The Effect of the Restor The Effect of the Restor

Multifocal IOL on Multifocal IOL on

Frequency Doubling Frequency Doubling Perimetry Perimetry

Elizabeth Yeu, MD1, Elizabeth Woznak, BS2 , Elizabeth Yeu, MD1, Elizabeth Woznak, BS2 , Nicole Kesten, BS2, Steven VL Brown, MD, Nicole Kesten, BS2, Steven VL Brown, MD,

FACS1,2FACS1,2

1 Rush University Medical Center, Chicago, IL1 Rush University Medical Center, Chicago, IL2Chicago Glaucoma Consultants, Chicago, IL and 2Chicago Glaucoma Consultants, Chicago, IL and

Evanston, ILEvanston, IL

* NO FINANCIAL INTERESTS* NO FINANCIAL INTERESTS

ABSTRACTABSTRACT PURPOSE:PURPOSE:  To determine the effect of ReSTOR Multifocal IOL lenses   To determine the effect of ReSTOR Multifocal IOL lenses

on FDT Visual Field Perimetry in patients with glaucoma.on FDT Visual Field Perimetry in patients with glaucoma.

SETTINGS:SETTINGS:  Private Practice - Chicago Glaucoma Consultants:   Private Practice - Chicago Glaucoma Consultants: Chicago, ILChicago, IL

METHODS:METHODS:  This prospective study included 13 patients (25   This prospective study included 13 patients (25 eyes): Patients had varied ocular history (3 with glaucoma, 3 eyes): Patients had varied ocular history (3 with glaucoma, 3 glaucoma suspects, and 7 without "high risk" for glaucoma). All with glaucoma suspects, and 7 without "high risk" for glaucoma). All with phacoemulsification with AcrySof ReSTOR Natural IOL (Alcon) phacoemulsification with AcrySof ReSTOR Natural IOL (Alcon) implantation.  Participants underwent Frequency-doubling perimetry implantation.  Participants underwent Frequency-doubling perimetry (FDT) Humphrey Matrix 24-2 (Carl Zeiss Meditec Inc.) testing before (FDT) Humphrey Matrix 24-2 (Carl Zeiss Meditec Inc.) testing before and after cataract extraction.  The MD and the PSD were recorded and after cataract extraction.  The MD and the PSD were recorded along with considerations for accurate test taking.  Changes in visual along with considerations for accurate test taking.  Changes in visual acuity using LogMAR, IOP, and visual complaints post ReSTOR acuity using LogMAR, IOP, and visual complaints post ReSTOR intraocular lens implantation were also noted.intraocular lens implantation were also noted.

RESULTS:RESULTS:  No significance with data.   No significance with data.

CONCLUSIONS:CONCLUSIONS:  Patients with well controlled glaucoma can enjoy   Patients with well controlled glaucoma can enjoy the benefits of the ReSTOR lens without compromising their the benefits of the ReSTOR lens without compromising their treatment.  FDT visual field testing remains consistent and accurate treatment.  FDT visual field testing remains consistent and accurate after placement of the ReSTOR IOL.after placement of the ReSTOR IOL.

Methods and MaterialsMethods and MaterialsRetrospective ReviewRetrospective Review

Patient DemographicsPast Ocular Hx: # eyesNormal 14GLC suspect 5NTG 2

ACG 4Past Ocular Sx:LPI 4ALT 2SLT 1* One 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.

ResultsResultsPre-opPre-op Post-opPost-op p valuep value

Va MeanVa Mean -.36 -.36 logMARlogMAR

-.08 logMAR-.08 logMAR

MD: FDTMD: FDT -2.25 -2.25 ++ 2.602.60

-2.39 -2.39 ++ 2.39 2.39 p=0.81p=0.81

PSD: FDTPSD: FDT 4.17 4.17 ++ 2.052.05

4.06 4.06 ++ 1.69 1.69 p=0.69p=0.69

IOP (mm IOP (mm Hg)Hg)

14.47 14.47 ++ 3.553.55

14.58 14.58 ++ 5.61 5.61SUMMARYSUMMARY

VaVa Pre-OpPre-Op Post-opPost-op

MeanMean --.36.36 -.08-.08

MDMD Pre-OpPre-Op Post-opPost-opFDTFDT -2.25 -2.25 ++ 2.60 2.60 -2.39 -2.39 ++ 2.39 2.39

DISCUSSION Prospective study designProspective study design Prior studies examined pre- and post- cataract surgery Prior studies examined pre- and post- cataract surgery

patients patients MD improved, but PSD unchanged MD improved, but PSD unchanged This study showed that the post-operative changes in This study showed that the post-operative changes in

MD and PSD were insignificantMD and PSD were insignificant Trend of slightly worse MD Trend of slightly worse MD secondary to reduced secondary to reduced

contrast sensitivitycontrast sensitivity The reliability of test taking is unaffected by the Restor The reliability of test taking is unaffected by the Restor

IOLIOL Limited incidence of glare and increased halosLimited incidence of glare and increased halos Small sample sizeSmall sample size Only 2 VF were compared Only 2 VF were compared

Likely valid results since all patients were experienced in Likely valid results since all patients were experienced in perimetry and the tests were reliableperimetry and the tests were reliable

Conclusion Conclusion PSD values of the FDT Matrix are not PSD values of the FDT Matrix are not

affected by the Restor IOL implant.affected by the Restor IOL implant. Glaucoma may be appropriately followed Glaucoma may be appropriately followed

after Restor implantationafter Restor implantation Reduced contrast sensitivity post ReStor Reduced contrast sensitivity post ReStor

Highlighted by the slight depression in MDHighlighted 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

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