Comparison of Wavefront Analysis and Visual Function Between Monofocal and Multifocal Aspheric Intraocular Lenses

Jong Uk Yoon; Jae Lim; Chung; Jin Pyo Hong; Byoung Jin Ha; Tae-im Kim; Eung Kweon Kim

doi:10.3341/jkos.2009.50.2.195

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Yoon, Lim, Chung, Hong, Ha, Kim, and Kim: Comparison of Wavefront Analysis and Visual Function Between Monofocal and Multifocal Aspheric Intraocular Lenses

Original Article

J Korean Ophthalmol Soc 2009;50(2):195-201.

Published online: 3 January 2009

DOI: https://doi.org/10.3341/jkos.2009.50.2.195

Comparison of Wavefront Analysis and Visual Function Between Monofocal and Multifocal Aspheric Intraocular Lenses

Jong Uk Yoon, MD¹, Jae Lim, Chung, MD¹, Jin Pyo Hong, MD¹, Byoung Jin Ha, MD², Tae-im Kim, MD¹, Eung Kweon Kim, MD, PhD¹

¹The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

²Siloam Eye Hospital, Seoul, Korea

Address reprint requests to Tae-im Kim, MD Department of Ophthalmology, Yonsei University College of Medicine #134 Shinchon-dong, Seodaemun-gu, Seoul 120-140, Korea Tel: 82-2‐2228‐3570, Fax: 82-2‐312‐0541, E-mail: tikim@yumc.yonsei.ac.kr

Received 2 May 2008 Accepted 2 September 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare postoperative vision, high‐ order aberrations, contrast sensitivity, power of accommodation, and depth of focus of monofocal aspheric (TECNIS ZA9003) and multifocal aspheric (TECNIS ZM900) intraocular lenses (IOL).

Methods

Thirty‐ four eyes which received intraocular lens implantation in the posterior chamber were equally divided into two groups: TECNIS ZA9003 (17 eyes) and TECNIS ZM900 (17 eyes). Before and three months after surgery, visual acuities at near, intermediate, and far distances, and depth of focus were recorded. High order aberrations, spherical aberrations and accommodation power were measured with iTrace, and contrast sensitivity was evaluated using Optec 6500. An independent T‐ test analysis was used to compare the two groups.

Results

There were no significant differences of high order aberrations, spherical aberrations, accommodation power, or distance vision between the two groups at three months postoperatively. The multifocal IOL (TECNIS ZM900) group revealed better intermediate and near vision (p<0.01) and deeper depth of focus, and lower contrast sensitivities (p=0.03) than the monofocal IOL group.

Conclusions

There was no difference in accommodation power between the two groups, but multifocal TECNIS ZM900 IOL exceeds monofocal TECNIS ZA9003 IOL in intermediate and near vision due to diffractive lens design and less spherical aberration by its asphericity.

Keywords: Aspheric, Diffractive, Multifocal, TECNIS

References

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Figure 1.

Contrast sensitivity test of the two groups at photopic condition (^* p<0.05).

Figure 2.

Contrast sensitivity test of the two groups at mesopic condition (^* p<0.05).

Figure 3.

Visual acuity at various defocus levels. The values are a mean of logMAR visual acuity (^* p<0.05). Red line=logMAR 0.3; Green line=monofocal group depth of focus; Blue line=multifocal group depth of focus.

Figure 4.

A case of accommodation power of phakic eye.

Figure 5.

A case of accommodation power of monofocal IOL (TECNIS ZA9003) eye.

Figure 6.

A case of accommodation power of multifocal IOL (TECNIS ZM900) eye.

Table 1.

Demographics of study groups Mean± SD^†

IOL groups	TECNIS ZM900	TECNIS ZA9003	p-value
No^* of eyes (%)	17	17
OD	7 (41.2)	9 (52.9)
OS	10 (58.8)	8 (47.1)
Gender (M:F)	10:7	9:8
Mean Age	68.00±6.84	64.67±10.37	0.42
Preoperative GD^§	-0.02±0.11	-0.24±0.26	0.14
Postoperative SE^‡	-0.19±0.17	-0.29±0.45	0.47
Preoperative corneal Ast^∏	0.43±0.17	0.45±0.21	0.88
Postoperative Ast^∏	0.40±0.29	0.47±0.18	0.48

^* No=number;

^† SD=standard deviation;

^‡ SE=spherical equivalent;

^§ GD=goal diopter;

^∏ Ast=astigmatism.

Table 2.

Postoperative visual acuity (logMAR)(Mean± Standard deviation)

IOL groups	TECNIS ZM900	TECNIS ZA9003	p-value
BCDVA^*	0.03±0.03	0.03±0.04	0.85
DCIVA^†	0.04±0.09	0.30±0.09	<0.01^**
DCNVA^‡	0.06±0.07	0.47±0.19	<0.01^**
UCDVA^§	0.07±0.04	0.10±0.04	0.11
UCIVA^∏	0.09±0.11	0.35±0.10	<0.01^**
UCNVA^#	0.10±0.07	0.45±0.20	<0.01^**

^* BCDVA=best corrected distance visual acuity;

^† DCIVA=distance corrected intermediate visual acuity;

^‡ DCNVA=distance corrected near visual acuity;

^§ UCDVA=uncorrected distance visual acuity;

^∏ UCIVA=uncorrected intermediate visual acuity;

^# UCNVA=uncorrected near visual acuity;

^** Statically significant.

Table 3.

Total aberrations (μm) of the examined eyes (Mean± Standard deviation)

IOL groups	RMS^* total	HO A^†	Sph A^‡	Coma7 A	Coma8 A	Trefoil6 A	Trefoil9 A
ZM900	0.48±0.26	0.22±0.09	-0.02±0.03	0.03±0.06	0.06±0.06	-0.06±0.07	0.13±0.07
ZA9003	0.56±0.24	0.24±0.11	-0.01±0.06	0.01±0.03	-0.03±0.15	-0.1±0.07	0.05±0.11
p-value	0.57	0.74	0.62	0.52	0.18	0.32	0.11

^* RMS=Root mean square;

^† HO A=higher-order aberration;

^‡ Sph A=Spherical aberration.

Table 4.

Internal aberrations (μm) of the examined eyes (Mean± Standard deviation)

IOL groups	RMS^* total	HO A^†	Sph A^‡	Coma7 A	Coma8 A	Trefoil6 A	Trefoil9 A
ZM900	0.51±0.36	0.19±0.1	-0.07±0.04	-0.02±0.08	0.05±0.08	-0.06±0.07	0.05±0.07
ZA9003	0.52±0.13	0.27±0.18	-0.15±0.14	-0.02±0.06	-0.02±0.11	-0.1±0.07	-0.03±0.17
p-value	0.99	0.37	0.13	0.97	0.16	0.32	0.25

^* RMS=Root mean square;

^† HO A=higher-order aberration;

^‡ Sph A=spherical aberration.

Table 5.

Difference (diopter) of refraction map (Mean± Standard deviation)

IOL groups T	TECNIS ZM900	TECNIS ZA9003	p-value
Mean	0.08±0.14	-0.09±0.29	0.15
Range	2.72±1.02	3.39±1.9	0.4

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