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Up Front | Jan 2008

Bilateral Implantation Versus Mixing the Crystalens, ReZoom, and AcrySof Restor IOLs

Recent research found that bilateral Crystalens (Eyeonics, Inc., Aliso Viejo, California) implants elicited fewer nighttime glare symptoms compared with bilateral ReZoom (Advanced Medical Optics, Inc., Santa Ana, California) or AcrySof Restor (Alcon Laboratories, Inc., Fort Worth, Texas) IOLs. Combining an accommodating and a multifocal lens produced fewer photic disturbances than either multifocal IOL implanted bilaterally, but more disturbances than patients with a Crystalens in both eyes. Whether implanted bilaterally or combined with another IOL, the Crystalens provided patients with the best intermediate vision. The AcrySof Restor lens in one or both eyes provided the best near vision. The Crystalens and AcrySof Restor grouping achieved better overall uncorrected distance, intermediate, and near vision than the other four combinations. Jay Pepose, MD, presented the study's results at the 2007 AAO Annual Meeting in New Orleans.1

The prospective, nonrandomized study compared the visual performance of patients who either underwent the implantation of a presbyopia-correcting IOL bilaterally or who received a combination of the Crystalens and ReZoom IOLs or the Crystalens and AcrySof Restor lenses. The 49 patients enrolled in the five-arm study received either the Crystalens IOL bilaterally (n = 14); the AcrySof Restor IOL bilaterally (n = 12); the ReZoom IOL bilaterally (n = 14); a combination of the Crystalens and AcrySof Restor IOLs (n = 6); or a combination of the Crystalens and ReZoom IOLs (n = 3). Diagnostic testing at 4 to 6 months postoperative included UCVA and BSCVA at distance, intermediate, and near; contrast-sensitivity function; and quality-of-life questionnaires (6 months postoperatively).

Eyes with the Crystalens had statistically better BSCVA, uncorrected and distance-corrected intermediate, and best corrected near vision compared with eyes in the other study groups. Crystalens eyes also had better contrast sensitivity with and without glare under mesopic conditions. According to patients' responses to subjective quality-of-vision and quality-of-life questionnaires, the bilateral Crystalens group received the highest scores. Eyes with the AcrySof Restor IOL achieved better uncorrected near vision, needed the lowest reading add, and had the lowest uncorrected and distance-corrected intermediate vision.

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