Abstract

This study evaluated visual acuity, contrast sensitivity, and wavefront aberrations after refractive multifocal intraocular lens (IOL) implantation. A prospective study comprising 174 eyes of 87 patients who had bilateral implantation of a multifocal IOL was carried out. A control group of 100 eyes of 50 age-matched patients with a monofocal IOL was used for comparison. Uncorrected and corrected distance and near visual acuity, contrast sensitivity (CS), and wavefront analysis (Hartmann-Shack) was performed 6 months after surgery. Contrast sensitivity was tested for distance and near under mesopic (2 cd/m2) and photopic conditions (90 cd/m2). Distance photopic CS was not significantly different from the monofocal group, while distant mesopic CS and near photopic and mesopic CS were significantly lower. Mean aberration root mean square (RMS) values for the multifocal IOL group were 0.229 ± 0.103 µm for coma, 0.137 ± 0.067 µm for spherical aberration (SA), and 0.301 ± 0.133 µm for higher order aberrations (HOAs). Strehl ratio averaged 0.096 ± 0.045. Distant visual performance with the multifocal IOL was excellent under photopic conditions, but was reduced under mesopic levels. Near vision showed suboptimal results in both photopic and mesopic conditions. Coma, SA, and HOAs with the multifocal IOL were higher than those reported previously, with a lower Strehl ratio.

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