Visual outcomes and optical performance with a monofocal intraocular lens and a new-generation single-optic accommodating intraocular lens

Abstract

To compare the visual acuity outcomes and the ocular and intraocular optical quality in patients with a monofocal intraocular lens (IOL) or a new-generation single-optic accommodating IOL. Vissum Corporation, Alicante, Spain. Comparative case series. Consecutive eyes of bilateral cataract patients were divided into 2 groups. One group had implantation of a monofocal IOL (Acri.Smart 48S) and the other group, of a single-optic accommodating IOL (Crystalens HD). Distance and near visual acuities were evaluated preoperatively and postoperatively. In addition, postoperative ocular optical quality, intraocular aberrations, and defocus curves were evaluated. The 20 patients included in the study ranged in age from 50 to 87 years. The monofocal IOL group comprised 24 eyes and the accommodating IOL group, 16 eyes. In both groups, the uncorrected and corrected distance visual acuities improved significantly from preoperatively to postoperatively (P ≤ .03). The distance-corrected near visual acuity also improved significantly in both groups (P ≤ .03); the difference between groups was at the limit of statistical significance (P = .05). The uncorrected near visual acuity was significantly better in the accommodating IOL group (J5 versus J3; P = .01). The defocus curves showed significantly better visual acuity in the accommodating IOL group at several levels of defocus. There were no statistically significant differences between the 2 groups in any intraocular aberrometric coefficient (P ≥ .06). The new-generation single-optic accommodating IOL restored distance visual function after cataract surgery and improved near vision. The optical quality with the accommodating IOL was similar to that with the conventional monofocal IOL.