Comparison of visual outcomes, spectacles dependence and patient satisfaction of multifocal and accommodative intraocular lenses: innovative perspectives for maximal refractive-oriented cataract surgery

Abstract

BackgroundThe aim of this study was to evaluate visual outcomes for different working distances (far, 60 cm and 33 cm) and impact on vision quality of multifocal IOLs AcrySof ResTOR SN6AD1 and SN6AD3 (Alcon, Inc., Fort Worth, Texas, USA) as well as REVIEW FIL611PV multifocal and OPTOFLEX FIL618 accommodative IOLs (Soleko, Ltd., Rome, Italy) in patients undergoing bilateral phacoemulsification.MethodsIn this observational prospective study 63 patients undergoing binocular cataract surgery were divided into four groups for implantation of one of the IOLs under evaluation. Visual outcomes were evaluated at 1 day, 7 days, 1 month, 3 months and 6 months after surgery. Patients’ satisfaction and spectacle independence were evaluated with questionnaires administered at the 6-months follow-up.ResultsImprovements in visual acuity for the three working distances were statistically significant in all cases compared to the preoperative status, especially after binocular implantation. The AcrySof ReSTOR SN6AD1 multifocal IOL provided the best visual acuity results and tolerability for all working distances. While performing worse than SN6AD1, FIL611PV and FIL618 provided better uncorrected visual acuity and spectacles independence for intermediate/close-up and far distances respectively, in comparison with the SN6AD3 group.ConclusionsSN6AD1 was confirmed the best choice for all working distances. However, FIL611PV IOL may represent a valid and more cost-effective alternative, especially if surgeons intend to prioritize spectacle independence and patient autonomy at intermediate and close-up distances, in accordance to specific needs and requests.Trial registrationTrial retrospectively registered in ISRCTN Registry on 02/02/2017. TRN: ISRCTN14145737.

Clinical outcomes after mix-and-match implantation of diffractive multifocal intraocular lenses with +2.75 and +4.00 diopter add powers

“…16 On the other hand, these results are superior to those of previous studies with implantation of bilateral multifocal IOLs. 18,19 In addition, the rate of spectacle independence was higher in our study than in the CONCERTO study. Our findings that 93.8% of subjects reported that they would recommend mix-and-match implantation of diffractive multifocal IOLs with +2.75 D and +4.00 D add powers to their friends and relatives indicated that despite some visual problems, these symptoms did not have a significant impact on overall satisfaction.…”

A clinical assessment of visual performance of combining the TECNIS^® Symfony Extended Range of Vision IOL (ZXR00) with the +3.25 D TECNIS Multifocal 1-piece IOL (ZLB00) in subjects undergoing bilateral cataract extraction

“… 1 Lens replacement surgery with MIOL technology can offer patients with cataracts the opportunity to be less dependent on, or even free of, eyeglasses, readers, or bifocals after cataract surgery. 2 , 3 This flexibility provides not just a solution to eliminate glasses, but a functional convenience that allows patients with cataracts to conduct their daily living activities in an unencumbered manner.…”

Comparison of 3-month visual outcomes of a spherical and a toric trifocal intraocular lens

“…2,3 Multifocal IOLs have also been shown to improve visual rehabilitation, in particular, in providing patient independence for different working distances as well as reducing spectacle dependence. 4,5 However, halos, glare, and reduced contrast sensitivity continue to be reported with presbyopia-correcting IOLs. 6,7 Multifocal IOLs can be broadly categorized based on their design: either concentric focal zones (alternating for near, intermediate, or far) or segmented, two zones (bifocal) with one zone for distance and the other for near.…”