Bifocal versus monofocal intraocular lenses in bilateral pseudophakia

After a mean follow up of 19 months, the visual characteristics of eyes with bifocal diffractive intraocular lenses (IOLs) ("bifocals") in one eye were compared with those of fellow eyes with monofocal IOLs ("monofocals") in 29 bilateral pseudophakic patients. All of the eyes had a distance-corrected acuity of 0.6 or more, but 24.1% of the bifocals and 48.3% of the monofocals had an acuity of 1.00. Near acuity with distance correction was J2 or more in 93.1% of the bifocals and in 17.4% of the monofocals (without correction: 79.3% and 41.4%, respectively). In 55.2% of the bifocals and 20.7% of the monofocals, the combined uncorrected acuity was 0.5 or more for distance and J2 or more for near. Fogging revealed a similar depth of focus in the monofocals and a similar distance focus in the bifocals. The bifocals had two peaks of acuity but no "plateau" between them. The eye with the monofocal IOL was preferred by 37.9% and the eye with the bifocal IOL by 10.3%. Vision in no eye was rated "poor." Visual disturbances were more frequent in the bifocals. No glasses were prescribed for 20.7% of all of these patients; 65.5% required bifocal glasses; 44.8% managed most of daytime without glasses.