Visual performance with multifocal intraocular lenses: mesopic contrast sensitivity under distance and near conditions. 2004

Robert Montés-Micó, and Enrique España, and Inmaculada Bueno, and W Neil Charman, and José L Menezo
Optometry and Vision Sciences Unit, University of Valencia, Valencia, Spain. roberto.montes@uv.es

OBJECTIVE To evaluate distance and near visual performance under bright (photopic) and dim (mesopic) conditions in patients who had undergone uncomplicated cataract extraction with multifocal or monofocal intraocular lens (IOL) implantation. METHODS Prospective, nonrandomized, masked, comparative, observational case series. METHODS Thirty-two eyes of 32 patients after zonal-progressive multifocal IOL implantation (Allergan Medical Optics Array SA-40N) and 32 eyes of 32 age-matched patients after monofocal IOL implantation (Allergan Medical Optics SI-40NB). METHODS All eyes underwent phacoemulsification and IOL implantation. METHODS At 18 months after surgery, the monocular contrast sensitivity (CS) function was measured with sinusoidal grating charts at distance and near, at one photopic luminance level and 2 mesopic luminance levels (85, 5, and 2.5 candelas per square meter). RESULTS Under bright conditions, CS at distance in the multifocal group was not statistically different (P>0.01) from that in the monofocal group at any tested grating spatial frequency (1.5, 3, 6, 12, and 18 cycles per degree [cpd]). At low luminances, distance CS for the multifocal group was worse than that for the monofocal group at the highest test spatial frequencies (12 and 18 cpd; P<0.01). At near, photopic CS in the multifocal group was lower than at distance; patients with only a monofocal distance correction, however, could not detect the test gratings, even at the highest available contrast. With optimal near spectacle additions (i.e., using the distance correction of the multifocal IOL), there were no significant differences between the photopic near CS values for the multifocal and monofocal groups. When the luminance was decreased, near CS at all spatial frequencies was reduced in both groups. Contrast sensitivity in the near-corrected, multifocal group was significantly worse than in the near-corrected, monofocal group at high spatial frequencies (12 and 18 cpd). CONCLUSIONS This work supports the findings of earlier authors that the Array multifocal IOL, with its center-distance design, is distance biased. Distance CS is within normal limits under bright photopic conditions but shows deficits at higher spatial frequencies (more than approximately 12 cpd) under dim mesopic conditions. Near CS obtained with the multifocal IOL is below that which can be achieved by an appropriate monofocal near correction, for all spatial frequencies and illumination conditions.

UI MeSH Term Description Entries
D007910 Lenses, Intraocular Artificial implanted lenses. Implantable Contact Lens,Lens, Intraocular,Contact Lens, Implantable,Intraocular Lens,Intraocular Lenses,Lens, Implantable Contact
D008027 Light That portion of the electromagnetic spectrum in the visible, ultraviolet, and infrared range. Light, Visible,Photoradiation,Radiation, Visible,Visible Radiation,Photoradiations,Radiations, Visible,Visible Light,Visible Radiations
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011680 Pupil The aperture in the iris through which light passes. Pupils
D003623 Dark Adaptation Adjustment of the eyes under conditions of low light. The sensitivity of the eye to light is increased during dark adaptation. Scotopic Adaptation,Adaptation, Dark,Adaptation, Scotopic
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D014792 Visual Acuity Clarity or sharpness of OCULAR VISION or the ability of the eye to see fine details. Visual acuity depends on the functions of RETINA, neuronal transmission, and the interpretative ability of the brain. Normal visual acuity is expressed as 20/20 indicating that one can see at 20 feet what should normally be seen at that distance. Visual acuity can also be influenced by brightness, color, and contrast. Acuities, Visual,Acuity, Visual,Visual Acuities

Related Publications

Robert Montés-Micó, and Enrique España, and Inmaculada Bueno, and W Neil Charman, and José L Menezo
July 2001, The British journal of ophthalmology,
Robert Montés-Micó, and Enrique España, and Inmaculada Bueno, and W Neil Charman, and José L Menezo
January 1993, Journal of cataract and refractive surgery,
Robert Montés-Micó, and Enrique España, and Inmaculada Bueno, and W Neil Charman, and José L Menezo
April 2003, Journal of cataract and refractive surgery,
Robert Montés-Micó, and Enrique España, and Inmaculada Bueno, and W Neil Charman, and José L Menezo
January 2017, International journal of ophthalmology,
Robert Montés-Micó, and Enrique España, and Inmaculada Bueno, and W Neil Charman, and José L Menezo
March 1993, Journal of cataract and refractive surgery,
Robert Montés-Micó, and Enrique España, and Inmaculada Bueno, and W Neil Charman, and José L Menezo
August 1992, Archives of ophthalmology (Chicago, Ill. : 1960),
Robert Montés-Micó, and Enrique España, and Inmaculada Bueno, and W Neil Charman, and José L Menezo
April 2022, Optometry and vision science : official publication of the American Academy of Optometry,
Robert Montés-Micó, and Enrique España, and Inmaculada Bueno, and W Neil Charman, and José L Menezo
December 2019, Journal of refractive surgery (Thorofare, N.J. : 1995),
Robert Montés-Micó, and Enrique España, and Inmaculada Bueno, and W Neil Charman, and José L Menezo
November 2010, Clinical & experimental optometry,
Robert Montés-Micó, and Enrique España, and Inmaculada Bueno, and W Neil Charman, and José L Menezo
January 2013, Clinical ophthalmology (Auckland, N.Z.),
Copied contents to your clipboard!