Bilateral mix-and-match versus unilateral multifocal intraocular lens implantation: long-term comparison

To compare the visual outcomes and subjective satisfaction levels of patients who had bilateral mix-and-match implantation or monocular implantation of multifocal intraocular lenses (IOLs).

Asan Medical Center, Seoul, South Korea.

Retrospective comparative case series.

Patients had implantation of a diffractive multifocal IOL (Tecnis ZM900) in 1 eye and a refractive multifocal IOL (Rezoom NXG1) in the other eye via the mix-and-match approach or of a Tecnis ZM900 IOL in 1 eye only. After 1 year, the uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and contrast sensitivity were evaluated. Patient satisfaction, spectacle dependence, and halo and glare symptoms were also evaluated.

Twenty-three patients were evaluated. One year postoperatively, the mean values in the bilateral group and unilateral group were, respectively, binocular UDVA, 0.10 logMAR ± 0.18 (SD) and 0.10 ± 0.13 logMAR (P=.574); UIVA, 0.23 ± 0.12 logMAR and 0.29 ± 0.14 logMAR (P=.127); UNVA, 0.25 ± 0.18 logMAR and 0.27 ± 0.25 logMAR (P=.926). Subjective patient satisfaction was slightly higher in the bilateral implantation group (P=.083). There were no significant differences in contrast sensitivity, spectacle dependency, halos, or glare.

There were no significant differences in postoperative visual acuity, subjective patient satisfaction, spectacle independence, or other visual symptoms between patients who had bilateral or unilateral implantation of multifocal IOLs. Unilateral implantation of a multifocal IOL is an option to lower spectacle dependency and increase patient satisfaction.