[Comparison of visual acuity in pseudophakic eyes with multifocal intraocular lens versus fellow eyes with clear lens]

Abstract

Objective: To evaluate the visual acuity and subjective satisfaction of different aged monocular cataract patients who were implanted with ReSTOR multifocal intraocular lens (MIOL).

Methods: Prospective comparative study: the objects are 24 cases of monocular cataract patients who consecutively received phacoemulsification and implantation of ReSTOR MIOL. The patients were divided into two groups by age: the presbyopic group has 17 cases with age ≥ 45 years, the non-presbyopic group has 7 cases with ages < 45 years. Research parameters: uncorrected and corrected distance (4 m), intermediate (80 cm, 60 cm), and near visual acuity; contrast sensitivity (CS); and questionnaire survey. All data were statistically analyzed with rank sum test.

Results: Among presbyopia patients, the near vision of the eyes implanted with ReSTOR MIOL is better than that of the contralateral eyes with clear lens (Z = 2.864, Z = 2.911;P = 0.004), whereas the distance and intermediate vision and the CS results show no significant differences compared to that of contralateral eyes with clear lens (Z = 0.183 - 1.417, P = 0.855 - 0.156); the subjective satisfactions are 7 to 10 points with 70.6% (12/17) patients scoring higher than 9 points; and the spectacle-independent rate among presbyopia patients is 58.8% (10/17). In non-presbyopic group, the near and intermediate visions of ReSTOR MIOL implanted eyes are lower than that of the contralateral eyes with clear lens (Z = 2.197 - 2.371;P = 0.028 - 0.018); CS results of MIOL implanted eyes are also generally lower than that of the contralateral eyes, and the difference between CSs of bilateral eyes under night glare mode (3 cd/m(2)+28 Lux) with low spatial frequency (1.5 c/d) is statistically significant (Z = 1.997, P = 0.046); the subjective satisfactions are 6 to 9 points with 14.3% (1/7) patients scoring higher than 9 points; the spectacle-independent rate of both eyes is 85.7% (6/7).

Conclusions: The monocular cataract patients with presbyopia are suitable for implantation of ReSTOR MIOL, because their near visual acuity of ReSTOR MIOL implanted eyes is better than that of the contralateral clear lens eyes with higher subjective satisfaction and without decrease in distance and intermediate visions and CS. For non-presbyopic young patients with monocular cataracts, the near and intermediate visions of MIOL implanted eyes are lower than that of the contralateral clear lens eyes and with lower subjective satisfaction (compared to that of presbyopic patients), though the distance visions are similar. Therefore, although ReSTOR MIOL can be implanted in non-presbyopic group, a more detailed preoperative communication with these patients is needed.