Quality of vision in patients with aspherical diffractive multifocal intraocular lens implantation

Abstract

To evaluate the visual performance of patients with Tecnis ZM900 aspherical diffractive multifocal intraocular lens (MIOL) as compared with aspherical monofocal intraocular lens (IOL). A prospective nonrandomized controlled study was conducted. Consecutively 114 senile cataract patients (114 eyes) received phacoemulsification and IOL implantation, 57 patients (57 eyes) were implanted Tecnis ZM900 MIOL (multifocal group) and 57 patients (57 eyes) were implanted aspherical Tecnis ZA9003 IOL (monofocal group). All patients were assessed at 3 months postoperatively: uncorrected and best corrected visual acuities for distance and near, distance corrected near visual acuity, higher-order aberrations of IOL, modulation transfer function, contrast visual acuity at different contrast levels and different distance (40 cm, 63 cm and 100 cm) and pseudoaccommodation. Patient satisfaction (spectacle independence, photic phenomena and overall satisfaction) was assessed by a questionnaire. At 3 months post-operation, both uncorrected near visual acuity and distance corrected near visual acuity were significantly better in multifocal group than monofocal group (t = - 7.62, - 9.89, P < 0.05). The accommodative range was (4.74 +/- 1.05) D in multifocal group and (1.65 +/- 0.68) D in monofocal group (P < 0.01). There was no statistically significantly difference between the two groups in IOL higher-order aberration with different pupil sizes (3 mm vs 5 mm). At the distance of 40 cm and 63 cm, visual acuity scores were higher in multifocal group than in monofocal group (P < 0.01). Modulation transfer function was similar in the two groups and there was no statistically significantly difference. The spectacle independence was 85.9% in multifocal group versus 24.6% in the monofocal group (chi2 = 43.46, P < 0.05). Compared with aspherical monofocal IOL, the Tecnis ZM900 aspherical diffractive MIOL not only provided certain pseudoaccommodation with a better useful near visual acuity, but also provided a better quality of vision, resulting in higher levels of spectacle independence and patient satisfaction.