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Piggyback monofocal and multifocal IOLs enhance near, distance visual acuity
J Cataract Refract Surg. 2009;35(12):2136-2143.
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Implantation of a monofocal IOL and an add-on diffractive multifocal IOL improved near and distance visual acuity, a study showed.
Many patients choose not to receive multifocal IOLs because of reduced contrast sensitivity, increased spherical aberrations, glare and halo, the study authors said.
"Explantation of a diffractive IOL and its replacement by a monofocal IOL is a possible, although not desirable, solution," they said. "The concept of an additional functional diffractive optic is an alternative for uneventful reversibility of this complex refractive surgical procedure."
The prospective randomized clinical study included 56 eyes of 30 patients with a mean age of 65 years and mean preoperative logMAR corrected distance visual acuity of 0.3 or worse. Patients underwent phacoemulsification and received an MS 612 ASP-Y monofocal IOL (HumanOptics) in the capsular bag and an MS 714 PB multifocal IOL (HumanOptics) in the sulcus.
Study data showed that at 3 months postoperatively, mean monocular logMAR uncorrected distance visual acuity was 0.10, with a remaining mean postoperative spherical equivalent of 0.01 D. Mean logMAR uncorrected intermediate visual acuity was 0.20. Mean uncorrected near visual acuity was 0.16.
No postoperative complications were reported. No patient required spectacle correction for distance vision; two patients required spectacles for near functioning at 3 months postop, the authors said.