Prospective visual evaluation of apodized diffractive intraocular lenses

PURPOSE: To evaluate distance, intermediate, and near visual performance in patients who had multifocal apodized diffractive intraocular lens (IOL) implantation. SETTING: Fernández‐Vega Ophthalmological Institute, Oviedo, Spain. METHODS: The best corrected distance visual acuity, best distance‐corrected near visual acuity, intermediate visual acuity, distance contrast sensitivity under photopic and mesopic conditions, and patient satisfaction were measured in 325 patients and 335 patients who had bilateral implantation of the model SA60D3 IOL (AcrySof ReSTOR, Alcon) and model SN60D3 IOL (AcrySof Natural ReSTOR), respectively. RESULTS: At the 6‐month postoperative visit, binocular best corrected distance acuity with the ReSTOR IOL and the Natural ReSTOR IOL was 0.034 logMAR ± 0.004 (SD) and 0.019 ± 0.020 logMAR, respectively (∼20/20). Binocular best distance‐corrected near acuity was 0.011 ± 0.012 logMAR and 0.035 ± 0.013 logMAR, respectively (∼20/20). Intermediate visual acuity with both IOL models worsened significantly as a function of the distance of the test (P<.01). Photopic contrast sensitivity was within the standard normal range with both IOLs. Under mesopic conditions, contrast sensitivity with both IOLs was comparable to that with monofocal IOLs and lower, particularly at higher spatial frequencies, than under photopic conditions. No statistically significant differences in visual acuity or photopic and mesopic contrast sensitivity were found between the 2 IOL models (P>.1). A patient satisfaction questionnaire showed that both IOLs performed well and were comparable in satisfaction regarding distance, intermediate, and near activities under different lighting conditions. CONCLUSIONS: The AcrySof ReSTOR IOL and AcrySof Natural ReSTOR IOL provided good visual performance at distance and near under photopic and mesopic conditions. Intermediate vision with both models was reduced compared with distance and near vision.