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Multifocal IOL offers higher spectacle independence than monofocal lens

J Cataract Refract Surg. 2010;36(2):282-285.

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A multifocal IOL enhanced near visual acuity and yielded higher spectacle independence than a monofocal IOL, a study showed.

"The diffractive apodized multifocal IOL provided better [uncorrected near visual acuity] and greater spectacle independence than the monofocal IOL and equivalent [uncorrected distance visual acuity]," the study authors said. "Patients with the multifocal IOL reported mild to moderate halos and glare. Although the monocular contrast sensitivity was slightly lower in the multifocal group than in the monofocal group, the clinical significance is not known."

The prospective study included 161 eyes of 161 patients who underwent unilateral phacoemulsification with IOL implantation. Seventy-two eyes were implanted with the AcrySof ReStor SA60D3 multifocal IOL, and 89 eyes received the AcrySof SA60AT single-piece monofocal IOL (both Alcon).

Investigators conducted examinations preoperatively and at 1 week, 1 month and 6 months postoperatively. Examinations included manifest refraction; biomicroscopy; and assessment of posterior capsule opacification, IOP and funduscopy. Self-reported vision and spectacle independence were also recorded.

Patients in the multifocal IOL group had better pseudoaccommodation than those in the monofocal group. However, the monofocal IOL patients had better contrast sensitivity than those in the multifocal IOL group; both differences were statistically significant (P < .05).

Patients in the multifocal group had better uncorrected near visual acuity than those in the monofocal group from 1 week postop to final follow-up, as well as better corrected near visual acuity at 6 months. Both differences were statistically significant (P < .05).

Data showed no significant difference in uncorrected distance visual acuity or corrected distance visual acuity between the two groups at any follow-up point.

In addition, 66.6% of multifocal IOL recipients and 23.5% of monofocal IOL patients reported spectacle independence.

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