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Comparing the 1CU accommodative, multifocal, and monofocal intraocular lenses: a randomized trial
F E Harman1, S Maling, G Kampougeris
1Department of Ophthalmology, Hillingdon Hospital, Uxbridge, United Kingdom. harmanfran@hotmail.com
Ophthalmology
|November 23, 2007
Summary
The 1CU accommodating intraocular lens (IOL) improved near vision compared to monofocal IOLs. Multifocal IOLs offered excellent near acuity but caused glare issues.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Vision Science
Background:
- Cataract surgery often involves intraocular lens (IOL) implantation to restore vision.
- Accommodating and multifocal IOLs aim to provide improved near and distance vision compared to traditional monofocal IOLs.
- Assessing binocular near vision performance is crucial for evaluating IOL efficacy.
Purpose of the Study:
- To compare the binocular near vision performance of the 1CU accommodating intraocular lens (IOL) against multifocal and monofocal IOLs.
- To evaluate visual acuity, contrast sensitivity, accommodative amplitude, reading speed, glare symptoms, and spectacle independence.
- To determine the clinical effectiveness of the 1CU accommodating IOL in cataract patients.
Main Methods:
- A prospective, randomized, double-masked clinical trial involving 90 patients undergoing bilateral sequential cataract surgery.
- Patients received either the 1CU accommodating IOL, a multifocal IOL, or a monofocal IOL (control).
- Visual acuities, contrast sensitivity, accommodative amplitude, reading speed, glare, and spectacle independence were assessed at 3 and 18 months post-surgery.
Main Results:
- The 1CU and multifocal IOL groups demonstrated significantly better unaided and distance-corrected binocular near visual acuities than the monofocal control group.
- Reading speed was similar across all groups, but critical print sizes were significantly better in the 1CU and multifocal groups compared to the control.
- The multifocal IOL group had the highest accommodative range, while the 1CU group showed no significant difference from the control group in defocus or near point at 18 months.
- Fewer patients in the 1CU (71.4%) and monofocal (63.2%) groups reported glare symptoms compared to the multifocal group (25%), with P=0.01.
- Spectacle independence was achieved by 19% of the 1CU group and 27.3% of the multifocal group, versus none in the control group (P=0.05).
Conclusions:
- The 1CU accommodating IOL offers enhanced near vision compared to a standard monofocal IOL.
- A discrepancy exists between the measured near function and accommodative amplitude for the 1CU IOL.
- While multifocal IOLs provide excellent near acuity, they are associated with significant photopic phenomena (glare).
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