Visual Outcomes After Implantation of a Segmental Refractive Multifocal Intraocular Lens Following Cataract Surgery

Abstract

To evaluate visual outcomes, with particular attention to intermediate visual acuity (VA), of a segmental refractive multifocal intraocular lens (IOL) with optimized depth of focus (DoF). Prospective, nonrandomized, noncomparative case series. Setting: Department of Ophthalmology, Goethe University, Frankfurt/Germany. Patient or Study Population: Fifty eyes (25 patients) were included. Inclusion criteria were bilateral cataract, age > 45 years, corneal astigmatism ≤ 0.75 diopter (D) postoperatively, pupil size 3-6mm (mesopic), and center shift < 1mm (Pentacam). Exclusion criteria were ocular surgeries, amblyopia, or potential postoperative distance-corrected VA (DCVA) > 0.3 logMAR. Intervention or Observation: Uncorrected (UCVA) and DCVA in 4 m, 80cm, 40cm; contrast sensitivity (CS); reading skills; defocus curve; and questionnaire on optical quality (OQ) and spectacle independence were assessed after 3months. UCVA and DCVA in 4 m, 80cm, 40cm; defocus curve. UCVA was 0.05 ± 0.122 logMAR at 4 m, 0.18 ± 0.164 logMAR at 80cm, and 0.16 ± 0.140 logMAR at 40cm. Defocus curve testing showed, respectively, a flat monocular and binocular VA range from 0.00 to-2.00 D (-0.03 to 0.11 logMAR,-0.05 to 0.05 logMAR). Median CS under photopic and mesopic conditions without and with glare was 1.81 logCS, 1.65 logCS, 1.52 logCS, and 1.14 logCS, respectively. Reading speed at 40cm showed a reading acuity of 0.100 logRAD with 94 words/minute. This segmental multifocal IOL provides good VA at all distances (<0.20 logMAR), particularly providing good intermediate visual acuity and DoF. It showed good reading skills, OQ, and CS and high spectacle independence.