Clinical Results of Diffractive, Refractive, Hybrid Multifocal, and Monofocal Intraocular Lenses

Agnieszka Dyrda, Ana Martínez-Palmer, Daniel Martín-Moral, Amanda Rey, Antonio Morilla, Miguel Castilla-Martí, Janny Aronés-Santivañez, Agnieszka Dyrda, Ana Martínez-Palmer, Daniel Martín-Moral, Amanda Rey, Antonio Morilla, Miguel Castilla-Martí, Janny Aronés-Santivañez

Abstract

Purpose: To present the outcomes of hybrid multifocal and monofocal intraocular lenses (IOLs) and to compare with refractive and diffractive multifocal IOLs (MFIOLs).

Methods: Three hundred twenty eyes (160 patients) underwent cataract surgery with randomized IOLs bilateral implantation. Changes in uncorrected and distance-corrected logMAR distance, intermediate and near (UNVA and DCNVA) visual acuity (VA), contrast sensitivity (CS), presence of dysphotopsia, spectacle independence, and patient satisfaction were analyzed.

Results: Postoperative VA in the hybrid (OptiVis) group was improved in all distances (p < 0.001). OptiVis acted superiorly to monofocal IOLs in UNVA and DCNVA (p < 0.001 for both) and to refractive ones in DCNVA (p < 0.005). Distance, mesopic, without glare CS in OptiVis was lower than in the monofocal group and similar to other MFIOLs. No differences in dysphotopsia pre- and postoperatively and spectacle independence in near for OptiVis and refractive MFIOLs were detected. OptiVis patients were more satisfied than those with monofocal IOLs (p=0.015).

Conclusions: After cataract surgery, patients with OptiVis improved VA in all distances. Near and intermediate VA was better than monofocal, and DCNVA was better than the refractive group. CS was lower in OptiVis than in the monofocal group, but there was no difference between MFIOLs. Patient satisfaction was higher in OptiVis than in the monofocal group. This trial is registered with NCT03512626.

Figures

Figure 1
Figure 1
Figure 2
Figure 2
Pre- and postoperative visual performance of (a) UDVA and (b) UNVA of all five IOLs. UDVA BIN: binocular uncorrected distance visual acuity; UNVA BIN: binocular uncorrected near visual acuity; IOL: intraocular lens.
Figure 3
Figure 3
Binocular UIVA and DCIVA pre- and postoperative results in the OptiVis group. UIVA BIN: binocular uncorrected intermediate visual acuity; DCIVA BIN: binocular distance-corrected intermediate visual acuity; IOL: intraocular lens.
Figure 4
Figure 4
Postoperative mesopic log contrast sensitivity function at far distances without glare in all five IOLs. IOL: intraocular lens; SD: standard deviation; CS: contrast sensitivity; spatial frequencies of 1.5, 3, 6, 12, and 18 cycles per degree.
Figure 5
Figure 5
Visual function (VF-14) results in multifocal intraocular lens. VF-14: visual function test; IOL: intraocular lens.

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