Comparison of visual and optical quality of monofocal versus multifocal intraocular lenses. 2020

Irene Altemir-Gomez, and Maria S Millan, and Fidel Vega, and Francisco Bartol-Puyal, and Galadriel Gimenez-Calvo, and Jose M Larrosa, and Vicente Polo, and Luis E Pablo, and Elena Garcia-Martin
Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.

OBJECTIVE To compare visual quality in patients implanted with Tecnis® monofocal (ZCB00) and multifocal (ZMB00) intraocular lenses taking into account their optical quality measured in vitro with an eye model. METHODS In total, 122 patients participated in this study: 44 implanted with monofocal and 78 with multifocal intraocular lenses. Measurements of visual acuity and contrast sensitivity were performed. The optical quality of the intraocular lenses was evaluated in three image planes (distance, intermediate and near) using an eye model on a test bench. The metric considered was the area under the curve of the modulation transfer function. RESULTS Optical quality at the far focus of the monofocal intraocular lens (area under the curve of the modulation transfer function = 66.97) was considerably better than that with the multifocal lens (area under the curve of the modulation transfer function = 32.54). However, no significant differences were observed between groups at the distance-corrected visual acuity. Distance-corrected near vision was better in the multifocal (0.15 ± 0.20 logMAR) than that in the monofocal group (0.43 ± 0.21 logMAR, p < 0.001), which correlated with the better optical quality at near reached by the multifocal intraocular lens (area under the curve of the modulation transfer function = 29.11) in comparison with the monofocal intraocular lens (area under the curve of the modulation transfer function = 5.0). In intermediate vision, visual acuity was 0.28 ± 0.16 logMAR (multifocal) and 0.36 ± 0.14 logMAR (monofocal) with p = 0.014, also in good agreement with the values measured in the optical quality (area under the curve of the modulation transfer function = 10.69 (multifocal) and 8.86 (monofocal)). The contrast sensitivity was similar in almost all frequencies. Pelli-Robson was slightly better in the monofocal (1.73) than in the multifocal group (1.64; p = 0.023). CONCLUSIONS Patients implanted with multifocal ZMB00 achieved a distance visual acuity similar to those implanted with monofocal ZCB00, but showed significantly better intermediate and near visual acuity. A correlation was found between intraocular lenses' optical quality and patients' visual acuity. Contrast sensitivity was very similar between the multifocal and monofocal groups.

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
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000075542 Multifocal Intraocular Lenses Artificially implanted lenses that direct light toward distant and near focal points allowing clear vision for a range of distances. Accommodating IOLs,Accommodating Intraocular Lens,Accommodating Intraocular Lenses,Multifocal IOLs,Multifocal Intraocular Lens,Accommodating IOL,IOL, Accommodating,IOL, Multifocal,IOLs, Accommodating,Intraocular Lens, Accommodating,Intraocular Lens, Multifocal,Intraocular Lenses, Accommodating,Multifocal IOL
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
D015350 Contrast Sensitivity The ability to detect sharp boundaries (stimuli) and to detect slight changes in luminance at regions without distinct contours. Psychophysical measurements of this visual function are used to evaluate VISUAL ACUITY and to detect eye disease. Visual Contrast Sensitivity,Sensitivity, Contrast,Sensitivity, Visual Contrast
D019654 Lens Implantation, Intraocular Insertion of an artificial lens to replace the natural CRYSTALLINE LENS after CATARACT EXTRACTION or to supplement the natural lens which is left in place. Implantation, Intraocular Lens,Implantations, Intraocular Lens,Intraocular Lens Implantation,Intraocular Lens Implantations,Lens Implantations, Intraocular

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