Comparative visual performance of diffractive bifocal and rotationally asymmetric refractive intraocular lenses

Abstract

We compared the visual performance of a diffractive bifocal intraocular lens (IOL) with + 4.0 D near addition (ZMB00 [Johnson & Johnson Surgical Vision]) and a rotationally asymmetric refractive IOL with + 1.5 D near addition (LS-313 MF15 [Teleon Surgical BV]) 10 weeks after cataract patients’ last surgery for bilateral ZMB00 or LS-313 MF15 implantation between 2011 and 2020, with the lenses of each eye implanted within 3 months of each other. The ZMB00 and LS-313 MF15 groups comprised 1326 eyes of 663 patients (age: 67.0 ± 7.8 years; females/males, 518/145) and 448 eyes of 224 patients (73.6 ± 7.0 years; females/males, 125/99), respectively. A linear mixed-effects model using data for both eyes, with strict adjustments for sex, age, subjective refraction spherical equivalent, subjective refraction cylinder, corneal astigmatism, axial length, corneal higher-order aberrations, and pupil diameter, ensured statistical validity. Compared to LS-313 MF15, ZMB00 achieved significantly superior uncorrected near visual acuity, reduced higher-order aberrations (ocular/internal, scaled to a 4-mm pupil; Wavefront_4_post_Ocular_Total Higher-Order Aberration/Third/Fourth/Trefoil/Coma/Tetrafoil/Spherical, Wavefront_4_post_Internal_Astigmatism/Total Higher-Order Aberration/Third/Trefoil/Coma/Tetrafoil/Spherical), and superior distance and near spectacle independence (p < 0.00068, Wald test). Contrast sensitivity, measured without (visual angle of the test target: 6.3°/4.0°/2.5°/1.6°/1.0°/0.7°) or with glare (4.0°/2.5°/1.6°/1.0°/0.7°), was significantly better in the LS-313 MF15 than the ZMB00 group (p < 0.00068, Wald test).

Comparative Visual Performance of Ultraviolet Light-Filtering and Violet Light-Filtering Monofocal Intraocular Lenses of the Same Material and Basic Design

“…At a superior level of performance, the two groups of IOLs exhibited distinctive attributes with respect to diverse vision-related parameters. in our previous study [10][11][12] . Participants were recruited for enrollment in a consecutive case series study (outpatients with or without a doctor's referral).…”

“…The patient demographic variables and pre and postoperative visual parameters used in the study are presented in Supplementary Multiple regression analysis was conducted on all postoperative parameters of the two groups 10 weeks after surgery in both eyes in the same way as in our previous studies [10][11][12] , i.e., we ensured statistical validity through a linear mixed-effects model using data for both eyes, with strict adjustments for sex, age, subjective refraction spherical equivalent, subjective refraction cylinder, corneal astigmatism, axial length, corneal higher-order aberrations, and pupil diameter. The parameters were adjusted by multiple regression according to the explanatory variables in Table 1.…”

“…Preoperative examinations were conducted as described in our previous study [10][11][12] . All patients underwent full ophthalmologic examinations, including evaluations of the corneal curvature radius, corneal astigmatism, axial length, refractive status, ocular aberrations, pupil diameter, distance/intermediate/near visual acuity, contrast sensitivity, and contrast sensitivity under glare, as well as anterior segment evaluations using a slit lamp, tonometry and indirect fundoscopy.…”

“…Axial length was measured using IOL Master 700 (Carl Zeiss Meditec AG, Jena, Germany) and AL-3000 (TOMEY, Nagoya, Japan) biometers. Contrast sensitivity and contrast sensitivity under glare (visual angle of the test target: 6.3°/4.0°/2.5°/1.6°/1.0°/0.7°; 13 contrast levels: 0.01 to 0.64 contrast or 2.00 to 0.34 log10CS) were measured using a CGT-1000 contrast glare tester (Takagi Seiko, Nakano, Japan) [10][11][12][13]19 , and the pupil diameter and ocular aberrations were measured using a KR-1W Wavefront Analyzer (Topcon, Tokyo, Japan). All measurements were taken by experienced technicians.…”

“…To our knowledge, no studies have undertaken a detailed, comprehensive clinical comparison of these two IOLs on a large scale under a strictly controlled analysis. Previously, we retrospectively compared the visual performance of several other combinations of the two IOLs based on a large set of patient data; in those studies, detailed statistical analysis with a linear mixed-effects model using data for both eyes, with strict adjustments for sex, age, subjective refraction spherical equivalent, subjective refraction cylinder, corneal astigmatism, axial length, corneal higher-order aberrations, and pupil diameter, successfully unveiled the different characteristics of the different lenses [10][11][12] . In this study, using the same rigorous statistical analysis as in our previous report [10][11][12] , we comprehensively compared the clinical performance of the ZCB00 group and the ZCB00V group in a large cohort of patients who underwent cataract surgery over a decade of clinical practice at a single hospital to clarify which product might be preferable for a patient undergoing cataract surgery and to investigate the potential effects of blue-light transmitting, violet lightltering IOL yellow tinting on comprehensive visual performance.…”