Near visual acuity for everyday activities with accommodative and monofocal intraocular lenses

To determine the levels of functional near visual acuity required for everyday social reading activities and to compare the levels to those attained with accommodative and monofocal intraocular lenses (LOLs).

Font size equivalencies of an Early Treatment Diabetic Retinopathy Study near chart and a variety of commonly read print objects were determined and correlated to the findings of distance-corrected near vision measurements with 2 accommodative (Tetraflex, 1CU) and 1 monofocal (Acrysof MA30) IOLs.

The smallest print objects studied were sweetener packets with type between 20/40 (Jaeger [J] 5) and 20/50 (J6). Type in classified ads, stock quotations, and pocket bibles was 20/50 (J6), type in a telephone directory was 20/63 (J8), and type in standard newspapers, journals, and magazines was 20/80 (J9). Tested monocularly, 88% of Tetraflex, 40% of ICU, and 7% of Acrysof MA30 eyes had distance-corrected near vision sufficient to read newspaper and telephone directory print, and 63% of Tetraflex, 30% of 1CU, and 0% of Acrysof MA30 eyes could read classified ads, stock quotations, and pocket bibles, respectively. Tested binocularly after bilateral implantation, 96% of Tetraflex patients could read telephone directory print and 89% could read ads, stock quotations, and pocket bibles.

Functional near visual acuity is not equivalent to the bottom-line objective at 20/20 (J1) near visual acuity. No print size was found at or smaller than 20/40 (J5), indicating that a requirement of nearly perfect near visual acuity, while desirable, may not be necessary for patients' social reading needs for accommodative IOLs.