Search

To evaluate the visual and refractive outcomes of laser corneal enhancement after trifocal intraocular lens (IOL) implantation in eyes previously treated with myopic/hyperopic laser corneal refractive surgery (LCRS).Clinica Baviera-AIER-Eye Group, Spain.Retrospective comparative case series.Patients were divided by primary LCRS into myopic and hyperopic groups. The outcomes evaluated were uncorrected distance (UDVA), corrected distance (CDVA), uncorrected intermediate (UIVA), and uncorrected near visual acuity (UNVA), and predictability, safety, efficacy, and satisfaction after implantation of 2 trifocal IOL models (Physiol-FineVision and Zeiss-ATLisa 839) and subsequent laser enhancement.186 eyes (89 myopic and 97 hyperopic eyes) from 146 patients were assessed. At the last visit, refractive outcomes were better in myopic than those in hyperopic eyes, with statistically significant differences for sphere ( P.001), cylinder ( P.001), manifest refraction spherical equivalent (MRSE) ( P = .003), CDVA ( P = .005), UDVA ( P = .047), and UNVA ( P = .003) but not for UIVA ( P = .580), binocular UIVA ( P = .660), or binocular UNVA ( P = .836). Predictability differences were nonsignificant between groups for a final MRSE of ±0.5 diopters (D) and ±1.0 D (P = .167 and .502, respectively). Efficacy and safety were similar in both groups ( P = .235 and P = .080). A greater myopic MRSE was present after trifocal implantation in myopic than in hyperopic eyes (MRSE = -0.93 vs -0.69 D, P = .013), and the statistically significant differences were maintained after enhancement between both groups (MRSE -0.00 vs 0.00 D, P = .003). Overall satisfaction was similar in both groups ( P.05 all items).Corneal laser enhancement after implantation of a trifocal IOL in eyes previously treated for myopia or hyperopia with LCRS was safe, effective, predictable, and highly satisfactory.

Honglei Li,1,2 Dongle Liu,1,2 Han Gao,3 Jiajun Sun,1,2 Huiran Bai,1,2 Xiaoming Wu1,2 1Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People’s Republic of China; 2State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, People’s Republic of China; 3Department of Ophthalmology, Qingdao Central Hospital, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao, People’s Republic of ChinaCorrespondence: Xiaoming WuQingdao Eye Hospital of Shandong First Medical University, 5 Yanerdao Road, Qingdao, 26600, People’s Republic of ChinaEmail wuxiaominglmm@126.comPurpose: This study compared the clinical outcomes after cataract surgery with implantation of refractive rotationally asymmetric bifocal intraocular lens (IOL) (LS-313 MF30) and apodized diffractive bifocal IOL (ReSTOR SN6AD1).Methods: This was a prospective, non-randomized, controlled study, where patients diagnosed with age-related cataracts were selected for phacoemulsification combined with bilateral IOL implantation. Based on the type of IOL voluntarily implanted, the patients were divided into two groups, ie, refractive and diffractive groups. In total, 30 cases (60 eyes) were in a refractive group, while 30 cases (60 eyes) were in diffractive group. Three months after surgery, we examined the uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), defocus curve, objective visual quality, and subjective questionnaire.Results: Three months after surgery, the UIVA of the refractive group (0.18 ± 0.08) logMAR was better than that of the diffractive group (0.29 ± 0.16) logMAR (P < 0.05). No significant difference in UDVA and UNVA was noted between the two groups. For a 4mm pupil diameter, the intraocular and total eye aberration, higher-order aberration (HOA), coma, spherical aberration, and trefoil in the refractive group were significantly higher than those in diffractive group (P < 0.05). The intraocular modulation transfer function (MTF), intraocular strehl ratio (SR), total eye MTF, and total eye SR in the refractive group were lower than those in diffractive group (P < 0.05). No significant difference in glare incidence, spectacle independence rate, and patient satisfaction was observed between the two groups (P > 0.05). The halos incidence in the refractive group was lower than the diffractive group (P < 0.05).Conclusion: Both bifocal IOLs obtained satisfactory UDVA and UNVA, with higher patient satisfaction. Unlike the apodized diffractive bifocal IOL, the refractive rotationally asymmetric bifocal IOL yielded slightly better UIVA, lower halos incidence, whereas the apodized diffractive bifocal IOL showed a better objective visual quality.Keywords: refractive rotationally asymmetric, apodized diffractive, intraocular lens, visual quality

Purpose To determine if intraoperative aberrometry (IA) improves astigmatic outcomes for trifocal toric IOL (TTI) cases. Patients and Methods This was a retrospective study examining 137 eyes that underwent cataract extraction and TTI implantation using femtosecond laser, digital registration, and IA. Final cylinder power and axis of placement were determined by IA. Monocular uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and refractive data were collected at 3 months. Postoperative residual astigmatism (PRA) determined by manifest refraction was compared to back-calculated residual astigmatism (BRA) using the cylinder power calculated preoperatively. Results Postoperatively, 97.8% of eyes had IA PRA ≤ 0.50D and 80.3% had BRA ≤ 0.50 D, a difference of 17.5%. Mean PRA for IA was 0.07 D ± 0.19 (range 0.00-1.00 D) compared to BRA 0.31 D ± 0.33 (range 0.00-1.34 D) (P < 0.001). Cylinder power was changed in 50.4% of cases based upon IA. Postoperative mean UDVA (LogMAR) was 0.04 ± 0.09 (range -0.12-0.30 logMAR), and 65% of eyes were ≤ 0.0, 85% ≤ 0.1, and 99% ≤ 0.18. Conclusion The proportion of eyes with PRA ≤ 0.50 D and mean PRA was significantly lower using IA versus the preoperative planned cylinder power.

Purpose The purpose of this study was to analyse whether an extended depth of focus (EDOF) monofocal intraocular lens (IOL) (TECNIS Eyhance) provides better intermediate visual acuity (VA) than another monofocal IOL (TECNIS 1-piece) from the same platform. Methods Randomised prospective observational study. Patients who required cataract surgery in both eyes were included. Patients in one group were implanted with Tecnis 1-piece IOL and those in the other group with Eyhance EDOF monofocal IOL. One month after surgery in the second eye, we assessed the corrected intermediate VA (66 cm) and obtained defocus curves. We also explored the correlation of: high-order and spherical aberrations with intermediate VA, pupil size with intermediate VA and age with intermediate VA. Results We analysed 30 patients (60 eyes), 15 patients in the TECNIS 1-piece group and 15 in the Eyhance group. Both groups achieved a far VA of 0.00 logMAR. In contrast, for intermediate vision, VA was better with the Eyhance EDOF monofocal IOLs (0.16 ± 0.12 LogMAR), the difference being statistically significant (p Conclusions The new EDOF monofocal IOL (Eyhance) offers sufficient depth of focus to provide patients with comfortable vision without impairing far vision.

Purpose The AT LARA 829MP is a next-generation extended depth of focus (EDOF) intraocular lens (IOL) providing continuous vision over a range of distances. The aim of this prospective multi-centre randomised trial was to compare two EDOF IOLs and one monofocal IOL. Methods Cataract patients between 50 and 80 years were randomised for bilateral implantation with either the AT LARA 829MP (EDOF), the TECNIS Symfony (EDOF) or the CT ASPHINA 409MP (monofocal). Follow-up was at 1 to 2 weeks, 1 month and 4 to 6 months. Results A total of 211 patients were randomised and included in the final analysis. Monocular depth of focus was significantly better for AT LARA 829MP eyes compared with that for TECNIS Symfony at all thresholds (p = 0.024, 0.001 and 0.006, for 0.1, 0.2 and 0.3 logMAR respectively) with no significant difference for binocular depth of focus. LARA eyes had significantly better monocular depth of focus at all levels compared with ASPHINA eyes (all p p p = 0.002). Distance visual acuity was similar for all IOLs at 6 months; intermediate and near visual acuity were significantly better for the EDOF IOLs than for the monofocal (p Conclusion The two EDOF intraocular lenses investigated provided good visual outcomes with comparable visual acuity at all distances. The AT LARA 829MP provided the widest monocular depth of focus at 0.1 and 0.2 logMAR, with a clear superiority compared with the monofocal IOL. TECNIS Symfony was superior to the monofocal control at 0.3 logMAR. Spectacle independence and patient satisfaction were comparable. Trial registration Trial registered on https://clinicaltrials.gov/ under the identification NCT03172351 (date of registration 1 June May 2017).

BACKGROUND The aim of this study was to determine the repeatability of an automated-ETDRS (Early Treatment Diabetic Retinopathy Study) near and intermediate visual acuity measurement in subjects with normal visual acuity and subjects with reduced visual acuity. The agreement of automated-ETDRS with gold standard chart-based visual acuity measurement was also studied. METHODS Fifty-one subjects were tested (aged 23 to 91 years; 33 subjects with normal visual acuity: 6/7.5 or better; 18 subjects with reduced visual acuity: 6/9 to 6/30). Near and intermediate visual acuity of one eye from each subject was measured with an automated tablet-computer system (M&S Technologies, Inc.) and Precision Vision paper chart in a random sequence. Subjects were retested one week later. Repeatability was evaluated using the 95 per cent limits of agreement (LoA) between the two visits. RESULTS Average difference between automated-ETDRS near visual acuity and near visual acuity by paper chart was 0.02 ± 0.10 logMAR (p > 0.05). Agreement of near visual acuity between automated-ETDRS and paper chart was good, with 95 per cent LoA of ±0.19 logMAR. Furthermore, automated-ETDRS near visual acuity showed good repeatability (95 per cent LoA of ±0.20). Mean difference between automated-ETDRS intermediate visual acuity and intermediate visual acuity by paper chart was 0.02 ± 0.10 logMAR (p > 0.05). Agreement of intermediate visual acuity between automated-ETDRS and paper chart was good, with 95 per cent LoA of ±0.20 logMAR. In addition, automated-ETDRS intermediate visual acuity had good repeatability (95 per cent LoA of ±0.16). CONCLUSION Automated-ETDRS near and intermediate visual acuity measurement showed good repeatability and agreement with the gold standard chart-based visual acuity measurement. The findings of this study indicate the automated visual acuity measurement system may have potential for use in both patient care and clinical trials.

Aim To evaluate clinical outcomes following implantation of an extended range of vision intraocular lens (IOL), the ZXR00, and a diffractive multifocal IOL with +2.75 diopters (D) add power, the ZKB00. Methods Totally 30 patients who underwent either bilateral implantation of the ZXR00 IOL with intended emmetropia (ZXR00 emmetropia group: 20 eyes) and intended micromonovision (ZXR00 monovision group: 20 eyes), or bilateral implantation of the ZKB00 IOL with intended emmetropia (ZKB00 group: 20 eyes) were included in this study. Visual acuity at 4 m, 80, and 40 cm; and the types of halos (misty, fine, and rainbow) were analyzed at one and three months after surgery. Results There were no significant differences in distance visual acuity among the three groups. The mean uncorrected intermediate visual acuity was better in the ZXR00 emmetropia and monovision groups (0.02 logMAR and 0.02 logMAR, respectively) than in the ZKB00 group (0.14 logMAR). The mean uncorrected near visual acuity was worse in the ZXR00 emmetropia group (0.26 logMAR) than in the ZXR00 monovision and ZKB00 groups (0.12 logMAR and 0.10 logMAR, respectively). There was an increased incidence of rainbow halos in the ZKB00 group vs in either ZXR00 group (P=0.033). Conclusion Implantation of the ZXR00 IOL with intended micromonovision provide superior visual acuity than implantation of the ZXR00 IOL with intended emmetropia. The ZXR00 IOLs tend to show a lower incidence of rainbow halos than did the ZKB00 IOL.

Purpose To evaluate the clinical outcomes following bilateral implantation of PanOptix intraocular lens (IOL). Methods This study included consecutive patients scheduled to undergo cataract or refractive lens exchange surgery between October 2017 and June 2018 at two centers. Manifest refraction, uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA, 60 cm) and uncorrected near visual acuity (UNVA, 40 cm), defocus curves, presence of dysphotopsia, need for spectacles, presence of posterior capsule opacification and visual function were evaluated at 6 months after surgery. Results The IOL was implanted in 138 eyes of 69 patients. The mean binocular UDVA was 0.02 +/- 0.05 logMAR, UIVA 0.06 +/- 0.07 logMAR and UNVA 0.05 +/- 0.07 logMAR. Defocus curve showed two peaks at 0.00 D and - 1.50 D. Complete spectacle independence was reported in 94.2% of the patients. The mean VF-14 test result was 97.7 +/- 2.2 (93.2-100). Only one patient (1.4%) reported seeing bothersome halos. The presence of posterior capsule opacification was noted in seven eyes (10%), whereas Nd:Yag capsulotomy was required only in one eye. Conclusions This trifocal IOL provided excellent visual outcomes at all distances with high spectacle independence and patient's satisfaction.

Purpose The purpose of this prospective, randomized, double-masked, study was to compare the visual performance of patients after bilateral implantation of six different IOLs. Methods The following IOLs were used in the study: SV25T0 (n = 19), ATLISA 809M (n = 18), ATLISA Tri 839MP (n = 19), ZKB00 (n = 20), ZLB00 (n = 20) and Symfony ZXR00 (n = 20). Visual performance was assessed by the monocular distance-corrected visual acuity at 4 m (CDVA), distance-corrected intermediate visual acuity (DCIVA) at 60 cm and distance-corrected near visual acuity (DCNVA) at 40 cm. Binocular defocus curves were obtained for a range of defocus from + 1.50 D to - 4.50 D, in 0.50 D steps. Quality of life was assessed with the VF-14 questionnaire. Results CDVA was better with the Symfony ZXR00 than with the SV25T0 (p = 0.032), ATLISA Tri 839MP (p = 0.032) and ATLISA 809M (p = 0.018). The Symfony ZXR00 offered the best DCIVA, followed by the ZKB00. The best and worst DCNVA results corresponded to the ZLB00, and the SV25T0 and Symfony ZXR00, respectively. Defocus curves at distance were good in all groups, although the Symfony had a wider range of clear vision (- 1.50 D to + 0.50 D), with no decay. For intermediate vision, only the Symfony obtained sharp visual acuity. The ATLISA 809M, ATLISA Tri 839MP and ZLB00 were superior at near distance. Conclusions The extended depth of focus of the Symfony ZXR00 offers a superior range of clear vision at far and intermediate distances than other multifocal designs, with worse results at near distance. Visual outcomes reflect the particular optical, geometrical and power distribution characteristics of each IOL.

Background To compare clinical outcomes and optical performance of a new monofocal with enhanced intermediate function intraocular lenses (IOLs) with that of conventional monofocal IOLs. Methods Sixty eyes of 30 patients who underwent phacoemulsification with bilateral implantation of the ICB00 (15 patients) or ZCB00 (15 patients) IOLs were enrolled. Binocular corrected distance visual acuity (CDVA), distance corrected near visual acuity (DCNVA), and distance corrected intermediate visual acuity (DCIVA) were measured at 4 weeks after surgery. Patient satisfaction for overall, near, intermediate, and distance vision were assessed. The binocular defocus curves were measured. The root mean square of modulation transfer function (MTFRMS) was measured in the optical bench study. Results The mean binocular DCIVA was significantly better in the ICB00 group (0.01 logMAR) compared to the ZCB00 group (0.13 logMAR), but CDVA and DCNVA were not. The patient satisfaction for near and intermediate vision was significantly higher in the ICB00 group compared to the ZCB00. However, there was no difference in patient satisfaction for overall and distance vision between two groups. The defocus curves showed that mean visual acuity of the ICB00 group was significantly better than that of the ZCB00 group at between − 1.00 D to − 3.00 D of defocus. The ICB00 IOL had higher MTFRMS values at between − 0.50 D to − 2.00 D of defocus compared to the ZCB00 IOL. Conclusions The ICB00 IOL provides better binocular intermediate vision and higher satisfaction for near and intermediate vision than the ZCB00 IOL while maintaining excellent distance vision.

BACKGROUND: To investigate visual outcomes following cataract surgery in patients who were implanted monocularly with an extended range of focus IC-8 IOL. METHODS: A multicentre, non-randomised, retrospective case series of 126 consecutive patients implanted with the IC-8 IOL. Data were collected and pooled from six centres across Australia. Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) at 80 cm and uncorrected near visual acuity (UNVA) at 40 cm were measured in eyes implanted with the IC-8 IOL. Adverse events, spectacle independence, visual symptoms and patient satisfaction were assessed at final follow-up. RESULTS: Over 90% of the patients without pre-existing ocular pathology (n = 109) achieved UDVA, UIVA and UNVA of 6/12 or better in the IC-8 eye. Binocularly, in this group, 98% achieved UDVA of 6/9, 94% UIVA of 6/12 and 91% UNVA of 6/12 or better. By final follow-up, over 50% of patients reported complete spectacle independence for distance, intermediate and near visual activity, with the remainder only using spectacles for specific tasks such as near-vision hobbies and reading in dim light. CONCLUSIONS: The IC-8 IOL is capable of providing extended depth of focus following cataract surgery. It allows complete spectacle independence in more than half of the patients implanted with the IC-8 IOL.

AIM: To analyze postoperative clinical results after implantation of trifocal intraocular lenses (IOLs) in highly myopic eyes with different axial lengths (ALs). METHODS: This retrospective study describes 61 eyes of 44 patients that were implanted with trifocal diffractive IOLs (AT LISA tri 839MP). Twenty-one eyes (15 patients) were included in the AL0.05). Better near and intermediate visual acuity (from -1.5 D to -3.0 D) were noted on the defocus curve of the AL

To evaluate the temporary changes in visual outcomes and anterior segment parameters after cataract surgery plus low-add bifocal intraocular lens (IOL) implantation for primary angle closure disease (PACD). This retrospective comparative case–control study included two groups: low-add-power segmented IOL and monofocal IOL. Postoperative examination involved evaluation of uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), uncorrected intermediate visual acuity (UIVA), and spherical equivalent (SE). Anterior segment examination was performed using anterior segment optical coherence tomography. This study included 19 eyes of 11 consecutive patients who underwent cataract surgery. The low-add group had better UDVA than the monofocal group at 3 months postoperatively, better UIVA at 1 month postoperatively, better UNVA at 1 week postoperatively. In the low-add group, SE increased at 1 and 3 months postoperatively compared with 1 week postoperatively. In the monofocal group, objective SE decreased at 1 and 3 months postoperatively compared with 1 week postoperatively. In the low-add group, the anterior chamber depth (ACD) became significantly deep gradually at 1 and 3 months compared with at 1 week postoperatively. In the monofocal group, the ACD became significantly shallow gradually at 1 and 3 months than at 1 week postoperatively. The low-add-power segmented IOL achieved better far and intermediate distance visual acuity after cataract surgery in PACD patients than did the monofocal IOL. The ACD became deeper and SE showed a hyperopic shift with the low-add-power segmented IOL at 1 and 3 months after cataract surgery compared with at 1 week after cataract surgery.

This study compared the visual outcome, visual quality, and satisfaction following implantation of the Mix-and-Match bifocal IOLs (+ 2.75 D and + 3.25 D add power Tecnis Multifocal Model), EDOF IOL (Tecnis Symfony IOL), and Trifocal IOL (FineVision PodFT, PhysIOL). All outcomes were compared among the three groups. The manifest refraction indicated that the EDOF group had significantly higher myopic spherical equivalent values than did the others. In the terms of visual acuity, there were no significant differences in far or intermediate visual acuity among the three groups. Only in near (33 cm), the EDOF group had significantly worse binocular visual acuity than did the Trifocal group (p = 0.002). Regarding to defocus curve, the Trifocal group had better defocus curves at near distances (− 2.0 to − 3.5 D; p = 0.001 vs. EDOF) than did the other two groups. In contrast sensitivity test, the EDOF group had relatively lower value than did the other two groups. In reading speed, only at 0.3 logMAR (6.5-point font), Mix-and-Match group had a significantly higher reading speed than did the other two groups (p = p = 0.007 vs. Trifocal). also Mix-and-Match group showed significantly fewer visual artifacts. There were no differences between the three groups in terms of patient satisfaction.ClinicalTrials.gov number: NCT04019691.

Purpose To compare clinical outcomes after cataract surgery and bilateral implantation of 2 diffractive trifocal toric intraocular lenses (IOLs). Setting Hospital da Luz, Lisbon, Portugal. Design Double-arm, randomized, prospective case series. Methods A total of 60 patients were randomly allocated to receive bilateral implantation of either the FineVision Pod FT toric IOL (PhysIOL) or the AcrySof IQ PanOptix toric IOL (Alcon). Visual and refractive outcomes, contrast sensitivity, IOL misalignment, and quality of vision outcomes (QoV questionnaire) were evaluated at 3 months postoperatively. Surgically induced astigmatic changes were evaluated by vector analysis. Results Each group (FineVision toric and AcrySof IQ PanOptix toric) comprised 30 patients (60 eyes). No significant differences between groups were found regarding uncorrected and corrected distance and near visual outcomes (P ≥ .333). Mean postoperative distance-corrected intermediate visual acuity at 60 cm was 0.04 ± 0.09 logarithm of the minimum angle of resolution (logMAR) and 0.09 ± 0.11 logMAR in the PanOptix and Pod FT group, respectively (P = .032). Mean IOL axis misalignment was 1.59 degrees ± 2.15 degrees (PanOptix group) and 1.89 degrees ± 3.31 degrees (Pod FT group) (P = .821). Mean magnitude of error of astigmatic correction was -0.09 diopters (D) and -0.11 D in the PanOptix group and Pod FT group, respectively (P = .333). Contrast sensitivity, QoV scores for the presence of photic phenomena, and the level of spectacle independence were similar in both groups (P > .05). Conclusions Both trifocal toric IOLs allowed complete patient visual restoration, and good spectacle independence and good visual quality outcomes. The PanOptix IOL provided superior intermediate visual acuity for distances around 60 cm.

The aim of this study was to compare the distance, intermediate, and near visual performance of a new IOL (ICB00, Eyhance, Tecnis) and classic monofocal IOL (SN60WF IQ AcrySof, Alcon) after unilateral implantation. Sixty-three patients were unilaterally implanted with the ICB00 Eyhance IOL (study group) and 65 patients with the SN60WF IQ AcrySof (control group). Visual performance was assessed with monocular corrected distance visual acuity (CDVA) and uncorrected distance visual acuity (UDVA) at 4 m, corrected intermediate visual acuity (CIVA) and uncorrected intermediate visual acuity (UIVA) at 60 cm, and corrected near visual acuity (CNVA) and uncorrected near visual acuity (UNVA) at 40 cm. CDVA, UDVA, CNVA, and UNVA values did not differ significantly between the study and control groups (0.02 ± 0.02 vs. 0.03 ± 0.02, p = 0.523; 0.05 ± 0.13 vs. 0.05 ± 0.15, p = 0.637; 0.46 ± 0.17 vs. 0.46 ± 0.15, p = 0.821; and 0.47 ± 0.21 vs. 0.49 ± 0.25, p = 0.612; respectively), whereas the study group showed significantly better results for CIVA (0.28 ± 0.12 vs. 0.38 ± 0.13, p = 0.001) and UIVA (0.31 ± 0.16 vs. 0.41 ± 0.12, p = 0.001). The Eyhance IOL, which features a new optical design based on a continuous power profile, was determined to be superior to a classic monofocal IOL for intermediate visual acuity and not inferior for corrected and uncorrected distance and near visual acuity.

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.

The purpose was to determine the optimum negative spherical aberration induction required to improve near and intermediate visual acuity (VA) of presbyopic eyes. A total of 174 normal and diabetic (no retinopathy) presbyopic eyes (age 40 years) were measured with visual adaptive optics simulator (Voptica, Spain). First, baseline uncorrected VA and aberrations were measured. VA at 40 cm (near), 80 cm (intermediate) and distance was measured. Then, a negative spherical aberration (SA) was added to baseline ocular SA, and VA at all targets was reassessed after correction of distance refractive error. Clinically, baseline SA and root mean square of higher order aberrations were similar between the normal and diabetic presbyopic eyes. Baseline VA of the diabetic eyes at near and intermediate was better than the same of normal eyes (P = 0.001). After SA change, VA at near and intermediate of both normal and diabetic presbyopic eyes improved. However, fewer diabetic eyes needed higher SA change than normal eyes (P = 0.03). The corresponding trends with change in VA at near and intermediate were also similar between the normal and diabetic eyes. Patient-specific modulation of ocular SA to improve near and intermediate VA in a large cohort of eyes was successful in improving VA, sometimes even distance VA.

In this chapter an apodized diffractive multifocal (MF) intraocular lens (IOL) model is presented and consists of a summary of the clinical trial involving 20 cases of patients who underwent cataract surgery and were implanted bilaterally with the SeeLens MF. A significant improvement in the uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), and corrected near visual acuity (CNVA) (p < 0.01) was observed. In measurements of intermediate vision, UIVA and DCIVA, no changes were observed. With respect to defocus curve provides maximum viewing two peaks, one for distance and one for near. Between these two peaks has a slight slope which generates an adequate and functional intermediate visual acuity. Regarding optical quality outcomes a significant reduction of higher order internal aberration and also a significant increase of the ocular Strehl ratio was observed. SeeLens MF IOL provides great results in far and near vision in addition to a functional intermediate vision at optimal performance of intraocular optical quality, so this is an appropriate option IOL within the different alternatives for cataract surgery.

Béatrice Cochener University Hospital of Brest – Hospital Morvan, Brest, France Purpose: The purpose of this study was to evaluate the influence of different levels of monovision on the clinical outcomes achieved with an extended range of vision (ERV) intraocular lens (IOL). Patients and methods: Subanalysis of 411 patients from the multicenter CONCERTO study aimed at evaluating the outcomes after bilateral implantation of the Tecnis Symfony IOL. Visual acuity, spectacle independence, photic phenomena incidence, and patient satisfaction outcomes were evaluated in six groups defined according to the level of monovision: 0.0 D (75 patients; group 1), 001.0 D (19 patients; group 6). Results: Mean binocular uncorrected distance visual acuity (decimal) ranged from 0.90±0.17 in group 6 to 0.97±0.20 in group 2. Mean binocular uncorrected intermediate visual acuity (decimal) ranged from 0.77±0.25 in group 2 to 0.94±0.30 in group 4. Mean binocular uncorrected near visual acuity ranged from 0.64±0.23 in group 2 to 0.79±0.26 in group 6. The level of spectacle independence was high, with the highest value for near vision in group 6 (94.7%). Less patients reported halos (6.7%) in group 1, whereas only 3.8% of patients in group 4 reported disturbing glare symptoms. For near vision, the highest patient satisfaction was achieved in groups 4, 5, and 6. A total of 96.7% (group 3) and 96.2% (group 4) of patients would recommend the same procedure to their friends and family and would choose the same lens again.Conclusion: Mini-monovision of around 0.75 D after implantation of the Tecnis Symfony IOL provides a complete visual rehabilitation with minimal photic phenomena and high levels of patient satisfaction. Keywords: Tecnis Symfony IOL, CONCERTO study, targeted monovision, visual acuity, residual refraction

Purpose: To compare the visual and refractive outcomes, patient satisfaction and spectacle independence between three novel designs of diffractive IOLs. Method: Prospective study including 150 patients with implantation of three IOLs: trifocal diffractive IOL AT LISA tri 839 MP (ATLISA, n = 50), trifocal diffractive IOL PhysIOL FineVision (FineVision, n = 50) and the extended range of vision IOL Tecnis Symfony ZRX00 (Symfony, n = 50). Patients were followed up for 6 months after surgery. Major parameters were monocular and binocular uncorrected (UDVA) and corrected (CDVA) distance, uncorrected (UIVA) and distance corrected (DCIVA) intermediate (80 cm), and uncorrected (UNVA) and distance corrected (DCNVA) near (40 cm) visual acuities (UNVA), contrast sensitivity (CS), defocus curve as well as patient satisfaction and spectacle use. Results: Mean postoperative decimal UDVA was 1.01 for Symfony, 0.96 for ATLISA and 0.95 for the FineVision IOL. Postoperative UIVA was 0.95 with Symfony, 0.72 with ATLISA and 0.85 with the FineVision IOL. Postoperative UNVA was 0.96 with the FineVision, 0.72 with the ATLISA and 0.63 with the Symfony IOL. The Symfony defocus curve showed the smoothest profile. Mean mesopic CS was 0.84 log units with the Symfony, 0.83 with the ATLISA (0.83) and 0.65 with the FineVision IOL. Mean photopic CS with the Symfony, ATLISA and FineVision was 1.05, 0.85 and 0.69 log units, respectively. Twenty percent of the patients with the ATLISA and FineVision IOLs and 5.6% of the Symfony patients reported halos and glare as troublesome or disabling. Reading glasses were frequently used by 5.6% of the Symfony patients. All patients with the trifocal IOLs reported to be spectacle-free for any distance. Conclusion: All 3 IOLs produce excellent results with high levels of spectacle independence. The Symfony produces better levels of distance and intermediate visual acuity, whereas the trifocal IOLs produced better near vision. Higher frequency of dysphotopsia was seen with the 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.

Background To evaluate visual acuity, corneal astigmatism and corneal higher-order aberrations (HOAs) after implantation of trifocal diffractive IOLs operated with either a corneal steep-axis incision or 135° incision. Method This prospective study enrolled patients randomly assigned to different groups. According to preoperative corneal astigmatism, 101 eyes of 77 patients were assigned into group A1 (0 ~ 0.50 D) or A2 (0.51 ~ 1.00 D) with a corneal steep-axis incision or group B1 (0 ~ 0.50 D) or B2 (0.51 ~ 1.00 D) with a 135° incision. Visual acuity, corneal astigmatism and corneal higher-order aberrations (HOAs) were followed-up for 3 months. Results Corneal astigmatism in group A2 significantly decreased 3 months after surgery (P

Background: The results of implantation of refractive intraocular lenses (IOL), especially with an inferior segmental near add are of great interest due to advantages of the new lenses over more frequently used diffractive multifocal IOL. Aim: To assess the ocular optical performance of eyes implanted with a new IOL Lentis Mplus. Materials and methods: 78 patients (100 eyes) aged > 50 years were implanted with 100 IOLs Lentis Mplus. Preoperative examination included measuring uncorrected and corrected distance visual acuity, uncorrected and corrected near visual acuity. Postoperatively, uncorrected and corrected distance visual acuity, uncorrected and corrected near visual acuity (distance 33 cm) were estimated along with intermediate vision measurement using near-vision charts (60 cm). Results: On the day 3 after the procedure, distance visual acuity was good, and patients were able to near-reading of medium-size fonts. In 1 year, uncorrected visual acuity was 0.8–1.0 in two thirds of patients. 25% of patients needed distance visual correction from (-)0.5 to (-)0.75 D. Corrected visual acuity improved to 0.9–1.0. In 1 year, near visual acuity was 0.5 or more and intermediate visual acuity was 0.4 or more in all patients. In 78% of patients, 60 cm visual acuity was 0.5. Conclusion: Implantation of multifocal IOL Lentis Mplus produced good distance visual acuity and satisfactory (working) near and intermediate visual performance.

Purpose Reliable estimation of visual acuity requires that observers maintain a constant distance from the target, but use of chin rests is not always feasible. Our aim was to quantify children's movement during community testing and its impact on near (40 cm) and intermediate (150 cm) acuity measures. Methods Thirty-three 7-year-old children performed several acuity tests run on a tablet computer, administered in the child's home by a trained lay screener. The tablet webcam was used to derive a continuous estimate of the child's position during testing. We estimated acuity using both the recommended viewing distance and using trial-by-trial estimates of the child's physical distance from the screen. Results Although initial positioning in the 40-cm viewing distance condition was accurate, on 18% of trials children moved sufficiently to support a 0.1 logMAR improvement in acuity, leading 16% of staircases to overestimate acuity by more than one line. Initial positioning for the 150-cm condition was less accurate, but the longer viewing distance minimized the impact of children's movement on the visual angle of the target. Overall, at 150 cm 8% of staircases were overestimated by more than 0.1 logMAR. Conclusions Children move substantially during intermediate and near acuity tests despite assessors encouraging maintenance of the correct viewing distance. Translational Relevance Real-time estimates of the child's physical distance from the target are possible when assessments are conducted on camera-enabled devices. Correction for movement will likely lead to more accurate measures of near and intermediate visual acuity.

Daniel H Chang Empire Eye and Laser Center, Bakersfield, CA, USA Purpose: The aim of the study is to evaluate the visual acuity and patient satisfaction at varied distances under photopic and mesopic lighting conditions in patients bilaterally implanted with aspheric diffractive multifocal one-piece intraocular lenses. Methods: In this retrospective–prospective study, 16 patients with a mean age of 66.2±9.2years (range: 50–81years) who had undergone bilateral phacoemulsification surgery with implantation of a Tecnis multifocal one-piece intraocular lens (ZMB00) were evaluated. Monocular and binocular uncorrected and distance-corrected visual acuities were measured at distance (20ft), intermediate (70–80cm), and near (35–40cm) under photopic (85cd/m2) and mesopic (3cd/m2) lighting conditions and were compared using the paired t-test. All patients also completed a subjective questionnaire. Results: At a mean follow-up of 9.5±3.9months, distance, near, and intermediate visual acuity improved significantly from preoperative acuity. Under photopic and mesopic conditions, 93.8% and 62.5% of patients, respectively, had binocular uncorrected intermediate visual acuity of 20/40 or better, and 62.5% and 31.3% of patients had binocular uncorrected near visual acuity of 20/20 or better. All patients were satisfied with their overall vision without using glasses and/or contact lenses when compared with before surgery. A total of 87.5% of patients reported no glare and 68.8% of patients reported no halos around lights at night. Conclusion: Tecnis multifocal one-piece intraocular lenses provide good distance, intermediate, and near visual acuity under photopic as well as mesopic lighting conditions. High levels of spectacle independence with low levels of photic phenomenon were achieved, resulting in excellent patient satisfaction. Keywords: Tecnis multifocal one-piece IOL, photopic visual acuity, mesopic visual acuity, intermediate visual acuity, near visual acuity&nbsp

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).

BACKGROUND A prospective study was carried out to evaluate postoperative visual acuity and patients satisfaction after implantation of a multifocal add-on IOL. PATIENTS AND METHODS In 50 eyes of 25 patients operated by two surgeons "group A (MK) = 15 patients; group B (MWR) = 10 patients" with age-related cataract after "normal" cataract surgery, sulcus-fixated multifocal add-on IOLs (MS 714 PB Diff., Dr. Schmidt Intraocularlinsen, Sankt Augustin) were implanted. 12 weeks after surgery in both groups the following parameters were evaluated: far visual acuity; intermediate visual acuity (1 meter) and near visual acuity (33 centimeter). In addition, the patients satisfaction was measured in three steps (1 = excellent; 2 = satisfied; 3 = not satisfied) ermittelt. In group A also contrast sensitivity was measured using the Ginsberg box. RESULTS Surgery was performed in all cases without complications. No postoperative complications were observed. After 12 weeks the results in both groups were comparable. Median distance visual acuity was 0.05 +/- 0.02 (LogMar) uncorrected and 0 +/- 0.05 (LogMar) with correction. Intermediate visual acuity was 0.25 +/- 0.06 (LogMar) uncorrected (0.1 +/- 0.09 (LogMar) with correction. Near visual acuity was 0.2 +/- 0.07 (LogMar) and 0.15 +/- 0.02 (LogMar), respectively. Patients satisfaction was 80 - 90%. CONCLUSIONS Sulcus-fixated add-on IOLs are a useful addition to our refractive surgical armamentarium. The present results encourage us to use this method as a standard procedure.

Purpose: To evaluate the clinical outcomes of patients with diffractive aspheric trifocal intraocular lens (AT.LISA tri839 MP IOL, Carl Zeiss Meditec, Jena, Germany) implantation. Methods: Forty eyes of 53 patients received phacoemulsification and implantation of AT.LISA tri839 MP IOL (Carl Zeiss Meditec). Uncorrected distant visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), refractive values, and defocus curve were evaluated at postoperative 1 month and 3 months. Optical quality was evaluated with the Optical Quality Analysis System (OQAS, Visiometrics, Castelldefels, Spain). Results: At the 3-month postoperative follow-up, the mean spherical equivalent was 0.01 ± 0.31 D and the mean UDVA, UIVA and UNVA were 0.023 ± 0.020, 0.155 ± 0.091, and 0.139 ± 0.069, respectively. The means of the objective scatter index, modulation transfer function cut-off value, Strehl ratio measured by OQAS (Visiometrics) were 1.83 ± 0.52, 33.58 ± 14.27 cycle per degree and 0.18 ± 0.11, respectively. Intermediate visual acuity did not fall sharply at defocus curve. Conclusions: Implantation of the diffractive aspheric trifocal intraocular lens in patients with cataracts provided excellent distant, intermediate and near visual acuities with high visual quality. J Korean Ophthalmol Soc 2015;56(9):1338-1344

To evaluate functional outcomes after bilateral implantation of apodized diffractive aspheric acrylic intraocular lenses (IOLs) with a +3.0 or +4.0 diopter (D) addition (add) power.Twelve study centers in the United States.This randomized patient-masked parallel-group 6-month follow-up study comprised patients having bilateral cataract extraction with implantation of an AcrySof IQ ReSTOR SN6AD3 IOL with a +4.0 D add power (+4.0 D group) or an AcrySof IQ ReSTOR SN6AD1 IOL with a +3.0 D add power (+3.0 D group) (both IOLs, Alcon, Inc.). Visual acuity, defocus testing, patient-reported outcomes, and safety measures were assessed.Of the 279 patients, 141 were in the +3.0 D group and 138 were in the +4.0 D group. Binocular distance-corrected intermediate visual acuity was statistically significantly better in the +3.0 D group than in the +4.0 D group (P.0001); there was no difference in binocular near or distance visual acuity. There were no statistically significant differences in visual disturbances between the 2 groups. Patients in both groups reported excellent overall spectacle independence, near visual function, and satisfaction with the IOLs.Intermediate vision at a mean reading distance of approximately 40 cm was better with the aspheric IOL with a +3.0 D add than with the aspheric IOL with a +4.0 D add, as shown by the near peak in the mean binocular defocus curve; near and distance acuity were similar between the 2 IOLs. Patients reported excellent overall quality of vision, spectacle independence, and satisfaction.

PURPOSE: To evaluate the clinical results and safety obtained with a new type of multifocal intraocular lens (IOL) using a trifocal design to achieve pseudoaccommodation. METHODS: A pilot observational study of patients with a trifocal IOL (FineVision; PhysIOL, Liege, Belgium) implanted by 1 of 12 surgeons between March and December 2010. Visual outcomes that were assessed postoperatively included uncorrected and corrected distance, intermediate, and near visual acuity. RESULTS: One hundred ninety-eight eyes of 99 patients were analyzed. Patients were observed for an average of 6.44 ± 4.67 months (range: 0.2 to 17 months). Preoperative corrected distance visual acuity was 0.22 ± 0.26 logMAR. At the final follow-up visit, corrected distance visual acuity was 0.01 ± 0.10 logMAR, uncorrected distance visual acuity was 0.01 ± 0.06 logMAR, uncorrected intermediate visual acuity was 0.08 ± 0.10 logMAR, and mean uncorrected near visual acuity was 0.00 ± 0.04 logMAR. Postoperative binocular uncorrected distance visual acuity was 0.01 ± 0.07 logMAR, uncorrected intermediate visual acuity was 0.06 ± 0.08 logMAR, and uncorrected near visual acuity was −0.03 ± 0.04 logMAR. Postopeative mean residual sphere was 0.21 ± 0.48 diopters (D), with a residual cylinder of −0.24 ± 0.31 D. Postoperative spherical equivalent was 0.11 ± 0.36 D. CONCLUSIONS: The results demonstrated that the trifocal FineVision IOL is able to restore near, intermediate, and distance visual function. [ J Refract Surg . 2014;30(11):762–768.]

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.

PURPOSE: To evaluate distance, intermediate, and near visual acuity and patient satisfaction over a period of 2 years after implantation of the ReZoom multifocal intraocular lens. METHODS: Fifty-five eyes of 35 cataract patients were included in this retrospective study. Only patients with a preoperative photopic pupillary diameter superior to 3 mm were included. Monocular visual acuities and visual symptoms were compared at different time points. RESULTS: Preoperative mean distance uncorrected visual acuity (UCVA) was 0.5+/-0.3 LogMAR, uncorrected intermediate visual acuity (UCiVA) at 50 cm was 0.6+/-0.3 LogMAR, and near uncorrected visual acuity (UNVA) was J7.8+/-0.6. Mean follow-up was 28.1+/-7.2 months. At 6 months, UCVA improved to 0.05+/-0.09 logMAR (p

Purpose This survey determined uncorrected visual acuity (VA) at near, intermediate, and far distances in cataract patients implanted with ReSTOR®, and assessed patient satisfaction. Methods Consecutive cataract patients implanted bilaterally with ReSTOR® were followed up at least 4 months. The Early Treatment Diabetic Retinopathy Study scale was used to measure VA for near (40 cm), intermediate (50, 60, and 70 cm), and distance vision, with VAs expressed in logMAR and adjusted for distance using Bennett's (1993) formula. Satisfaction was self-rated on a visual analogue scale ranging from 0 (poor) to 10 (high). Results Twenty-four consecutive patients (mean age 67.6 years) were operated upon by a single surgeon and followed up for a mean of 336.5 days after second eye surgery. Average postoperative VAs for uncorrected distance were 0.06 logMAR and intermediate VAs were 0.21 logMAR at both 50 cm and 60 cm and 0.22 logMAR at 70 cm. These levels of uncorrected intermediate VA would allow patients to read Word® computer text in Times New Roman font 8 zoomed to 100%, at 70 cm from the monitor screen. The authors found that 23/24 patients (96%) no longer wore spectacles. The remaining patient required correction for astigmatism as this refraction error is not yet correctable by ReSTOR®. Average self-rated satisfaction was 8.54. Conclusions In an everyday surgical practice, none of the studied bilateral ReSTOR® cataract patients without astigmatism required spectacles when followed up 6 months or later. Intermediate VA was compatible with reading and led to high patient satisfaction.

Purpose To compare visual acuity after bilateral implantation of 2 models of multifocal aspheric intraocular lenses (IOLs). Setting Fernandez-Vega Ophthalmological Institute, Oviedo, and University of Valencia, Valencia, Spain. Methods Prospective study of patients who had bilateral implantation of an AcrySof ReSTOR SN6AD3 IOL (Group 1) or an Acri.LISA 366D IOL (Group 2). Six months postoperatively, binocular uncorrected and best corrected distance visual acuity, uncorrected-distance and best distance-corrected near visual acuity, best corrected intermediate visual acuity, and the defocus curve were measured in both IOL groups. Results Group 1 comprised 36 eyes (18 patients) and Group 2, 40 eyes (20 patients). The mean binocular values in Group 1 and Group 2, respectively, were as follows: best corrected distance acuity, −0.05 ± 0.09 logMAR and −0.08 ± 0.08 logMAR (both approximately 20/20); best distance-corrected near acuity, −0.01 ± 0.16 logMAR and −0.05 ± 0.07 logMAR; best corrected intermediate acuity at 80 cm, 0.20 ± 0.18 logMAR (approximately 20/32) and 0.16 ± 0.13 logMAR (approximately 20/25) and at 60 cm, 0.16 ± 0.16 logMAR (approximately 20/25) and 0.18 ± 0.13 logMAR (approximately 20/25). There were no statistically significant between-group differences in visual acuity at any distance (P>.3). Defocus curves were similar between groups (2.00 to −5.00 diopters) (P>.26). Conclusions The 2 multifocal aspheric IOL models gave similar and good high-contrast visual acuity at distance and near. Intermediate visual acuity, also comparable between IOL models, was better than published results of a spherical IOL model.

Evaluate the visual performance of the AcrySof ReSTOR intraocular lens (IOL) and compare it with the monofocal SA60AT IOL.Prospective, nonrandomized, clinical trial.Forty patients (80 eyes) from the Federal University of São Paulo were enrolled in two groups. Twenty-five patients were assigned to the ReSTOR group and 15 patients to the monofocal group. Inclusion criteria were corneal astigmatism1.0 diopter, potential acuity meter0.2 logMAR units, and no associated ocular diseases. Parameters analyzed included distance uncorrected and best-corrected visual acuity, near uncorrected and distance corrected visual acuity, intermediate visual acuity, contrast sensitivity (Pelli-Robson chart), stereopsis (Titmus test), reading speed, wavefront measurement (LADARWave aberrometer), and a quality-of-life questionnaire. main outcome measure: Distance and near uncorrected and best distance corrected visual acuity, contrast sensitivity, and reading speed.Distance uncorrected and best-corrected visual acuity in the ReSTOR group were not statistically different from the monofocal group (P = .66). Near uncorrected and distance corrected visual acuity were statistically better in the ReSTOR group than the monofocal group (0.16 +/- 0.13 vs 0.62 +/- 0.09, P.001, and 0.14 +/- 0.12 vs 0.62 +/- 0.07, P.001, respectively). The ReSTOR group demonstrated less spherical aberrations compared with the monofocal group (P.001). Monocular photopic contrast sensitivity was statistically lower in the ReSTOR group (P.001). Stereopsis and reading speed were not statistically different between the groups.The AcrySof ReSTOR IOL provides a satisfactory full range of vision and achieves a more satisfactory quality of life when compared with the monofocal SA60AT IOL, but with lower contrast sensitivity.