Results of a European multicenter study of the True Vista bifocal intraocular lens

Abstract

The True Vista intraocular lens (IOL), a three-zone refractive bifocal lens, was implanted in 446 patients in a prospective study. Visual acuity, pupil size, and astigmatism were determined. Contrast acuity was measured in a randomized subgroup of best-case patients (n = 60; Regan charts); subjective assessment of vision was compared in 41 best cases with a monofocal fellow eye. Two hundred twenty-seven best-case patients were available for four to six months follow-up, and 145 for seven to eleven months. Best corrected distance acuity was 20/40 or better in 96% and 98%, respectively. Near acuity was 20/30 or better in 93% and 92% with near add, in 64% and 69% uncorrected, and in 79% and 78% with distance correction, respectively. Distance and near acuity decreased with increasing astigmatism and increasing age. Contrast acuity at distance focus was lower than for monofocal IOLs (11% contrast); values at near focus were considerably lower at all contrast steps tested. Of the patients with a monofocal fellow eye, 96% rated their distance vision with glasses in the monofocal eye as good, compared with 78% in the bifocal eye. The True Vista IOL favors distance vision while near acuity is still sufficient. As high image contrast at distance is usually more important than at near, this might be a good compromise. However, bifocal IOLs should probably not be implanted in patients with a monofocal fellow eye.