Effect of postoperative refractive error on visual acuity and patient satisfaction after implantation of the Array...

To determine the ideal target refraction to optimize visual acuity (VA) and patient satisfaction after implantation of Array SA40N multifocal intraocular lens (IOL) (AMO).

Inha University College of Medicine, Incheon, Korea.

The study prospectively enrolled 188 eyes of 163 patients and assigned them to 1 of 3 groups according to their postoperative refractive status: Group 1 (43 myopic eyes, -0.50 diopter [D] to -1.50 D), Group 2 (114 emmetropic eyes, -0.50 D to +0.50 D) and Group 3 (31 hyperopic eyes, +0.50 D to +1.50 D). Uncorrected distance visual acuity (UCDVA), uncorrected near visual acuity (UCNVA), UCDVA under glare conditions, contrast sensitivity, and patient satisfaction were then compared between the 3 groups.

Three months postoperatively, UCDVA, UCNVA, UCDVA under glare conditions, and contrast sensitivity were good in all eyes and more than 72% of patients never wore glasses for near vision. In Group 2, UCDVA was significantly better (0.74 +/- 0.20; P<.05) compared with Groups 1 and 3 (0.40 +/- 0.24 and 0.38 +/- 0.30, respectively); UCNVA was also significantly better in Group 2 (0.68 +/- 0.08; P<.05) than in Groups 1 and 3 (0.45 +/- 0.21 and 0.41 +/- 0.17, respectively). However, there were no significant differences in patient satisfaction, contrast sensitivity, and UCDVA under glare conditions between the 3 groups (P>.05).

Aiming for emmetropia rather than myopia when calculating the power for the multifocal intraocular lens may improve visual acuity. However, patients must be considered on an individual basis to meet their expectations and requirements.