Short-term outcomes of combined implantation of diffractive multifocal intraocular lenses with different addition power

To compare short-term binocular visual function between patients implanted with diffractive multifocal intraocular lenses (MIOLs) of different near addition powers in each eye or the same MIOLs bilaterally.

Seventy patients scheduled for implantation of diffractive MIOLs were divided into two groups: (i) mix and match group, a MIOL with +3.0 dioptre (D) addition power implanted in the dominant eye (Alcon SN60D1) and a MIOL with +4.0D power implanted in the non-dominant eye (SN60D3) or (ii) same MIOL group, same MIOL (SN60D1) implanted bilaterally. At 3 months postoperatively, we examined binocular visual acuity (VA) at various distances, binocular contrast VA and that with a glare (glare VA), and near stereoacuity.

Mean binocular uncorrected (UNVA) or corrected near VA (CNVA) at 0.3 m was significantly better in the mix and match group than in the same MIOL group (p ≤ 0.0066). Binocular uncorrected and distance-corrected VA at other distances was similar. Binocular UNVA of 0.8 or better was achieved in 77.1% of patients in the mix and match group and 45.7% in the same MIOL group (p = 0.0144). Binocular contrast and glare VA, and stereoacuity did not significantly differ between groups. Spectacle independence and patient satisfaction with near vision were significantly better in the mix and match group (p ≤ 0.0195).

Mix and match implantation of diffractive MIOLs with different addition power provides a better binocular VA curve and spectacle independence than bilateral implantation of the same MIOLs, without compromising contrast sensitivity and stereopsis.