Retinal Straylight and Complaint Scores 18 Months After Implantation of the AcrySof Monofocal and ReSTOR Diffractive Intraocular Lenses

Abstract

Purpose: To evaluate retinal straylight and patient complaint scores 18 months after implantation with the AcrySof ReSTOR diffractive multifocal intraocular lens (IOL) (Alcon Laboratories Inc). Methods: Retinal straylight was measured with the C-Quant (Oculus Optikgeräte GmbH) system in 40 eyes implanted with the AcrySof ReSTOR IOL (SA60D3) and in 40 eyes implanted with the AcrySof SA60AT monofocal IOL. Complaint scores were assessed by a questionnaire in both groups of patients at three different lighting conditions—day light, dimmed light, and at night. Results: Seventy-five percent of eyes (30/40) of the ReSTOR group and 80% of eyes (32/40) of the SA60AT control group showed a retinal straylight value within or better than the normal range. No statistically significant differences between groups were found ( P =.790). Patients of the ReSTOR group showed significantly more complaint scores at all assessed lighting conditions: increasing factors were 1.53, 2.02, and 2.66, for day light, dimmed light, and night, respectively ( P <.0001). Comparing the amount of straylight, the multifocal group had 20% more straylight, albeit not significant at the 1% level. Conclusions: The AcrySof ReSTOR IOL showed similar retinal straylight values compared to the monofocal IOL. Subjectively, patients with the diffractive IOL claimed significantly more glare for all light conditions, especially at night. [ J Refract Surg. 2009;25:485–492.]

Visual outcomes after cataract surgery with implantation of a +3.00 D or +4.00 D aspheric diffractive multifocal intraocular lens: Comparative study

“…Multifocal IOLs are associated with higher straylight levels [23][24][25] and lower contrast sensitivity 5 than monofocal IOLs. In the current study, 2 multifocal IOLs were compared and no significant differences in contrast sensitivity or in intraocular straylight were noted between them.…”

“…Intraocular straylight levels were measured monocularly using a C-Quant straylight meter (Oculus Optikgeräte GmbH) as described previously. [23][24][25] Wavefront Aberrometry Wavefront aberrometry was performed using an Imagine Eyes aberrometer (Ziemer Group). The maps were analyzed with a 5.0 mm pupil diameter and up to the 10th order of Zernike coefficients.…”

Near visual outcomes with single-optic and dual-optic accommodating intraocular lenses

“…Multifocal IOLs divide the light entering the eye into near and distance foci; this provides near vision at the expense of reducing contrast sensitivity and causing photic visual phenomena, such as increased glare and halos. [1][2][3][4][5][6] Accommodating IOLs were designed to mimic the physiologic mechanism of accommodation to avoid the optical side effects of multifocal IOLs. Several mechanisms have been described for this kind of IOL.…”

Relevance of pupil size in the clinical determination of retinal straylight on young healthy human eyes

“…This psychophysical method was called the "direct comparison method" [19]. This method was later modified into the "compensation comparison method" [20], in order to adapt the original method to clinical practice, having been extensively evaluated [20][21][22][23] and successfully used in clinical studies [17,18,24,25], so that at current it could be considered the gold standard for the clinical determination of retinal straylight. Theoretical predictions suggest that retinal straylight in normal eyes is not affected by pupil size.…”

“…Theoretical predictions suggest that multifocal intraocular lens implants increase retinal straylight due to their design [16]. Clinical studies have shown, however, that perceived retinal straylight is not different from monofocal IOLs [17], even when complaint scores are different [18]. One of the reasons for the latter might be pupil size, since the psychometric determination of retinal straylight using the Van den Berg straylightmeter is essentially a photopic test.…”