Compared optical performances of multifocal and monofocal intraocular lenses (contrast sensitivity and dynamic visual...

The functional results (contrast sensitivity and dynamic visual acuity) of 19 multifocal (3M design) and 14 all polymethylmethacrylate biconvex monofocal intraocular lenses (IOLs), 6 mm in optical diameter were compared. Best corrected visual acuity was > or = 8/10 (Monoyer chart) Parinaud 2 in all cases. Major differences of functional performance in favour of monofocal IOLs were found outside standard conditions of vision (low contrast and illumination levels). A significant difference in contrast sensitivity was found for each spatial frequency in favour of multifocal IOLs (0.0016 < p < 0.05). Mesopic vision was statistically higher in the monofocal IOL group (p = 0.0015). Moreover, dynamic visual acuity allowed accurate evaluation of the difference in performance between these two models of implant. In view of these results multifocal IOLs should be reserved for patients with normal psychosensitive adaptation; an ocular pathology that could alter contrast sensitivity or mesopic vision is a contraindication for multifocal IOLs.