Reading performance with a refractive multifocal and a diffractive bifocal intraocular lens

Abstract

Purpose To evaluate the reading performance of a diffractive bifocal (811E, Pharmacia) and a refractive multifocal (SA40N, Allergan) intraocular lens (IOL) and compare it with that of a monofocal IOL (811C, Pharmacia) with respect to reading acuity, reading speed based on print size, maximum reading speed, reading distance, and critical print size. Setting Department of Ophthalmology, University of Vienna, Vienna, Austria. Methods This study comprised 120 pseudophakic eyes of 70 patients; each IOL group had 40 eyes. The patients’ age, sex, and best corrected logMAR visual acuity were recorded. Reading acuity and speed were tested monocularly. Reading acuity was determined in logRAD (ie, the reading equivalent of logMAR). Patients with bifocal and multifocal IOLs read with best distance correction and patients with a monofocal IOL, with an addition of +3.0 diopters. Results The age, mean spherical equivalent, cylinder, and best corrected distance visual acuity were comparable among the 3 groups. The mean logRAD reading acuity was 0.17 ± 0.18 (SD) in the 811E group (94.0% of logMAR), 0.31 ± 0.13 in the SA40N group (73.2% of logMAR), and 0.24 ± 0.22 in the 811C group (94.1% of logMAR). The reading acuity in the SA40N group was statistically significantly lower than in the 811E and 811C groups. The best reading distance was 30 cm in the 811E group and 40 cm in the SA40N group. The mean maximum reading speeds in words per minute were comparable: 187.5 ± 26.1 (811E), 171.0 ± 21.1 (SA40N), and 179.4 ± 21.6 (811C). The reading speed, which ranged from logRAD 0.7 to 0.3, and the critical print size in the SA40N group were significantly worse than in the 811E and 811C groups. The mean critical print size in the 811E group was significantly worse than in the 811C group. Conclusion Reading performance was acceptable in the bifocal and multifocal IOL patients, with the diffractive bifocal IOL performing best in a standardized reading test setting.