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, 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; patients underwent surgery between 2011 and 2020. 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 the LS-313 MF15 group, the ZMB00 group had significantly superior uncorrected near visual acuity, reduced higher-order aberrations (ocular/internal, scaled to a 4-mm pupil; WF_4_post_O_TotalHOA/Third/Fourth/Trefoil/Coma/Tetrafoil/Spherical, WF_4_post_I_Astigmatism/TotalHOA/Third/Trefoil/Coma/Tetrafoil/Spherical), and superior distance and near spectacle independence (p<0.00068, Wald test). Contrast sensitivity, measured without (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 group than in the ZMB00 group (p<0.00068, Wald test).

Comparison of Visual Performance between Monofocal and Rotationally Asymmetric Refractive Intraocular Lenses

“…The study showed that patients in the monofocal group had better contrast sensitivity and higher night driving scores. As in the previous studies 17,18 , we used the CGT-1000 instrument to measure contrast sensitivity; this device determines the contrast threshold with an automated strategy for 6 spatial frequencies 19,20 . In this study, the contrast sensitivity with glare was signi cantly better in the rotationally asymmetric refractive group at 6.3 degrees.…”

“…The results of multiple regression analysis for all postoperative parameters, which were adjusted by multiple regression with the explanatory variables in Table 1 in the same way as in our previous study 17,18 , for the monofocal and rotationally asymmetric refractive groups 10 weeks after surgery on both eyes are shown in Supplementary Table S2. Corrected distance visual acuity and the higher-order aberrations (ocular/internal, scaled to a pupil size of 4 mm/6 mm) WF_4_post_O_TotalHOA, _Third, _Fourth, _Trefoil, _Coma, _Tetrafoil, _Spherical, WF_4_post_I_TotalHOA, _Third, _Fourth, _Trefoil, _Coma, _Tetrafoil, _Spherical, WF_6_post_O_Spherical, and WF_6_post_I_Spherical were signi cantly better in the monofocal group (p < 0.00068, Wald test) (Table 2 and Fig.…”

“…For numerical data, the mean and standard deviation are shown, and the two-sided Mann-Whitney U test was used to compare numerical data for the monofocal and rotationally asymmetric refractive IOL groups. The correlation coe cients (A) and p values for the correlation analyses (B) between all possible combinations of postoperative parameters, which were adjusted by multiple regression with the explanatory variables in Table 1 in the same way as in our previous study 17,18 , for the monofocal and rotationally asymmetric refractive groups are shown in Supplementary Table S3/Fig. 4 and Supplementary Table S4/Fig.…”

Comparison of Visual Performance between Diffractive Bifocal and Diffractive Trifocal Intraocular Lenses

“…Preoperatively, all patients received 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, in the same way described in our previous study 11,12 . The quality of vision was evaluated using the Japanese version of the NEI VFQ-25 34 .…”

“…As in our previous study 11,12 Both groups were adjusted for age, sex, axial length, subjective refraction spherical equivalent, subjective refraction cylinder, corneal astigmatism, corneal higher-order aberrations, and pupil diameter. In the regression analyses (2) and (3), the data were divided into two parts (left-eye data and right-eye data), and the regression model was applied to each dataset.…”