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Abstract
BackgroundTo evaluate monocular and binocular visual outcomes for near, intermediate, and far distance in patients implanted with diffractive multifocal intraocular lenses (IOLs) with different add power contralaterally.MethodsThis is a prospective contralateral study. Two diffractive multifocal IOLs with different added power were implanted bilaterally in twenty patients. TECNIS® ZKB00 (+ 2.75 D) was implanted in a dominant eye, and TECNIS® ZLB00 (+ 3.25 D) was implanted in a non-dominant eye. Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and manifest refraction (MR) values were measured at 1 month and 3 months postoperatively. At the 3-month follow-up, defocus curve, contrast sensitivity, and reading performance were evaluated. Quality of vision, overall satisfaction, and spectacle independence were evaluated by questionnaire.ResultsPostoperative binocular UDVA, visual acuity at 80 cm, 60 cm, 50 cm, 43 cm, 33 cm were − 0.08 ± 0.10, 0.12 ± 0.14, 0.09 ± 0.09, 0.07 ± 0.11, 0.14 ± 0.09, 0.25 ± 0.11 logMAR. The binocular defocus curve showed an extended range of good visual acuity with sharp vision being observed from 0 D to − 2.50 D defocus (logMAR≤0.1). Reading performance was significantly improved compared to baseline. All patients were spectacle-free at distance, and 94.74% of the patients did not require glasses for near and intermediate vision.ConclusionsMix-and-match implantation of diffractive multifocal IOLs with different add power provides an excellent wide range of vision, as well as high levels of visual quality and patient satisfaction.Trial registrationClinicalTrials.gov, NCT02556944,https://clinicaltrials.gov/show/NCT02556944
Highlights
To evaluate monocular and binocular visual outcomes for near, intermediate, and far distance in patients implanted with diffractive multifocal intraocular lenses (IOLs) with different add power contralaterally
Diffractive trifocal IOLs aim to provide a wider range of spectacle independence especially at an intermediate distance compared to bifocal IOLs
Decreased contrast sensitivity and unwanted visual symptoms may occur after trifocal IOLs implantation [6, 7]
Summary
To evaluate monocular and binocular visual outcomes for near, intermediate, and far distance in patients implanted with diffractive multifocal intraocular lenses (IOLs) with different add power contralaterally. Patients can achieve a good uncorrected-distance visual acuity after monofocal IOL implantation, most patients need glasses for reading or other activities at close distance. Yang et al BMC Ophthalmology (2018) 18:73 a suboptimal intermediate visual acuity compared to near and distance visual acuities [3, 4]. Diffractive trifocal IOLs aim to provide a wider range of spectacle independence especially at an intermediate distance compared to bifocal IOLs. Trifocal IOLs provide three foci to enhance intermediate visual acuity. The distribution of light energy for a third focus could negatively affect near and distance visual acuity [5]. Decreased contrast sensitivity and unwanted visual symptoms may occur after trifocal IOLs implantation [6, 7]
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