Patient adaptation to the refractive multifocal reZoom IOL

CE-marked since October 2004 and approved by the FDA in March 2005, the ReZoom IOL (AMO, Santa Ana, California, USA) was designed to provide hyperopic cataract patients with greater independence from glasses, although good visual outcomes can also be achieved in other patients. However, patient selection is essential and one of the criteria that candidates for multifocal IOLs must fulfil is an adaptable and open-minded personality. Patients should not have unrealistic expectations and should not be looking for perfect vision. Surgeons must also emphasize to patients that neuroadaptation is required to adjust to a new visual system and this might take a few months.

My own experience with the ReZoom IOL has shown that all my patients had reached almost optimal far vision within two months postsurgery, while their near vision continued to improve over time. At the early follow-up visit, a few patients complained of halos and glare, visual side-effects inherent to multifocal IOLs. Again, as a result of brain adaptation, the presence of these unwanted optical phenomena reduced or disappeared over time.

Two-month results

All eyes were evaluated at the two-month follow-up visit (Figure 1). The mean spherical equivalent was –0.03 ± 0.53. In all eyes, postoperative UCVA was significantly improved with 77% of eyes reaching 20/30 or better (0.10 ± 0.10 vs 0.78 ± 0.18). Similarly, BCVA was significantly improved in all eyes with 100% of eyes reaching 20/30 or better (0.90 ± 0.14 vs 0.99 ± 0.17). Near vision was also significantly improved but in a less impressive way: 69% of eyes achieved J3 or better near visual acuity and 74% of eyes achieved J3 or better DCNVA.

Six-month results