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Intraoperative view of vitreous surgery for the eyes implanted with diffractive multifocal intraocular lenses 1. Akiko Yamamoto-Ogasawara¹ ¹Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan Purpose: To compare intraoperative view of virteous surgery through diffractive multifocal intraocuar lenses (IOLs). Methods: Case control study. Vitreous surgery was performed in 4 eyes of 4 cases implanted diffractive multifocal IOLs (ZM900, Tecnis Multifocal, Abbott, CA or SA60D3, ReSTOR, Alcon Laboratories, TX) for retinal detachment or epiretinal membrane. Intraoperative view of fundus and intravitreally injected triamcinolone crystals to visualize the residual vitreous cortex was compared through contact lens sytem with that of monofocal IOLs (SA60AT). Results: To focus on the retinal vessels and macula in the eye with ZM900, the surgeon needed to adjust the focus several times comparing to that of SA60AT, especially when observing the epiretinal membrane. However, the retinal folds resulting from contraction of the epiretinal membrane were seen clearly and the epiretinal membrane was peeled successfully. The retinal image through the SA60D3 was clearly seen as well as that through SA60AT. When triamcinolone crystals were injected into the vitreous cavity in the eyes transplanted with ZM900, multiple or double crystals were observed. The crystals were elongated radially in the peripheral field of the flat contact lens. However, the crystals in the eyes implanted with SA60D3 were not duplicated and slightly blurred only in the central field of the flat contact lens. Conclusions: Intraoperative view through SA60D3 with diffractive optics only in the central optical zone was superior to that through Tecnis Multifocal with the whole diffractive optical zone. The duffractive optics in the peripheral optics may affect intraoperative view severely through the contact lens system. |
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