Transcript The Effect of the Restor Multifocal IOL on Automated

The Effect of the Restor
Multifocal IOL on
Frequency Doubling
Perimetry
Elizabeth Yeu, MD1, Elizabeth Woznak, BS2 ,
Nicole Kesten, BS2, Steven VL Brown, MD, FACS1,2
1 Rush University Medical Center, Chicago, IL
2Chicago Glaucoma Consultants, Chicago, IL and
Evanston, IL
* NO FINANCIAL INTERESTS
ABSTRACT
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PURPOSE: To determine the effect of ReSTOR Multifocal IOL lenses on FDT Visual
Field Perimetry in patients with glaucoma.
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SETTINGS: Private Practice - Chicago Glaucoma Consultants: Chicago, IL
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METHODS: This prospective study included 13 patients (25 eyes): Patients had
varied ocular history (3 with glaucoma, 3 glaucoma suspects, and 7 without "high
risk" for glaucoma). All with phacoemulsification with AcrySof ReSTOR Natural IOL
(Alcon) implantation. Participants underwent Frequency-doubling perimetry (FDT)
Humphrey Matrix 24-2 (Carl Zeiss Meditec Inc.) testing before and after cataract
extraction. The MD and the PSD were recorded along with considerations for
accurate test taking. Changes in visual acuity using LogMAR, IOP, and visual
complaints post ReSTOR intraocular lens implantation were also noted.
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RESULTS: No significance with data.
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CONCLUSIONS: Patients with well controlled glaucoma can enjoy the benefits of
the ReSTOR lens without compromising their treatment. FDT visual field testing
remains consistent and accurate after placement of the ReSTOR IOL.
Methods and Materials
Retrospective Review
Patient Demographics
Past Ocular Hx:
Normal
GLC suspect
NTG
ACG
Past Ocular Sx:
LPI
ALT
SLT
* One
# eyes
14
5
2
4
4
2
1
eye had both ALT and SLT. 7 laser treatments for 6 eyes.
Mean Age
74.77
Age Range
64-83
2 Males, 11 Females : All Caucasian
Patients underwent preoperative and postoperative automated visual fields
analyzed via the Humphrey FDT 24-2 perimetry (Carl Zeiss Meditec Inc.).
Mean deviation (MD) and pattern standard deviation (PSD) were evaluated
between the pre- and post-operative visual fields.
Pre-op
Results
Post-op
Va Mean
MD: FDT
PSD: FDT
-.36 logMAR
-2.25 + 2.60
4.17 + 2.05
-.08 logMAR
-2.39 + 2.39
4.06 + 1.69
IOP (mm Hg)
14.47 + 3.55
14.58 + 5.61
Va
Mean
MD
FDT
p value
p=0.81
p=0.69
SUMMARY
Pre-Op
Post-op
-.36
-.08
Pre-Op
Post-op
-2.25 + 2.60
-2.39 + 2.39
DISCUSSION
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Prospective study design
Prior studies examined pre- and post- cataract surgery
patients  MD improved, but PSD unchanged
This study showed that the post-operative changes in MD and
PSD were insignificant
Trend of slightly worse MD  secondary to reduced contrast
sensitivity
The reliability of test taking is unaffected by the Restor IOL
Limited incidence of glare and increased halos
Small sample size
Only 2 VF were compared
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Likely valid results since all patients were experienced in perimetry and
the tests were reliable
Conclusion
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PSD values of the FDT Matrix are not affected by the
Restor IOL implant.
Glaucoma may be appropriately followed after Restor
implantation
Reduced contrast sensitivity post ReStor
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Highlighted by the slight depression in MD
Patients with well controlled glaucoma can enjoy
the benefits of the ReSTOR lens without
compromising their treatment. FDT visual field
testing remains consistent and accurate after
placement of the ReSTOR IOL
References
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dependent in experimental glaucoma. Invest Ophthalmol Vis Sci.
1991;32:484–491.
3. Leeprechanon N, et al. Frequency-doubling perimetry: comparison with
standard automated perimetry to detect glaucoma. Am J Ophthalmol. 2007
Feb;143(2):263-271.
4. Teresa C, et al. The Influence of Learning Effect on FDT Perimetry. J
Glaucoma 2007;16:297-391.
5. Anderson AJ, Johnson CA. Frequency-doubling technology perimetry.
Ophthalmol Clin North Am 2003;16:213-25.
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Yellow Intraocular Lens Implantation. Am J Ophthalmol 2006;142:856-858.
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in Patients With Glaucoma. J Glaucoma 2007;16:205-208