Evolution of visual performance in 250 eyes implanted with the Tecnis ZM900 multifocal IOL

PURPOSE. To evaluate visual performance in relation to time after implantation of the multifocal Tecnis intraocular lens (IOL) in patients with cataract. METHODS. This prospective case series involved 250 eyes of 137 patients with cataract aged 68.5+/-9.9 years. Monocular uncorrected and corrected near visual acuity (NVA and DCNVA) and distance visual acuity (UCVA and BCVA), occurrence of visual symptoms, and patient satisfaction were evaluated at 1-3 days, 30-90 days, and 150-210 days after surgery. Posterior capsule opacification and contrast sensitivity under photopic conditions were also assessed. RESULTS. At the last follow-up visit, mean NVA and DCNVA was 0.215+/-0.082 and 0.189+/-0.045 log-MAR, respectively. The majority of eyes (96.8%) could read J2 without correction, including 83.2% reading J1. With best distance correction, 95.6% of eyes were able to read J1. Mean UCVA and BCVA was 0.144+/-0.101 and 0.09+/-0.03 logMAR, including 77.6% and 98.4% of eyes that achieved 20/30 or better, respectively. The majority of patients (>90%) ranked their near, distance, and global vision as good or excellent and 88.4% were free from spectacles. A significant improvement of uncorrected and corrected distance and near VA as well as a decrease in the intensity of subjective photic phenomena was observed over time. At the last follow-up visit, the rate of posterior capsule opacification (grade 1) was 4.4% and mean monocular contrast sensitivity was 1.44+/-0.26. CONCLUSIONS. The multifocal Tecnis IOL provides excellent near vision and good distance vision in patients with cataract. However, most patients required a neuroadaptation period of approximately 6 months to experience full visual benefits of the lens. (Eur J Ophthalmol 2009; 19: 762-8)