Comparative Analysis of Visual Performance and Optical Quality with a Rotationally Asymmetric Multifocal Intraocular Lens and an Apodized Diffractive Multifocal Intraocular Lens

Abstract

Purpose. To compare the short-term visual outcomes and intraocular optical performance of a rotationally asymmetric multifocal intraocular lens (MIOL) (SBL-3, Lenstec, Inc., Christ Church, Barbados) and an apodized diffractive MIOL (the Acrysof IQ ResTOR SN6AD1, Alcon Laboratories, Inc., Fort Worth, Texas, United States). Methods. A prospective, comparative, nonrandomized, and single-center study. Sixty-eight age-related cataract patients (81 eyes) after phacoemulsification cataract surgery and in-the-bag MIOL implantation were enrolled. Thirty-eight eyes received SBL-3, and 43 eyes received SN6AD1. Ophthalmological evaluation included uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), modulation transfer function (MTF), Strehl ratio (SR), intraocular aberrations (4 mm optical zone), and defocus curve at 3 months postoperatively. The Chinese version of the visual function index-14 (VF-12-CN) and spectacle independence were assessed in all patients. Results. There was no statistically significant difference between groups in postoperative UDVA (p=0.186). Postoperative UIVA and UNVA were significantly better for the SBL-3 group than for the SN6AD1 group (p<0.01). Statistically significant differences were revealed in defocus levels from –3.50 D to −4.00 D with better visual acuities for the SBL-3 group (p<0.01). For intraocular optical quality outcomes, statistically significant differences between groups were observed in RMS of intraocular total aberrations, coma, and trefoil high-order aberrations, presenting significantly higher values of these parameters in the eyes of the SBL-3 group (p < 0.01). Statistically significant differences were revealed in the MTF values at spatial frequencies of 5 and 10 cycles/degree between groups. There were no significant differences in scores of VF-12-CN, and spectacle independence between the groups (p>0.05). Conclusions. Both MIOLs were able to successfully restore visual function after cataract surgery. SBL-3 provided better UIVA and UNVA with a wider range of intermediate vision.

A comparative study on early vision quality after implantation of refractive segmental and diffractive multifocal intraocular lens

“…As for differences in spherical aberrations between both groups, no statistical significance is found (P > 0.05). These outcomes conform to research findings reported by Wang et al 14 This suggests that implantation of a SBL-3 IOL can introduce greater high order aberrations. Through follow-up visits to patients with Lentis Mplus IOL implantation, high intraocular coma is proved among them.…”

“…Such an outcome is consistent with those reported by Wang. 14 However, van der Linden et al 15 compared the Lentis Mplus with the Restor SN6AD1 IOL. They found that the IOLs achieved comparable distance vision, while the Restor provided better near visual acuity.…”

Visual Performance Following Bilateral Implantation of Refractive Rotationally Asymmetric Bifocal Intraocular Lens (LS-313 MF30) or Apodized Diffractive Bifocal Intraocular Lens (ReSTOR SN6AD1)

“…11,17 Nevertheless, the introduction of intraocular aberration potentially reduces the retinal image quality of rotationally asymmetric MIOL. 10 Similarly, Nio et al 18 discovered that HOA increases the depth of focus and decreases the MTF value at higher spatial frequency. Therefore, we concluded that the increase of intraocular aberration might decrease the MTF value.…”

“…The results were consistent with the previous findings of rotationally asymmetric and diffractive MIOL. [10][11][12] Wang etal 10 reported that rotationally asymmetricMIOL (SBL-3) provided better UIVA and wider range of intermediate vision than apodized diffractive MIOL (SN6AD1). Alio et al 11 Defocus curve is an effective method to evaluate the whole visual acuity of MIOL, showing a visual acuity of different defocus levels, with the result being equivalent to the visual acuity of different viewing distances.…”

“…15 However, the increased intraocular aberration of rotationally asymmetric MIOL potentially extended the focal depth, ie, its advantage in UIVA compared with diffractive bifocal IOL. 10,16 It was believed that the presence of this optical defect allowed an extended depth of focus that would grant adequate vision at various distances. We also reported significant differences in 5c/d, 10c/d, 15c/d, 20c/d, 25c/d, and 30c/d in intraocular and total eye MTF between the two groups.…”