Combining zonal refractive and diffractive aspheric multifocal intraocular lenses

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Optics

Background:

• Multifocal intraocular lenses (MIOLs) are designed to provide clear vision at multiple distances after cataract surgery.
• Aspheric designs and different optical principles (refractive vs. diffractive) aim to optimize visual outcomes and minimize visual disturbances.

Purpose of the Study:

• To evaluate the combined visual performance of a zonal refractive aspheric MIOL (Lentis Mplus) and a diffractive aspheric MIOL (Acri.Lisa 366).
• To compare the visual acuities, defocus curves, and contrast sensitivity of this MIOL combination against a monofocal intraocular lens (IOL) control group.

Main Methods:

• Prospective interventional cohort study involving 40 cataract patients (80 eyes).
• Each patient received the Lentis Mplus MIOL in one eye and the Acri.Lisa 366 MIOL in the fellow eye.
• Visual performance was assessed using uncorrected and corrected visual acuities, defocus curves, contrast sensitivity, and a quality of vision questionnaire, compared to a monofocal IOL control group.

Main Results:

• Excellent binocular uncorrected visual acuities (≥0.12 logMAR) were achieved at distance, intermediate, and near (6m to 33cm).
• The Lentis Mplus showed superior vision between 2m and 40cm, while Acri.Lisa performed better at 33cm.
• Contrast sensitivity was similar to monofocal IOLs except at higher frequencies; 92.5% of patients achieved spectacle independence.

Conclusions:

• The combination of zonal refractive and diffractive aspheric MIOLs yields excellent uncorrected binocular vision across all focal planes.
• This MIOL combination demonstrates a low incidence of significant photic phenomena and high patient satisfaction.
• The study supports the efficacy of combining different MIOL technologies for enhanced visual rehabilitation post-cataract surgery.