Initial experience with a refractive multifocal intraocular lens in a Japanese population

To evaluate a poly(methyl methacrylate) refractive, zonal-progressive multifocal intraocular lens (IOL) in patients requiring cataract surgery.

Department of Ophthalmology, Saiseikai Kurihashi Hospital, Saitama, Japan.

This open-label noncomparative study evaluated 58 eyes of 31 Japanese patients who had cataract surgery and implantation of a multifocal IOL (Array(R) PA154N, Allergan Surgical). The main outcome measures were visual acuity (VA) (distance and near, with and without correction), glare disability, and contrast sensitivity (CS) (distance and near, with and without glare under day and night conditions). A questionnaire was used to evaluate the effectiveness of the multifocal IOL.

Uncorrected distance VA was 0.7 or better (20/30) in 56 eyes (97.0%) and uncorrected near VA, 0.5 or better (20/40) in 52 eyes (89.7%). Corrected distance VA was 0.7 or better in all eyes. Near VA with distance correction was 0.5 or better in 51 eyes (87.9%). Daytime CS was within the normal range. However, nighttime CS with central glare for both distance and near was markedly decreased. Under all conditions, distance CS was significantly better than near CS from middle- to high-frequency areas. Seventy-four percent of patients with the IOL in both eyes did not need glasses for daily activities, and the others needed glasses only to read for long periods.

The results indicate that this refractive multifocal IOL is distance dominant and is beneficial in Japanese patients. However, since there are differences between Western countries and Japan in distance reading of characters and letters, further modification of this multifocal IOL may be required for use in Japanese patients.