ReSTOR, ReZoom lenses, the multifocal options after cataract surgery

Multifocal Intraocular Lenses


	read why we need multifocal lenses after the age of 40 or after having cataract surgery Eye ability to see at near (accommodation) and presbyopia

Traditionally, when a cataract develops (cloudy lens), the human lens is normally replaced with an artificial intraocular lens (IOL) inside the eye. This lens is usually focused for distance vision and the patient needs to wear reading glasses for all near tasks because of lack of accommodation or the ability of the lens to focus at near.

Through recent advancements in lens technology, we now have several options of intraocular lenses available that can provide a range of vision (near through distance) enabling a high degree of freedom from spectacles. A multifocal lens implant provides excellent vision after cataract surgery at a variety of distances eliminationg the need for reading-bi-multifocal glases afterwards. The 2 most advanced and commonly used in modern ractices in the world are the ReSTOR and ReZoom intraocular lenses. They can provide a full range of functional vision for patients who have a strong desire to significantly decrease their dependence on glasses and contacts. So, patients choosing to have a multifocal lens implant will likely find that they can drive, watch television, read or do crafts-without the need for glasses

The Acrysof ReSTOR

The AcrySof® ReSTOR® lens is a breakthrough lens that uses apodized diffractive technology (similar to technology used in telescopes and microscopes). It affords cataract patients restoration of vision at all focal lengths from near through distance.
For most cataract patients, life without reading glasses or bifocals is something they either experienced before presbyopia or they just dreamed about the most of their lives. But today, the AcrySof® ReSTOR® IOL is turning those dreams into reality with its revolutionary lens technology, which is designed to allow patients to see clearly at all distances without bifocals or reading glasses.
Dr. Khalil is a leader in implantation of the ReSTOR IOL and was among the first cataract surgeon in Cairo to implant the ReSTOR lens.




	Implanting the ReSTOR lens through a tiny incision	ReSTOR lens unfolded in its new place in the eye

The ReZoom

Today, with its many optical design enhancements, the ReZoom Multifocal IOL is providing patients with a full range of vision and greater independence from glasses or contact lenses than ever before.

The ReZoom Multifocal Lens features Balanced View Optics Technology - uniquely proportioned visual zones that provide it with a major advantage. Each ReZoom Multifocal Lens is divided into 5 different zones with each zone designed for different light and focal distances

several zones of optical power that are designed to provide good vision at varying distances, under varying lighting conditions. In a clinical study, 92 percent of ReZoom™ IOL patients reported never or only occasionally having to wear glasses.

What are the potential adverse effects of mIOL’s?

Glare, halos and reduced contrast sensitivity.

Glare and halos may occur after implantation of regular monofocal IOL’s as a result of lens design. They are more likely with mIOL’s because, in addition to lens design effects, mIOL’s create in-focus images for distance and near objects simultaneously and this overlay of images can cause symptoms.
Contrast sensitivity is the ability to differentiate between an object and its background. A reduction is inevitable following implantation of mIOL’s, and the tolerability of this depends on the patient’s expectations. Unrealistic expectations often lead to disappointment in the visual outcome. The following table is provided as a brief summary of outcomes. Please note that a great number of studies have been performed to look at the outcomes of lens surgery and implantation of monofocal as well as multifocal IOL’s. You should ask any questions you have before you make a decision regarding your desire to have mIOL implantation.

	% Totally free of spectacles	% Severe glare	% Severe halos	% Who would have the same lens implanted again
Monofocal IOL	10	Severe: up to 0.7% Moderate: up to 5%	Severe: Rarely Moderate: up to 2.5%	Not asked
mIOL	75 - 85	0 – 8.5	4	95
Chiam PJT et al. Journal of Cataract and Refractive Surgery 2006; 32: 1459-1463 Wolffe M et al. Eye 2006 Aug 25 [Epub]

A small proportion of patients (between 0 and 2% in different studies) have experienced symptoms of such severity that they have requested the mIOL be removed.

If not opting for the ReSTOR or ReZoom lenses, the classical and still commonly used options available to compensate for presbyopia after cataract surgery are

Monofocal lenses and Eyeglasses: Bifocals, progressive lenses and trifocals are the most common correction, and allow for correcting astigmatism as well as near- or far-sighted results. They are safe, effective and highly reliable

Monofocal lenses and Monovision: People who have worn "monovision" contacts, or who naturally have one distance eye and one focused for near are good candidates to have one eye corrected far and one for near in the selection of the implant for their cataract surgery. Glasses may still be helpful for such activities as night driving and prolonged reading.

What are the potential adverse effects of mIOL’s?

Send mail to secretariat@eyecairo.net with questions or comments about this web siteAuthor: Dr A K Khalil, Copyright © 2003 Dr A Khalil Eye Clinic. Last modified: 02/29/08