Zeiss user group meeting 18 th July 2015 Anil Arora

 Personal experience – began using the 839MP in November Have implanted over 200 of these IOLs.  Began using 939MP in November Have implanted just over 100 of these IOLs.  In the past 2 ½ years have implanted about 600 MFIOLs – 300 of the 839/939, about 60 Alcon ReStor +3 (SN6AD1), about 80 ReStor 2.5 (SV25T0), about 50 B&L FineVision trifocal, about 50 AMO Symfony (ZXR00) and about 30 Oculentis MF15  During the same period I have implanted about 2000 IOLs in total (average about 800 per year), so about 30% of all my IOLs implanted are MFIOLs

 This study/survey is of 192 eyes of 96 patients who have been bilaterally implanted  64 patients with bilateral 839MP (128 IOLs)  22 patients with bilateral 939MP (44 IOLs)  10 patients with one 839 and one 939 (20 IOLs)  Study involved checking patient’s monocular and binocular unaided VA for three distances:  Distance (6metres)  Intermediate (80cm)  Near (40cm)  Patients were asked to complete a questionnaire on the subjective quality of their unaided vision for these distances before and after surgery, on their need for glasses for these distances before and after surgery, on the incidence and severity of photic phenomena before and after surgery and on whether or not they would use the same IOL again and recommend it to a friend.  Survey typically carried out at 2 weeks after second eye surgery, so not much time for “neuroadaptation”.

 A big thanks to my orthoptists Jocelyn and Jo for collecting the data and doing the patient surveys.  A big thanks to another one of my orthoptists, Stacy, for data analysis and producing the graphs.

 Generally given to patients at about 2 weeks after second eye surgery  Quality of unaided vision graded subjectively from excellent to very poor before and after surgery for distance, intermediate and near  Incidence of halos and glare and spectacle dependency graded never, sometimes or regularly before and after surgery

  Would Use The Same Lens(es) (%)Would Recommend The Same Lens(es) (%)   Yes No Undecided YesNoUndecided   Both Eyes Toric   95% 5% 0% 95%5%0%   Both Eyes Non-Toric   93% 5% 2% 93%5%2%   One Eye Toric, One Eye Non-Toric   100% 0% 0% 100%0%0%   Total   94% 5% 1% 95%4%1% Probably not a meaningful question as the patient has nothing else to compare it with, but gives a gauge of level of satisfaction

 Great IOL for patients who are highly motivated to have spectacle independence.  In my experience other IOL that promise less photic phenomena (eg Symfony, ReStor 2.5, Oculentis MF15) do not provide as consistent a level of excellent unaided near vision.  B&L Fine Vision trifocal is a virtually identical IOL but is not preloaded and a little harder to rotate in the eye. ? benefit of apodisation and of being trifocal to the periphery?  839/939 still my “go to” IOL if patient keen for spectacle independence and really wants good near vision.  Intermediate vision better than with older bifocal design but still not ideal for many computer users (20% light distribution for intermediate)  Haloes and glare virtually universal but many are not troubled by them and about 95% of patients say they would have the same IOL again.  Pre-op counselling and management of expectation is essential.