Comparison of visual performance between monofocal and multifocal intraocular lenses of the same material and basic design

Abstract

To compare the visual performance of a monofocal intraocular lens (IOL) (ZCB00) and a multifocal IOL (ZMB00) of the same material and basic design, we evaluated postoperative parameters at 10 weeks after the last surgery in cataract patients who underwent bilateral ZCB00 or ZMB00 implantation from December 13, 2010, to July 29, 2019, with the right and left lenses implanted within 3 months of each other. The study enrolled 2,230 eyes of 1,115 patients. The monofocal group comprised 904 eyes of 452 patients (72.3 ± 6.8 years; females/males, 268/184), and the multifocal group comprised 1,326 eyes of 663 patients (67.0 ± 7.8 years; females/males, 518/145). Contrast sensitivity (4.0/2.5/1.6/1.0/0.7 degrees), contrast sensitivity with glare (1.6/1.0/0.7 degrees), and the VFQ-25 score for driving at night were significantly better in the monofocal group (p < 0.00068, Wald test). Uncorrected intermediate/near visual acuity and near spectacle independence were significantly better in the multifocal group (p < 0.00068, Wald test). The two IOL groups had different characteristics in terms of contrast sensitivity, night-time driving, uncorrected intermediate/near visual acuity and near spectacle independence.

Figure 1

Contrast sensitivity with or without glare in the monofocal and multifocal groups before and 10 weeks after surgery on both eyes. The solid line connects the median values for each group. Each parameter was adjusted by multiple linear regression with the explanatory variables in Table 1. The significance level was set to 0.0083 after Bonferroni’s correction.

Figure 2

Parameters that demonstrated a significant difference between the monofocal and multifocal groups at 10 weeks after surgery on both eyes. Each parameter was adjusted by multiple regression with the explanatory variables in Table 1.

Figure 3

Heatmap of correlation coefficients between all possible combinations of variables, which were adjusted by multiple regression with the explanatory variables in Table 1, in the monofocal IOL group. The asterisk * in this figure indicates a significant correlation between two parameters at p < 0.00002 after Bonferroni’s correction. The illustration was performed using a commercially available software program (R, version 3.6.1; R Core Team, 2019, Vienna, Austria.) (https://cran.r-project.org/web/packages/pheatmap/pheatmap.pdf).

Figure 4

Heatmap of correlation coefficients between all possible combinations of variables, which were adjusted by multiple regression with the explanatory variables in Table 1, in the multifocal group. The asterisk * in this figure indicates a significant correlation between two parameters at p < 0.00002 after Bonferroni’s correction. The illustration was performed using a commercially available software program (R, version 3.6.1; R Core Team, 2019, Vienna, Austria) (https://cran.r-project.org/web/packages/pheatmap/pheatmap.pdf).