A Contralateral Eye Study Comparing Apodized Diffrative and Full Diffrative Lenses: Wavefront Analysis and Distance and Near Uncorrected Visual Acuity

PURPOSE: To evaluate intraindividual visual acuity, wavefront errors and modulation transfer functions in patients implanted with two diffractive multifocal intraocular lenses. METHODS: This prospective study examined 40 eyes of 20 cataract patients who underwent phacoemulsification and implantation of a spherical multifocal ReSTOR intraocular lens in one eye and an aspheric Tecnis ZM900 multifocal intraocular lens in the other eye. The main outcome measures, over a 3-month follow-up period, were the uncorrected photopic distance and near visual acuity and the defocus curve. The visual acuity was converted to logMAR for statistical analysis and is presented in decimal scale. The wavefront error and modulation transfer function were also evaluated in both groups. RESULTS: At the 3-month postoperative visit, the mean photopic distance uncorrected visual acuity (UCVA) was 0.74 ± 0.20 in the ReSTOR group and 0.76 ± 0.22 in the Tecnis group (p=0.286). The mean near UCVA was 0.96 ± 0.10 in the ReSTOR group and 0.93 ± 0.14 in the Tecnis group (p=0.963). The binocular defocus curve showed measurements between the peaks better than 0.2 logMAR. The total aberration, higher-order aberration and coma aberration were not significantly different between the groups. The spherical aberration was significantly lower in the Tecnis group than in the ReSTOR group. (p=0.004). Both groups performed similarly for the modulation transfer function. CONCLUSION: The ReSTOR SN60D3 and Tecnis ZM 900 intraocular lenses provided similar photopic visual acuity at distance and near. The diffractive intraocular lenses studied provided a low value of coma and spherical aberrations, with the Tecnis intraocular lens having a statistically lower spherical aberration compared to the ReSTOR intraocular lens. In the 5 mm pupil diameter analyses, both intraocular lens groups showed similar modulation transfer functions.

[1]  Mujtaba A. Qazi,et al.  Visual performance of patients with bilateral vs combination Crystalens, ReZoom, and ReSTOR intraocular lens implants. , 2007, American journal of ophthalmology.

[2]  Wilhelm Stork,et al.  Imaging quality of intraocular lenses , 2005, Journal of cataract and refractive surgery.

[3]  T. Hoang‐Xuan,et al.  Ocular aberrations after cataract surgery with hydrophobic and hydrophilic acrylic intraocular lenses: Comparative study , 2006, Journal of cataract and refractive surgery.

[4]  J C Javitt,et al.  Cataract extraction with multifocal intraocular lens implantation: a multinational clinical trial evaluating clinical, functional, and quality-of-life outcomes. , 2000, Ophthalmology.

[5]  P. Piers,et al.  Comparison of wavefront aberrations and optical quality of eyes implanted with five different intraocular lenses. , 2004, Journal of refractive surgery.

[6]  J C Javitt,et al.  Outcomes of cataract extraction with multifocal intraocular lens implantation: functional status and quality of life. , 1997, Ophthalmology.

[7]  R. Lindstrom,et al.  Multifocal intraocular lenses , 1990, Journal of cataract and refractive surgery.

[8]  Jay S Pepose,et al.  Maximizing satisfaction with presbyopia-correcting intraocular lenses: the missing links. , 2008, American journal of ophthalmology.

[9]  Robert Montés-Micó,et al.  Apodized diffractive versus refractive multifocal intraocular lenses: Optical and visual evaluation , 2008, Journal of cataract and refractive surgery.

[10]  J. Alió,et al.  Optical performance of monofocal and multifocal intraocular lenses in the human eye , 2008, Journal of cataract and refractive surgery.

[11]  R A Applegate,et al.  Limits to vision: can we do better than nature? , 2000, Journal of refractive surgery.

[12]  M. Chalita,et al.  Postoperative wavefront analysis and contrast sensitivity of a multifocal apodized diffractive IOL (ReSTOR) and three monofocal IOLs. , 2005, Journal of refractive surgery.

[13]  P. Chiam,et al.  Functional vision with bilateral ReZoom and ReSTOR intraocular lenses 6 months after cataract surgery , 2007, Journal of cataract and refractive surgery.

[14]  A. Crandall,et al.  Intraocular lens explantation and exchange: A review of lens styles, clinical indications, clinical results, and visual outcome , 1991, Journal of cataract and refractive surgery.

[15]  Raymond A Applegate,et al.  Glenn Fry Award Lecture 2002: Wavefront Sensing, Ideal Corrections, and Visual Performance , 2004, Optometry and vision science : official publication of the American Academy of Optometry.

[16]  H. Hayashi,et al.  Anterior capsule contraction and intraocular lens dislocation after implant surgery in eyes with retinitis pigmentosa. , 1998, Ophthalmology.

[17]  Robert Montés-Micó,et al.  Retinal image quality after microincision intraocular lens implantation , 2005, Journal of cataract and refractive surgery.

[18]  R A Applegate,et al.  Optics of aberroscopy and super vision , 2001, Journal of cataract and refractive surgery.

[19]  J. Davison,et al.  History and development of the apodized diffractive intraocular lens , 2006, Journal of cataract and refractive surgery.

[20]  K. Pesudovs,et al.  Effect of cataract surgery incision location and intraocular lens type on ocular aberrations , 2005, Journal of cataract and refractive surgery.

[21]  M. Cox,et al.  Limitations of correcting spherical aberration with aspheric intraocular lenses. , 2005, Journal of refractive surgery.

[22]  Roberto Bellucci,et al.  Multifocal intraocular lenses , 2005, Current opinion in ophthalmology.

[23]  D. G. Green,et al.  Optical and retinal factors affecting visual resolution. , 1965, The Journal of physiology.

[24]  A. Franchini.  Compromise between spherical and chromatic aberration and depth of focus in aspheric intraocular lenses , 2007, Journal of cataract and refractive surgery.

[25]  P. Hugger,et al.  Potential of the 1 CU accommodative intraocular lens , 2005, British Journal of Ophthalmology.

[26]  Markus Sticker,et al.  Quantitative performance of bifocal and multifocal intraocular lenses in a model eye: point spread function in multifocal intraocular lenses. , 2002, Archives of ophthalmology.

[27]  J. Schwiegerling,et al.  Optical performance measurement and night driving simulation of ReSTOR, ReZoom, and Tecnis multifocal intraocular lenses in a model eye. , 2008, Journal of refractive surgery.

[28]  Gaetano Lodato,et al.  One-year outcomes with new-generation multifocal intraocular lenses. , 2008, Ophthalmology.

[29]  D. Chang.  Prospective functional and clinical comparison of bilateral ReZoom and ReSTOR intraocular lenses in patients 70 years or younger , 2008, Journal of cataract and refractive surgery.

[30]  H. Hayashi,et al.  Anterior capsule contraction and intraocular lens dislocation in eyes with pseudoexfoliation syndrome , 1998, The British journal of ophthalmology.

[31]  Jonathan H. Talamo,et al.  Wavefront Customized Visual Correction: The Quest for Super Vision II , 2005 .

[32]  José M Artigas,et al.  Image quality with multifocal intraocular lenses and the effect of pupil size: Comparison of refractive and hybrid refractive–diffractive designs , 2007, Journal of cataract and refractive surgery.

[33]  Hiroshi Uozato,et al.  Modulation transfer function and pupil size in multifocal and monofocal intraocular lenses in vitro , 2005, Journal of cataract and refractive surgery.

[34]  A. Bradley,et al.  Accuracy and precision of objective refraction from wavefront aberrations. , 2004, Journal of vision.

[35]  W. Charman,et al.  Can we measure wave aberration in patients with diffractive IOLs? , 2007, Journal of cataract and refractive surgery.

[36]  W. Charman,et al.  Problems in the measurement of wavefront aberration for eyes implanted with diffractive bifocal and multifocal intraocular lenses. , 2008, Journal of refractive surgery.

[37]  R. Bellucci,et al.  Pseudoaccommodation with the 3M diffractive multifocal intraocular lens: A refraction study of 52 subjects , 1993, Journal of cataract and refractive surgery.

[38]  Marrie van der Mooren,et al.  A new intraocular lens design to reduce spherical aberration of pseudophakic eyes. , 2002, Journal of refractive surgery.

[39]  Mark Packer,et al.  Improved functional vision with a modified prolate intraocular lens , 2004, Journal of cataract and refractive surgery.

[40]  L. Mastropasqua,et al.  Visual performance and biocompatibility of 2 multifocal diffractive IOLs: Six‐month comparative study , 2007, Journal of cataract and refractive surgery.

[41]  Carlos E Souza,et al.  Visual performance of AcrySof ReSTOR apodized diffractive IOL: a prospective comparative trial. , 2006, American journal of ophthalmology.