Buzard Eye Institute for Corneal and Refractive Surgery

Introduction

If you believe you may have a cataract, don't worry. You're not alone. Every year, some 2.5 million Americans have cataract surgery. And with the ARRAY® multifocal lens, vision restoration holds more promise than ever before.

The ARRAY® is the first and only lens that can potentially restore a full range of vision for cataract patients—a concept that is symbolized by the unique ARRAY® logo:

The red line is a distant mountain, representing the ability to focus on faraway objects.
The blue figures are people, representing the ability to focus on objects that are two to five feet away.
And the green object in the logo is a book, representing the ability to focus on objects that are near.

By enabling many patients to see clearly at all distances, the ARRAY® may reduce the need for glasses, even for people who have worn glasses for years.

We'd like to thank the makers of the ARRAY® Multifocal Intraocular Lens, Allergan, for providing much of this information. These pages should answer many of your questions about the ARRAY®.

As you may have read in the Cataract brochure, cataract surgery involves implanting an intraocular lens (IOL) to restore vision. IOL technology has evolved rapidly during the past decade, and cataract patients may wish to discuss with their eye care practitioner their choice of IOLs. Basically, there are two different types:

Designed to provide good vision at one distance–usually far–so most people need glasses after surgery for closeup activities like reading or crafts.

ARRAY® multifocal IOL, which offers proven benefits for today's cataract patients. Only the ARRAY® is designed to provide good distance vision, intermediate vision, and near vision. Compared with monofocal IOLs, the ARRAY® can reduce the need for glasses in activities like reading, viewing text on a computer screen, or watching a movie.

The implantation procedure is the same for both types of IOLs. The real difference between the IOLs is in the type of vision they provide.

When you compare the ARRAY® multifocal lens with a monofocal lens you can see that the ARRAY® has concentric rings instead of a flat surface.

Many patients with monofocal lenses can focus on distant objects, such as mountains. But objects at intermediate distances, such as people a few feet away, may not be in focus. Objects at close distances, such as a book they hold in their hand, may also not be in focus. So, many people with monofocal lenses need bifocals or reading glasses.

The ARRAY® multifocal lens is very different from the monofocal. Objects that are distant, intermediate, or close, can all be in focus and clear. This is accomplished by the concentric rings of the ARRAY®, which give it the capabilities of three lenses in one.

When you look at distant objects, like mountains, you see them through the parts of the ARRAY® lens that provide far vision.

When you look at intermediate objects, like people a few feet away, you see them through the parts of the ARRAY® that provide intermediate vision.

And when you look at a near object, like a book, you see it through the parts of the ARRAY® that provide near vision.

In this way, the ARRAY® multifocal lens can restore a full range of vision, making many patients less dependent on glasses.

Some people who receive either monofocal or multifocal IOLs report halos or glare at night. These effects are more common with multifocal than monofocal IOLs, although individual results may vary.

Only your eye care practitioner knows what kind of results you can expect, but scientific studies have shown that 89% of people who receive the ARRAY® are able to read small print without glasses; 89% are free of severe problems with glare; and 85% are free of severe difficulty with halos.*

A survey was conducted to determine how the ARRAY® affects peoples' everyday lives.1 Researchers were interested to learn, for example:

One hundered patients who had ARRAY® multifocal IOLs in both eyes, and 103 patients who had monofocal IOLs in both eyes. The results are summarized below.

ARRAY® patients and monofocal patients were asked if they felt at all limited in performing a variety of activities without glasses. These activities were broadly categorized as near vision activities, social activities, and distance vision activities. As shown in the following chart, ARRAY® patients felt they were significantly less limited than monofocal patients in all three categories.

To provide a sense of what the chart may mean to an actual patient, the individual activities comprising the scores are listed below.

ARRAY® patients were less limited in these NEAR VISION activities without glasses:

Reading a magazine, newspaper or telephone book
Crafts or hobbies
Reading labels or prices
Shaving or putting on makeup

Going to dinner in a restaurant
Going to movies or theater
Visiting with friends or relatives
Going to a party or dance
Going to a sporting activity

ARRAY® patients were less limited in these DISTANCE VISION activities without glasses:

Usual daily activities
Recognizing people or objects across the street
Daytime driving
Reading street or freeway signs
Watching television
Walking up or down stairs

In nighttime driving, ARRAY® patients rated their limitation at 0.80, while monofocal patients rated theirs at 0.53, using the same scale as the chart above. The difference was not statistically significant. Other studies have found that ARRAY® patients, on average, meet federal safety criteria for driving. However, because differences have been found between ARRAY® patients and monofocal patients in simulated nighttime driving, caution is recommended for prospective ARRAY® patients who drive at night or in poor visibility conditions.

Regardless of the lens you choose–multifocal or monofocal–Medicare generally covers the cost of the lens and the surgery for people 65 or older. People under 65 should check with their insurance provider.Reference:

1. Javitt JC, Wang F, Trentacost DJ, Rowe M, Tarantino N. Outcomes of cataract extraction with multifocal intraocular lens implantation: functional status and quality of life. Ophthalmology. 1997;104:589-599.
2. ARRAY® multifocal lens prescribing information.