Comparison of postoperative visual quality with different multifocal intraocular lens designs

Abstract

Objective To compare postoperative visual function and quality after 3 different multifocal intraocular lenses (MIOLs) were implanted:REZOOM (refractive MIOL),Tecnis ZMA00 (all optical diffractive MIOL) and Acri.Lisa 366D (refractive diffractive MIOL).Methods This was a prospective case-control study.Forty eyes of 29 patients who underwent cataract phacoemulsification and MIOL implantation in Tianjin Eye Hospital cataract center were selected from September 2008 to March 2010.Fifteen eyes were implanted with REZOOM,12 eyes with Tecnis ZMAO0,and 13 eyes with Acri.Lisa 366D.Patients were reviewed after 3 months or more following surgery.Colenbrander Mixed Contrast Card Set vision test cards were used to measure intermediate and near visual acuity under the best corrected distance visual acuity.Then iTrace visual function analyzer checks were used to plot 5,10,15,20,25,and 30 c/d for modulation transfer function (MTF) and to measure intraocular aberrations as well as pupil diameter.Data were analyzed using a one-way ANOVA.Results The differences in best corrected distance,intermediate,near visual acuity among the 3 groups were not statistically significant.Three months or more after MIOL implantation,all examined patients from the 3 groups had best corrected distance visual acuity with 20/25 or better visual acuity.Forty-seven percent,42％ and 54％ patients in REZOOM,ZMA00 and Acri.Lisa 366D groups had intermediate visual acuities with 20/25 or better under the best corrected distance visual acuity.In corresponding group,13％,31％ and 50％ with 20/25 or better best corrected near visual acuity.Exccept for trefoil,There were statistically significant differences among the 3 groups in spherical and coma aberrations compared with the spherical intraocular lens (IOL) (Ar40e) and Tetraflex IOL.There were no statistically significant differences in MTF among the 3 groups except at 5 c/d.Conclusion The differences among the 3 MIOLs for far visual acuity after surgery are not substantial.Performance for middle distance vision and near vision is good.The aspheric MIOLs,Tecnis ZMA00 and Acri.Lisa 366D,perform better with fewer aberrations and better MTF than the spherical design of the REZOOM. Key words: Cataract; Lenses,intraocular,multifocal; Visual quality; Modulation transfer function; Aberration