Comparative analysis of visual outcomes with 4 intraocular lenses: Monofocal, multifocal, and extended range of vision

Emilio Pedrotti; Francesco Carones; Francesco Aiello; Rodolfo Mastropasqua; Enrico Bruni; Erika Bonacci; Pietro Talli; Carlo Nucci; Cesare Mariotti; Giorgio Marchini

doi:10.1016/j.jcrs.2017.11.011

Comparative analysis of visual outcomes with 4 intraocular lenses: Monofocal, multifocal, and extended range of vision

J Cataract Refract Surg. 2018 Feb;44(2):156-167. doi: 10.1016/j.jcrs.2017.11.011.

Affiliations

¹ From the Department of Neurosciences, Biomedicine and Movement Sciences (Pedrotti, Mastropasqua, Bruni, Bonacci, Talli, Marchini), Eye Clinic, University of Verona, Verona, the Carones Ophthalmology Center (Carones), Milano, the Department of Experimental Medicine and Surgery (Aiello, Nucci), University of Rome Tor Vergata, Rome, and Ophthalmology (Mastropasqua, Mariotti), Department of Neuroscience, Polytechnic University of Marche, Ancona, Italy; Moorfields Eye Hospital (Aiello, Mastropasqua), NHS Foundation Trust, London, United Kingdom.
² From the Department of Neurosciences, Biomedicine and Movement Sciences (Pedrotti, Mastropasqua, Bruni, Bonacci, Talli, Marchini), Eye Clinic, University of Verona, Verona, the Carones Ophthalmology Center (Carones), Milano, the Department of Experimental Medicine and Surgery (Aiello, Nucci), University of Rome Tor Vergata, Rome, and Ophthalmology (Mastropasqua, Mariotti), Department of Neuroscience, Polytechnic University of Marche, Ancona, Italy; Moorfields Eye Hospital (Aiello, Mastropasqua), NHS Foundation Trust, London, United Kingdom. Electronic address: francescoaiello@hotmail.com.

PMID: 29587972
DOI: 10.1016/j.jcrs.2017.11.011

Abstract

Purpose: To compare the visual acuity, refractive outcomes, and quality of vision in patients with bilateral implantation of 4 intraocular lenses (IOLs).

Settings: Department of Neurosciences, Biomedicine and Movement Sciences, Eye Clinic, University of Verona, Verona, and Carones Ophthalmology Center, Milano, Italy.

Design: Prospective case series.

Methods: The study included patients who had bilateral cataract surgery with the implantation of 1 of 4 IOLs as follows: Tecnis 1-piece monofocal (monofocal IOL), Tecnis Symfony extended range of vision (extended-range-of-vision IOL), Restor +2.5 diopter (D) (+2.5 D multifocal IOL), and Restor +3.0 D (+3.0 D multifocal IOL). Visual acuity, refractive outcome, defocus curve, objective optical quality, contrast sensitivity, spectacle independence, and glare perception were evaluated 6 months after surgery.

Results: The study comprised 185 patients. The extended-range-of-vision IOL (55 patients) showed better distance visual outcomes than the monofocal IOL (30 patients) and high-addition apodized diffractive-refractive multifocal IOLs (P ≤ .002). The +3.0 D multifocal IOL (50 patients) showed the best near visual outcomes (P < .001). The +2.5 D multifocal IOL (50 patients) and extended-range-of-vision IOL provided significantly better intermediate visual outcomes than the other 2 IOLs, with significantly better vision for a defocus level of -1.5 D (P < .001). Better spectacle independence was shown for the +2.5 D multifocal IOL and extended-range-of-vision IOL (P < .001).

Conclusions: The extended-range-of-vision IOL and +2.5 D multifocal IOL provided significantly better intermediate visual restoration after cataract surgery than the monofocal IOL and +3.0 D multifocal IOL, with significantly better quality of vision with the extended-range-of-vision IOL.

Publication types

Comparative Study

MeSH terms

Aged
Contrast Sensitivity / physiology
Female
Glare
Humans
Lens Implantation, Intraocular / methods*
Lenses, Intraocular*
Male
Middle Aged
Multifocal Intraocular Lenses*
Patient Satisfaction
Phacoemulsification / methods*
Prospective Studies
Pseudophakia / physiopathology*
Refraction, Ocular / physiology*
Visual Acuity / physiology*