1. LONG TERM OUTCOMES OF RESTOR IOL IMPLANTATION Lori Dao, Orkun Muftuoglu, V. Vinod Mootha, Steven M. Verity, R. Wayne Bowman, H. Dwight Cavanagh, James P. McCulley University of Texas Southwestern Medical Center Department of Ophthalmology Dallas, Texas Drs. Bowman, Verity, and McCulley receive consultant reimbursement from Alcon. Dr. Cavanagh receives research reimbursements from Ciba and Menion. None of the authors have financial interest in the subject matter of this poster. Supported in part by an unrestricted research grant from Research to Prevent Blindness, Inc., New York, New York.

2. INTRODUCTION Multifocal IOLs were introduced to restore the distance and near without any correction. Multifocal IOLs were introduced to restore the distance and near without any correction. Early models provided limited near correction and/or often related with glare and halos Early models provided limited near correction and/or often related with glare and halos Recent models are reported to provide more powerful near correction with less unwanted visual phenomena. Recent models are reported to provide more powerful near correction with less unwanted visual phenomena. The AcrySof apodized diffractive IOL (Alcon Laboratories Inc., Fort Worth, Texas) The AcrySof apodized diffractive IOL (Alcon Laboratories Inc., Fort Worth, Texas) Good biocompatability with high refractive index, Flexibility Good biocompatability with high refractive index, Flexibility The diffractive steps gradually reduce in height and spacing from the lens center to the edge The diffractive steps gradually reduce in height and spacing from the lens center to the edge Add power of +4.0 Diopters (D). Add power of +4.0 Diopters (D).

3. PURPOSE To evaluate the long-term visual and refractive outcomes of apodized diffractive multifocal IOL (Restor) implantation.

4. METHODS Retrospective Retrospective IRB approval UT Southwestern Medical Center IRB approval UT Southwestern Medical Center Declaration of Helsinki guidelines for Declaration of Helsinki guidelines for HIPAA HIPAA Retrospective design, no consent form for the inclusion to the study. Retrospective design, no consent form for the inclusion to the study. 322 eyes of 176 consecutive patients underwent phacoemulsification surgery with AcrySof Restor IOL implantation between December 2005 and June 2008 at the University of Texas Southwestern Medical Center. 322 eyes of 176 consecutive patients underwent phacoemulsification surgery with AcrySof Restor IOL implantation between December 2005 and June 2008 at the University of Texas Southwestern Medical Center. 53 eyes of 34 patient who had refractive surgery prior to Restor IOL implantation were excluded 53 eyes of 34 patient who had refractive surgery prior to Restor IOL implantation were excluded 269 eyes of 151 patients included in the study 269 eyes of 151 patients included in the study 2 eyes of 1 patient with Restor explanted due to glare. 1 patient unhappy with Restor chose monofocal for fellow eye. 2 eyes of 1 patient with Restor explanted due to glare. 1 patient unhappy with Restor chose monofocal for fellow eye. The preoperative and follow-ups 1, 6 months, and the last follow-up after Restor IOL implantation were evaluated for this study The preoperative and follow-ups 1, 6 months, and the last follow-up after Restor IOL implantation were evaluated for this study 14 eyes of 8 patients lost to follow-up 6 months after Restor IOL impantation. 14 eyes of 8 patients lost to follow-up 6 months after Restor IOL impantation.

5. Groups Number of eyes Number of patients All269151 Restor only15194 LRI3523 LRI/LASIK2214 LASIK6145

6. 1 month: p = 0.71 6 month: p = 0.46 Last f/u: p = 0.30, P = One-way ANOVA

7. 1 month: p = 0.00 6 month: p = 0.09 Last f/u: p = 0.13, P = One-way ANOVA

8. Spherical Equivalent and Cylinder

9. CONCURRENT UCVA / UCNVA for Restor and Restor + LRI

10. Restor and Restor+LRI Groups UCVAUCNVA

11. Nd:YAG Comparison of vision and refraction of eyes that underwent Nd:YAG capsulotomy and those that did not at last follow-up. YAG (-)YAG (+)P* VISUAL ACUITY (logmar) UCVA0.10 ± 0.120.15 ± 0.210.16 BSCVA0.03 ± 0.070.08 ± 0.130.01 UCNVA0.10 ± 0.120.13 ± 0.140.14 REFRACTION (D) S-0.03 ± 0.50-0.26 ± 0.670.05 C0.65 ± 0.330.50 ± 0.230.02 SE0.10 ± 0.36-0.04 ± 0.540.07 *Student’s t-test

12. Discussion Although Restor alone and Restor+LRI groups significantly had better UCVA at 1 month, there was no significant difference in UCVA between groups at last follow-up. Although Restor alone and Restor+LRI groups significantly had better UCVA at 1 month, there was no significant difference in UCVA between groups at last follow-up. No statistically significant difference in BCVA and UCNVA between groups at 1 mos, 6 mos or last f/u. No statistically significant difference in BCVA and UCNVA between groups at 1 mos, 6 mos or last f/u. UCNVA and UCVA were stable for the duration of follow-up in Restor alone and Restor+LRI groups. UCNVA and UCVA were stable for the duration of follow-up in Restor alone and Restor+LRI groups. Spherical equivalent and cylinder were stable for all groups Spherical equivalent and cylinder were stable for all groups 69% of eyes in Restor alone and Restor+LRI groups had concurrent 20/25 or better UCVA and J1 or better UCNVA at last follow-up 69% of eyes in Restor alone and Restor+LRI groups had concurrent 20/25 or better UCVA and J1 or better UCNVA at last follow-up