Preliminary findings with this approach were published in 2004 and long-term results in 2008. With the aim of increasing patient satisfaction and spectacle independence after cataract surgery, a “mix and match” method involving implantation of a refractive multifocal IOL in one eye and a diffractive multifocal IOL in the contralateral eye, was first described by Gunenc in 2000. 16Īs with all multifocal IOL technologies, each of these unique designs has its limitations. The diffractive pattern is 32 concentric circles with a +4 diopters (D) near addition that evenly splits the light entering the eye into two focal planes regardless of pupil size: one for distance and one for near. The diffractive zones are located on the posterior surface. The modified, prolate anterior surface is designed to reduce spherical aberrations. The Tecnis ZMA00 multifocal IOL (Abbott Medical Optics, Santa Ana, CA, US) is a three-piece foldable, diffractive, aspheric, UV-blocking, hydrophobic acrylic optic with OptiEdge design.
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It is designed to allow 100% light transmission in order to provide the full range of vision. An aspheric transition between the zones is designed to provide balanced intermediate vision. The refractive surface has 5 optical zones (zones 1, 3, and 5 are distance-dominant, whereas zones 2 and 4 are near-dominant). The ReZoom NXG1 multifocal IOL (Abbott Medical Optics, Santa Ana, CA, USA) is a three-piece, refractive, hydrophobic acrylic, aspheric IOL with UV blocking and an OptiEdge design that is claimed to minimize edge glare and reduce posterior capsular opacification. 8, 9, 10, 11, 12 Diffractive multifocal IOLs provide very good results at near vision, but may not function effectively at intermediate distances. Refractive multifocal IOLs provide very good visual results for intermediate and distance vision, but offer limited near vision. 4, 5, 6, 7 Clinically, there are two types of multifocal optics in IOLs: diffractive and refractive. Multifocal IOLs have good clinical results with careful patient selection. Various presbyopic intraocular lenses (IOL) have been implanted to treat presbyopia during cataract surgery. Presbyopia is still one of the most challenging optical problems in cataract and refractive surgery, and spectacle independence is one of the major demands of the patients.
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