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Prospective, randomized, comparative, and controlled study to estimate the association between angle κ distance and higher-order aberrations (HOAs) with postoperative visual acuity after presbyopia-correcting IOL implantation. Forty-three eyes from 43 patients were included and randomly assigned in two groups for either AT LISA tri 839MP or Acrysof IQ PanOptix IOL implantation. The OPD-Scan III analyzer was utilized to assess the angle κ distance and higher-order aberration (HOAs). Twenty-three eyes were in the Acrysof IQ PanOptix group and 20 patients in the AT LISA tri 839MP group. The uncorrected distance visual acuity (UDVA) for the PanOptix group was 0.092 ± 0.10, whereas for AT LISA tri was 0.050 ± 0.06 (P=0.229). The uncorrected intermediate visual acuity (UIVA) for the PanOptix group was 0.173 ± 0.18, whereas for AT LISA tri, it was 0.182 ± 0.11 (P=0.669). Uncorrected near visual acuity (UNVA) was 0.068 ± 0.04 and 0.085 ± 0.07, respectively (P=0.221). Also, correlation coefficient between HOAs and the Strehl ratio for each group were −0.768 (P<0.0001) and −0.863 (P=0.0001). Patients implanted with both trifocal IOLs showed excellent postoperative visual performance at all distances at the six-month follow-up visit. No association was found between angle κ distance and postoperative visual acuity regardless of the angle κ magnitude or the two trifocal IOLs inner optical diameter. Also, internal aberrations demonstrated a significant inverse correlation with the Strehl ratio for both trifocal IOLs.

Objective. To compare the clinical performance of refractive rotationally asymmetric multifocal intraocular lens (IOLs) with spherical monofocal, accommodating, and bifocal IOLs. Methods. A comprehensive literature search of PubMed, EMBASE, Cochrane Controlled Trials Register, and Web of Science up to February 2017 was performed to identify randomized controlled trials (RCT) and comparative cohort studies. Main outcomes were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), higher-order aberrations (HOAs), MTF, Strehl ratio, and residual sphere and cylinder. Results. Mplus provided significantly worse UDVA than spherical monofocal IOLs (WMD: 0.13, P=0.008), but significantly better UIVA than high-add bifocal IOLs (WMD: −0.19, P<0.00001), spherical monofocal IOLs (WMD: −0.12, P<0.0001), and accommodating IOLs (WMD: −0.21, P<0.00001). Mplus provided significantly worse UNVA than high-add bifocal IOLs (WMD: 0.07, P<0.00001), but significantly better UNVA than spherical monofocal IOLs (WMD: −0.19, P<0.00001). Mplus resulted in significantly higher HOAs than high-add bifocal IOLs (WMD: 0.38, P<0.00001) and spherical monofocal IOLs (WMD: 0.51, P=0.0004). Mplus provided a significantly lower MTF cut-off and Strehl ratio than other type of IOLs. Conclusion. The Mplus IOLs perform best regarding intermediate visual acuity whereas they lack in distance visual acuity compared to monofocal IOLs and near visual acuity compared to bifocal IOLs. These results may be due to structure of Mplus IOLs resulting in higher-order aberrations.

Purpose.To compare near, intermediate, and distance vision and quality of vision, when refractive rotational multifocal intraocular lenses with 3.0 diopters or diffractive multifocal intraocular lenses with 2.5 diopters near addition are implanted.Methods.41 eyes of 41 patients in whom rotational +3.0 diopters near addition IOLs were implanted and 30 eyes of 30 patients in whom diffractive +2.5 diopters near addition IOLs were implanted after cataract surgery were reviewed. Uncorrected and corrected distance visual acuity, intermediate visual acuity, near visual acuity, and patient satisfaction were evaluated 6 months later.Results. The corrected and uncorrected distance visual acuity were the same between both groups (p=0.50andp=0.509, resp.). The uncorrected intermediate and corrected intermediate and near vision acuities were better in the +2.5 near vision added intraocular lens implanted group (p=0.049,p=0.005, andp=0.001, resp.) and the uncorrected near vision acuity was better in the +3.0 near vision added intraocular lens implanted group (p=0.001). The patient satisfactions of both groups were similar.Conclusion. The +2.5 diopters near addition could be a better choice in younger patients with more distance and intermediate visual requirements (driving, outdoor activities), whereas the + 3.0 diopters should be considered for patients with more near vision correction (reading).

Purpose. To evaluate 2-year visual acuities and questionnaire after bilateral implantation of SN6AD1 multifocal intraocular lens (MIOL) or SN60WF IOL.Methods. Patients randomly scheduled for bilateral implantation of SN6AD1 MIOL and SN60WF IOL with 2-year follow-up were enrolled. Uncorrected/corrected distance and near visual acuity, uncorrected intermediate visual acuity at 63 cm under high and low contrast, reading activity, the defocus curve, and a quality-of-life questionnaire were evaluated.Results. Each group comprised 20 patients. Uncorrected intermediate visual acuities and uncorrected near visual acuity were better in SN6AD1 group than in SN60WF group (P=0.005,P=0.011, andP<0.001). In SN6AD1 group, the uncorrected intermediate and near visual acuities 1 year and 2 years postoperatively were reduced than postoperative 3-month outcomes, respectively. SN6AD1 group reported superior overall spectacle independence and inferior satisfaction. SN6AD1 group had a longer reading newspaper duration than SN60WF group (P=0.036). When using mobile phone, SN6AD1 group had a more comfortable distance than SN60WF group (P<0.001) and higher speed of reading fixed text message (P<0.001).Conclusion. SN6AD1 MIOL provided a satisfactory full range of visual acuities and questionnaire performance 2 years postoperatively. One-year and 2-year uncorrected near and intermediate visual acuities of SN6AD1 MIOL were lower than those 3 months postoperatively.