Clinical Results and Optical Quality of Diffractive Multifocal Intraocular Lens

Jeong Jae Oh; Jin Seok Choi

doi:10.3341/jkos.2015.56.12.1867

Journal List > J Korean Ophthalmol Soc > v.56(12) > 1010162

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Oh and Choi: Clinical Results and Optical Quality of Diffractive Multifocal Intraocular Lens

Original Article

J Korean Ophthalmol Soc 2015;56(12):1867-1873.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.12.1867

Clinical Results and Optical Quality of Diffractive Multifocal Intraocular Lens

Jeong Jae Oh, M.D, Jin Seok Choi, M.D, PhD

Saevit Eye Hospital, Goyang, Korea

Address reprint requests to Jin Seok Choi, MD, PhD Saevit Eye Hospital, #1065 Jungang-ro, Ilsandong-gu, Goyang 10447, Korea Tel: 82-31-900-7700, Fax: 82-31-900-7777 E-mail: zenith716@hanmail.net

Received 10 April 20151 September 2015 Accepted 1 October 2015

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 clinical outcomes, optical quality, and patient satisfaction between two types of diffractive multifocal intraocular lens (IOL, Acri Lisa 366D and Acrysof ReSTOR +3.00 D).

Methods

In a total of 68 eyes, one of two diffractive multifocal IOL (Acri Lisa 366D and Acrysof ReSTOR +3.00 D) was implanted after cataract extraction. Visual acuity was measured postoperatively at one week, 1 month, and 6 months. Contrast sensitivity, wavefront aberration, and visual function were determined via questionnaire at postoperative 1 month.

Results

Intermediate visual acuity of Acri Lisa 366D and Acrysof ReSTOR at 6 months were 0.31 ± 0.14, and 0.24 ± 0.11 (log MAR), respectively. At 6 months, near and distant visual acuity results showed no significant differences between the two groups. The photopic contrast sensitivity of Acri Lisa 366D at 6 cycles/degree was 55.36 ± 7.40 and showed significant differ-ences with Acrysof ReSTOR (47.25 ± 9.67). The mesopic contrast sensitivity values of Acri Lisa 366D and Acrysof ReSTOR were 40.26 ± 11.38 and 28.97 ± 10.45, respectively, and the spherical aberration values were 0.037 ± 0.039 μ m and 0.105 ± 0.066 μ m. The spherical aberration of Acri Lisa 366D was significantly lower than that of Acrysof ReSTOR. Total and high order aberration, coma, and trefoil show no significant differences between the two groups.

Conclusions

The Acri Lisa 366D multifocal IOL showed better contrast sensitivity and spherical aberration compared to Acrysof ReSTOR multifocal IOL, which had an effective intermediate visual acuity.

Keywords: Contrast sensitivity, Multifocal intraocular lens, Patient satisfaction, Spherical aberration

References

1. Hofmann T, Zuberbuhler B, Cervino A. . Retinal straylight and complaint scores 18 months after implantation of the AcrySof monofocal and ReSTOR diffractive intraocular lenses. J Refract Surg. 2009; 25:485–92.

2. Hunkeler JD, Coffman TM, Paugh J. . Characterization of vis-ual phenomena with the Array multifocal intraocular lens. J Cataract Refract Surg. 2002; 28:1195–204.

3. Leyland M, Zinicola E. Multifocal versus monofocal intraocular lenses in cataract surgery: a systematic review. Ophthalmology. 2003; 110:1789–98.

4. Montés-Micó R, Alió JL. Distance and near contrast sensitivity function after multifocal intraocular lens implantation. J Cataract Refract Surg. 2003; 29:703–11.

5. Pieh S, Lackner B, Hanselmayer G. . Halo size under distance and near conditions in refractive multifocal intraocular lenses. Br J Ophthalmol. 2001; 85:816–21.

6. Steinert RF, Aker BL, Trentacost DJ. . A prospective com-parative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens. Ophthalmology. 1999; 106:1243–55.

7. Woodward MA, Randleman JB, Stulting RD. Dissatisfaction after multifocal intraocular lens implantation. J Cataract Refract Surg. 2009; 35:992–7.

8. Gwak JY, Choi JS, Pak KH, Baek NH. Visual and optical functions after diffractive multifocal intraocular lens. J Korean Ophthalmol Soc. 2012; 53:396–402.

9. Wang J, Wu X, Zhang J. Imaging properties of Fresnel zone plate-like surface plasmon polariton launching lenses. Opt Express. 2010; 18:6686–92.

10. Montés-Micó R, España E, Bueno I. . Visual performance with multifocal intraocular lenses: mesopic contrast sensitivity under distance and near conditions. Ophthalmology. 2004; 111:85–96.

11. Alfonso JF, Puchades C, Fernández-Vega L. . Visual acuity comparison of 2 models of bifocal aspheric intraocular lenses. J Cataract Refract Surg. 2009; 35:672–6.

12. Montés-Micó R, Alió JL. Distance and near contrast sensitivity function after multifocal intraocular lens implantation. J Cataract Refract Surg. 2003; 29:703–11.

13. Alió JL, Elkady B, Ortiz D, Bernabeu G. Clinical outcomes and in-traocular optical quality of a diffractive multifocal intraocular lens with asymmetrical light distribution. J Cataract Refract Surg. 2008; 34:942–8.

14. Heo JW, Yoon HS, Shin JP. . A validation and reliability study of the Korean version of National Eye Institute visual function questionnaire 25. J Korean Ophthalmol Soc. 2010; 51:1354–67.

15. Apple DJ, Sims J. Harold Ridley and the invention of the intra-ocular lens. Surv Ophthalmol. 1996; 40:279–92.

16. Alió JL, Plaza-Puche AB, Piñero DP. . Optical analysis, read-ing performance, and quality-of-life evaluation after implantation of a diffractive multifocal intraocular lens. J Cataract Refract Surg. 2011; 37:27–37.

17. Castillo-Gómez A, Carmona-González D, Martínez-de-la-Casa JM. . Evaluation of image quality after implantation of 2 dif-fractive multifocal intraocular lens models. J Cataract Refract Surg. 2009; 35:1244–50.

18. Fernandez-Vega L, Madrid-Costa D, Alfonso JF. . Bilateral im-plantation of the Acri.LISA bifocal intraocular lens in myopic eyes. Eur J Ophthalmol. 2010; 20:83–9.

19. Alfonso JF, Puchades C, Fernández-Vega L. . Contrast sensi-tivity comparison between AcrySof ReSTOR and Acri.LISA as-pheric intraocular lenses. J Refract Surg. 2010; 26:471–7.

20. Chang M, Eom Y, Kang SY. . Clinical outcome of diffractive multifocal aspheric intraocular lens. J Korean Ophthalmol Soc. 2009; 50:529–36.

21. Yoon JU, Chung JL, Hong JP. . Comparison of wavefront anal-ysis and visual function between monofocal and multifocal asphe-ric intraocular lenses. J Korean Ophthalmol Soc. 2009; 50:195–201.

22. Lee HS, Park SH, Kim MS. Clinical results and some problems of multifocal apodized diffractive intraocular lens implantation. J Korean Ophthalmol Soc. 2008; 49:1235–41.

23. Mangione CM, Lee PP, Gutierrez PR. . Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol. 2001; 119:1050–8.

24. Stelmack JA, Stelmack TR, Massof RW. Measuring low-vision re-habilitation outcomes with the NEI VFQ-25. Invest Ophthalmol Vis Sci. 2002; 43:2859–68.

25. Alió JL, Plaza-Puche AB, Piñero DP. . Quality of life evalua-tion after implantation of 2 multifocal intraocular lens models and a monofocal model. J Cataract Refract Surg. 2011; 37:638–48.

26. Goes FJ. Refractive lens exchange with the diffractive multifocal Tecnis ZM900 intraocular lens. J Refract Surg. 2008; 24:243–50.

27. Choi J, Schwiegerling J. Optical performance measurement and night driving simulation of ReSTOR, ReZoom, and Tecnis multi-focal intraocular lenses in a model eye. J Refract Surg. 2008; 24:218–22.

Figure 1.

Mean log contrast sensitivity functions in patients implanted with the Acri Lisa 366D and AcrylSof ReSTOR intraocular lenses for different lighting conditions (85 cd/m² and 3 cd/m²) at 1 month. (A) Photopic contrast sensitivity. (B) Mesopic contrast sensitivity. CPD = cycle per degree.

Table 1.

Demographics of the study group

IOL groups	AT LISA 366D	AcrySof ReSTOR (+3.00 D)	p-value
No. of patients (eyes)	20 (34)	21 (34)	-
Mean age (years, n)	57.2 ± 13.4	62 ± 10.3	-
Target diopter (D)	-0.06 ± 0.17	-0.08 ± 0.21	0.12
IOL power (D)	21.23 ± 1.68	21.36 ± 2.11	0.12
Axial length (mm)	23.84 ± 0.81	23.54 ± 0.98	0.14

Values are presented as mean ± SD unless otherwise indicated. IOL = intraocular lens.

Table 2.

Postoperative visual acuity after multifocal IOL implantation (log MAR)

Postoperative 1 week	Postoperative 1 month		Postoperative 6 months
	AT LISA 366D	AcrySof ReSTOR (+3.00 D)	AT LISA 366D	AcrySof ReSTOR (+3.00 D)	AT LISA 366D	AcrySof ReSTOR (+3.00 D)
Distance
UDVA	0.11 ± 0.12	0.18 ± 0.17	0.09 ± 0.13	0.08 ± 0.11	0.10 ± 0.11	0.08 ± 0.10
CDVA	0.08 ± 0.16	0.10 ± 0.11	0.08 ± 0.11	0.07 ± 0.07	0.06 ± 0.14	0.07 ± 0.07
Intermediate
UIVA	0.29 ± 0.17	0.31 ± 0.10	0.27 ± 0.15	0.31 ± 0.11	0.31 ± 0.14	0.24 ± 0.11
Near
UNVA	0.09 ± 0.14	0.11 ± 0.08	0.07 ± 0.12	0.06 ± 0.08	0.08 ± 0.14	0.14 ± 0.10
DCNVA	0.08 ± 0.13	0.09 ± 0.07	0.07 ± 0.11	0.06 ± 0.10	0.06 ± 0.10	0.10 ± 0.07

Values are presented as mean ± SD. IOL = intraocular lens; UDVA = uncorrected distance visual acuity; CDVA = corrected distance visual acuity; UIVA = un-corredted intermediate visual acuity; UNVA = uncorrected near visual acuity; DCNVA = distance-corrected near visual acuity.

Table 3.

Wavefront aberrations (μ m) after intraocular lens implantation

Total RMS	HOA	SA	Coma	Trefoil
AT LISA AcrySof	AT LISA AcrySof	AT LISA AcrySof	AT LISA AcrySof	AT LISA AcrySof
366D ReSTOR	366D ReSTOR	366D ReSTOR	366D ReSTOR	366D ReSTOR
0.66 ± 0.57 ±	0.24 ± 0.27 ±	0.037 ± 0.105 ±	0.119 ± 0.107 ±	0.137 ± 0.210 ±
0.290.31	0.080.10	0.0390.066	0.0560.049	0.0560.037

Values are presented as mean ± SD. RMS = root-mean-square; HOA = higher-order aberration; SA = spherical aberration.

TOOLS

Similar articles