenomena, 19 patients (33.9%) referred the perception of some type of halos (21.4%) or right glare (14.3%). Only in three patients (5.4%) were these photic phenomena referred to as moderate degree. The authors conclude that the introduction of this low add of +2.75D multifocal lens implant follows a trend to increase intermediate visual acuity reaching satisfying near results and high patient satisfaction for intermediate visual acuity. The limitations of the study according to the authors include no controlled group was included in this study and also the lack of validated questionnaires to evaluate patient satisfaction and photic phenomena. In addition, the defocus curve was not measured in this study and also the contrast sensitivity was not measured either. They recommended a further multicentre prospective larger study in the future to compliment this pilot study. 

Clinical evaluation of a new pupil independent diffractive multifocal intraocular lens with a ±2.75 D near addition: a European multicentre study.
Kretz FT, Gerl M, Gerl R.
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Jonathan Chan

Royal Hallamshire Hospital, Sheffield, UK.

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