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Optic Bench Testing &Premium IOL’sScott M. MacRae MDProfessor of OphthalmologyProfessor of Visual ScienceUniversity of RochesterDr. MacRae is a consultant toZiemer, B&L, Technolas, AcufocusUNIVERSITY OF ROCHESTERAcknowledgmentsGeunyoung Yoon PhD.Len Zheleznyak M.S.Jorge Alio MDUNIVERSITY OF ROCHESTERCorrect Astigmatism “At 1-3 months 57.6% of premiumIOL eyes may not have received fullbenefit due to refractive error”– R. Lindstrom 2012 Multifocals disproportionatelyaffectedUNIVERSITY OF ROCHESTER1
M IOL’s - Astigmatism ReStor 3 & 4 Astigmatism up to 1.00 D toleratedHayashi, Manabe JCRS Aug. 2010UNIVERSITY OF ROCHESTERAdaptive-Optics IOL Metrology SystemArtificial PupilWet Cell & IOLCCD Sensor:CapturesImage ofLetter ChartBadal Optometer:Changes Object DistanceProjector:DisplaysLetter ChartDeformable Mirror:Induces Corneal AberrationsUNIVERSITY OF ROCHESTERUniv. of Rochester StudyCorneal Astigmatism & Premium IOLsPupil 4.0 mmDepth Of Field region of contrast 50% of peak contrast of AcrySof MonofocalDepth of Field [D]65AcrySof monofocalCrystalens AOCrystalens HDReSTOR 3DTecnis Multifocal4321000.511.52Corneal Astigmatism [D]Yoon, MacRae 2012UNIVERSITY OF ROCHESTER2
Influence of Corneal AstigmatismOn Multifocals5 MM% Decrease inNormalized Image Quality25AcrySof Monofocal20% DecreaseCrystalens AOCrystalens HD15ReSTOR 3D Far PeakReSTOR 3D Near Peak10Tecnis Far PeakTecnis Near Peak500.2500.50.751Corneal Astigmatism [D]UNIVERSITY OF ROCHESTERYoon, MacRae 2012IOL Through-Focus Image Quality1D corneal astigmatism, 3mm pupilDefocus [D] :Intermediate012345AcrySofmonofocalCrystalens HDReSTOR 3DTecnis ZM900Zheleznyak et al., JCRS,2012.UNIVERSITY OF ROCHESTERIOL Through-Focus Image Qualitycorneal astigmatism, 3mm pupil: IntermediateHD500 3mm0.90.80.8CCCCSN60AT 3mm0.90.70.70.60.6Corneal Astigmatism0.50.5-20240.00-260246Defocus [D]Defocus [D]0.250.500.751.00ZM900 3mm0.90.90.80.8CCCCSN6AD1 3mm0.70.70.60.60.50.5-20246-2Defocus [D]Zheleznyak et al., JCRS,2012.0246Defocus [D]UNIVERSITY OF ROCHESTER3
Recent Multifocal IOLsFineVisionMicroFOculentisMplusAlconReSTOR 3DAlconAcrySofApodizeddiffractiveAspherical3 & 2.5 Dadd ctivetrifocal:asymmetricrefractivemultifocal1.75D & 3.5D add power 3D add powerdistance focusnear focusUNIVERSITY OF ROCHESTERrEffects of Corneal Astigmatism onThrough-Focus Image Quality of IOLs5mm pupilAstigmatism0.00 D0.25 D0.50 D0.75 D1.00 D-101234ReSTOR3D5-10123MplusRefractive “Bifocal”MicroFDiffractive Trifocal45-1012345-1012345Defocus (D)Yoon, Zheleznyak, MacRae Univ. of RochesterEffects of Corneal Higher Order AberrationsThrough-Focus Image Quality of IOLs5mm lusImage QualityImage QualityAcrySof MonofocalCorneal HO RMS (µm)Yoon, Zheleznyak & MacRae - University of Rochester4
Corneal Astigmatism ( 0.5 Diopters)& Higher Order AberrationsAffects All MultifocalsM IOL Refinement: Correct Astigmatism (& Sphere)– CRITICAL to correct in multifocals– LRI’s – mixed astigmatism– PRK/LASIK Mini PRK 7 mm Epith. removal diameter– Quicker recovery– Less Epi Defect risk– Less discomfortUNIVERSITY OF ROCHESTERThank YouUNIVERSITY OF ROCHESTER5
Scott M. MacRae MD Professor of Ophthalmology Professor of Visual Science University of Rochester Dr. MacRae is a consultant to Ziemer, B&L, Technolas, Acufocus UNIVERSITY OF ROCHESTER Acknowledgments Geunyoung Yoon PhD. Len Zheleznyak M.S. Jorge Alio MD UNIVERSITY OF ROCHESTER Correct Astigmatism “At 1-3 months 57.6% of premium
