Comparison of visual performance between monofocal and rotationally asymmetric refractive intraocular lenses

We compared the visual performance of a monofocal intraocular lens (IOL) (ZCB00) and a rotationally asymmetric refractive IOL with +1.5 diopters near addition (Lentis Comfort LS-313 MF15) by investigating the ten-week postoperative parameters of both eyes of cataract patients who underwent bilateral implantation with one of the two IOLs within three months between 2011 and 2019. A total of 1352 eyes of 676 patients were enrolled; the ZCB00 group comprised 904 eyes of 452 patients (72.3 ± 6.8 years; females/males, 268/184), and the LS-313 MF15 group included 448 eyes of 224 patients (73.6 ± 7.0 years; females/males, 125/99). Comparisons were made with a linear mixed-effects model, strictly adjusting for sex, age, subjective refraction spherical equivalent, subjective refraction cylinder, corneal astigmatism, axial length, corneal higher-order aberrations, and pupil diameter to ensure statistical validity. The corrected distance visual acuity was significantly better, and most of the higher-order aberrations were significantly smaller in the ZCB00 group (p < 0.00068, Wald test). Contrast sensitivity with glare (6.3 degrees) and spectacle independence (near) were significantly better in the LS-313 MF15 group (p < 0.00068, Wald test).