[Long-term visual outcome comparison of bilateral implantation of apodised diffractive versus progressive multizonal...

The aim of this study was to evaluate the functional effect of bilateral implantation of apodised diffractive versus progressive multizonal refractive multifocal intraocular lenses compared to standard monofocal intraocular lenses.

229 patients underwent cataract extraction; 66 Array SA40N (AMO, Irvine, CA, USA), 76 SA60D3 ReSTOR (Alcon, Fort Worth, TX, USA), and 87 MA60AC (Alcon, Fort Worth, TX, USA) were implanted. In this retrospective trial the main outcome measures were near, intermediate, and distance visual acuity and assessment of subjective function by questionnaire.

Mean follow-up was 4.7 ± 1.4 years with monofocal, 6.6 ± 1.7 with Array and 4.3 ± 1.1 with ReSTOR implants. Uncorrected binocular distance visual acuity was equivalent in the three groups. Uncorrected binocular near and intermediate visual acuity and spectacle independence were significantly higher in the two multifocal groups (p < 0.001). Glare and halos were more bothersome with multifocal than monofocals implants (p < 0.05) and adverse visual symptoms at night with Array implants but equivalent between ReSTOR patients and monofocal patients. Between the two multifocal groups spectacle independence was higher and adverse visual symptoms lower in ReSTOR patients than in Array patients (p < 0.05). ReSTOR patients reported a higher overall visual satisfaction than the other groups (p < 0.001) and rated their vision at 8.8 ± 1.8. Monofocal patients reported a slightly higher satisfaction at 7.6 ± 1.7 compared to Array patients at 6.9 ± 2.6 (p = 0.05).

In this long-term study the highest overall visual satisfaction could be achieved by bilateral implantation of apodised diffractive intraocular lenses.