Essentials in Ophthalmology Series Editor: Arun D. Singh Jorge L. Alió Joseph Pikkel E ditors Multifocal Intraocular Lenses The Art and the Practice Second Edition Essentials in Ophthalmology Series Editor Arun D. Singh More information about this series at http://www.springer.com/series/5332 Jorge L. Alió • Joseph Pikkel Editors Multifocal Intraocular Lenses The Art and the Practice Second Edition Editors Jorge L. Alió Joseph Pikkel Research & Development Department Department of Ophthalmology and Department of Cornea Assuta Samson Hospital Cataract, and Refractive Surgery Ashdod VISSUM Corporation and Miguel Israel Hernández University Alicante Ben Gurion University Spain School of Medicine Beer-Sheva Israel ISSN 1612-3212 ISSN 2196-890X (electronic) Essentials in Ophthalmology ISBN 978-3-030-21281-0 ISBN 978-3-030-21282-7 (eBook) https://doi.org/10.1007/978-3-030-21282-7 © Springer Nature Switzerland AG 2019 This work is subject to copyright. 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Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland To our dear wives and children who follow us along the routes of medicine, encourage, and support us – the reason for all that we do and the joy of our lives, and to our patients from whom we have received the inspiration and expertise to build up the second edition of this book. Jorge L. Alió and Joseph Pikkel Alicante (Spain)/Safed (Israel) Fall 2019 Preface In our modern world, now on the first quarter of the twenty-first century, medicine faces, more than ever before, the challenge of not only fighting diseases and saving lives but also improving quality of life. While life expec- tancy rises, patients’ activities remain at the same level that they were used to being young and hence their visual demands keep being high. While in previ- ous decades older people tended to lessen their activity, nowadays older peo- ple do not reduce daily activities as driving, sport activities, and various hobbies that require good visual acuity to different distances and are more convenient if multifocality exists. This evolution derived – among other things – new techniques and new approaches of cataract surgery. The evolution of cataract surgery and IOL implantation during the last decade has been, not surprisingly, focused on improving the quality of vision and the quality of life of our patients. Near vision and intermediate vision have been identified as one of the reasons by which quality of life is really acknowledged by our patients. Another trend in recent years is the tendency to operate younger patients than before with better visual acuities, even with mild cataracts, which means that patients are less tolerant to visual disabilities, and moreover the advances in refractive surgery have educated them in their request for spectacle indepen- dence. While usually we succeed in achieving good far vision without spec- tacles or contact lenses, optimal multifocality for far, intermediate, and near vision is still a challenge to be met. Since multifocal lenses, by definition, divide light into different foci, using multifocal intraocular lenses causes a dispersion of the energy of light enter- ing into the eye and, consequently, distributing the light in different foci. This causes a change in distribution of light and images at the level of the visual function at the level of the retina. This is the reason why neuroadaptation, which means the capability of the brain to adapt to changes, is necessary to adjust neurophysiology to the changes that are induced in the quality of the retinal image by dispersion of light. Moreover, the overlapping of different foci is neither physiological nor normal in the human or animal evolution. To the best of our knowledge, no visual system is multifocal in nature and it has not existed in the human being throughout evolution. For this reason, neuro- processing is the main challenge of multifocal intraocular lenses. The new technologies emerging in recent years have aimed at smoothing the changes in visual perception and to make a much more physiological division of light, vii viii Preface but even in these conditions, their effectivity has to be demonstrated and con- firmed by an improvement in the subjective quality of vision of the patient. About four years ago we published the first edition of this book which was welcomed by many ophthalmologists around the world. In recent years, a tremendous advance in the field of multifocal intraocular has been made. In this second edition, we bring the updated information on multifocal intraocu- lar lenses techniques and about lenses available in the market today as well as our personal experience on the subject. The main aims of this book are how the practical ophthalmologist and ophthalmic surgeon can select an adequate multifocal intraocular lens, how to differentiate them among the different technologies, how to identify the best on the market, and how to use evidence in favor of the selection of the best for the benefit of the patients. We hope that the reader will find this book useful for the purpose for which it was created, independent opinion, information, and credibility, and also unbiased information on the subject of multifocal intraocular lenses, which is constantly progressing and takes more and more part in our daily clinical practice. If we achieve this goal, the time and work dedicated to this book will be worthy. Alicante, Spain Jorge L. Alió Ashdod, Israel Joseph Pikkel Contents 1 Multifocal Intraocular Lenses: What Do They Offer Today? . . . 1 Jorge L. Alió and Joseph Pikkel Part I H istorical Background and Clinical Indications 2 Multifocal Intraocular Lenses: Historical Perspective . . . . . . . . 9 Kenneth J. Hoffer and Giacomo Savini 3 Multifocal Intraocular Lenses: Basic Principles . . . . . . . . . . . . . 31 Vicente J. Camps, Juan J. Miret, María T. Caballero, David P. Piñero, and Celia García 4 Multifocal Intraocular Lenses: Preoperative Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Jorge L. Alió and Joseph Pikkel 5 Multifocal Intraocular Lenses: Neuroadaptation . . . . . . . . . . . . 53 Jorge L. Alió and Joseph Pikkel 6 Multifocal Intraocular Lenses: Considerations in Special Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Jorge L. Alió and Joseph Pikkel 7 Multifocal Intraocular Lenses and Corneal Refractive Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Jorge L. Alió and Joseph Pikkel 8 Multifocal Intraocular Lenses: Complications. . . . . . . . . . . . . . . 73 Roberto Fernández Buenaga and Jorge L. Alió 9 Multifocal Intraocular Lenses: Postimplantation Residual Refractive Error . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 Maja Bohac, Ante Barisic, Sudi Patel, and Nikica Gabric 10 Multifocal Intraocular Lenses: Solutions for the Unhappy Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Richard B. S. Packard 11 Multifocal Intraocular Lenses: Neuroadaptation Failure Corrected by Exchanging with a Different Multifocal Intraocular Lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Olena Al-Shymali and Jorge L. Alió ix x Contents Part II M ultifocal Intraocular Lenses: Types and Models 12 Multifocal Intraocular Lenses: Types and Models . . . . . . . . . . . 123 Michael Mimouni and Jorge L. Alió Part III The Zeiss Family Multifocal IOLs 13 Multifocal Intraocular Lenses: AT LISA tri 839 MP . . . . . . . . . 177 Peter Mojzis, David Pablo Piñero, and Jorge L. Alió 14 Multifocal Intraocular Lenses: AT LISA Tri Toric 939 M/MP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 Peter Mojzis 15 Multifocal Intraocular Lenses: AT LISA 809 Diffractive Bifocal Intraocular Lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207 Ana B. Plaza-Puche and Jorge L. Alió 16 Multifocal Intraocular Lenses: The Hanita Family of Lenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213 Jorge L. Alió, Alfredo Vega-Estrada, and Ana B. Plaza-Puche 17 Multifocal Intraocular Lenses: The Acriva Family of Lenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221 Minoru Tomita Part IV The Alcon Family Multifocal IOLs 18 Multifocal Intraocular Lenses: AcrySof ReSTOR® SN6AD2 + 2.5 D Lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231 Rodolfo Mastropasqua, Francesco Aiello, Emilio Pedrotti, and Giorgio Marchini 19 Multifocal Intraocular Lenses: AcrySof ReSTOR SN6AD1 Lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237 Ana B. Plaza-Puche and Jorge L. Alió 20 Multifocal Intraocular Lenses: AcrySof IQ PanOptix Trifocal Lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243 Ana B. Plaza-Puche and Jorge L. Alió 21 Multifocal Intraocular Lenses: The Johnson and Johnson Family of Lenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249 Béatrice Cochener-Lamard 22 Multifocal Intraocular Lenses: FineVision (PhysIOL) Lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275 Verónica Vargas and Jorge L. Alió 23 Multifocal Intraocular Lenses: Fyodorov Gradiol . . . . . . . . . . . . 279 Boris Malyugin, Tatiana Morozova, and Valentin Cherednik