Effect of illumination on visual function after monofocal and multifocal intraocular lens implantation

Abstract

Purpose To compare best-corrected visual acuity (BCVA) and contrast sensitivity (CS) under different levels of illumination in patients who had monofocal and multifocal intraocular lenses (IOLs) and to establish the effect of different lighting conditions on vision in the two groups of patients. Methods We retrospectively reviewed 27 patients who underwent phacoemulsification for age-related cataract and IOL implantation of either monofocal (SI30NB; n ¼ 10, 37%) or multifocal (SA40N; n ¼ 17, 63%) IOLs. Binocular distance and near BCVA and CS were tested using logMAR and Pelli-Robson charts that were externally illuminated with 20, 200, 400 and 1600 lux, and were compared using repeated-measures analysis of variance. A questionnaire was administered to establish the lighting preference in the two groups and the effect of lighting conditions on their vision. Results Binocular distance and near BCVA and CS significantly increased with increasing illumination from 20 to 200 lux in the monofocal (mean ¼ 0.04 vs -0.07, P ¼ 0.006; 0.37 vs 0.26, P ¼ 0.002 and 1.47 vs 1.60, P ¼ 0.01) as well as in the multifocal group (mean ¼ 0.03 vs À0.12, Po0.001; 0.38 vs 0.23, Po0.001 and 1.47 vs 1.61, P ¼ 0.002). No significant difference in BCVA or CS was found between the two groups at any of the four illumination levels. Both groups had similar lighting preference, but 43.8% of patients in the multifocal group experienced subjective worsening of their vision in bright outdoor lights. Conclusions Distance and near BCVA and CS improve with increasing illumination in patients with monofocal and multifocal IOLs, but remain comparable in the two groups under common levels of indoor illumination. Patients with multifocal IOLs may experience worsening of their vision in bright outdoor lights.

Patient-Centered and Visual Quality Outcomes of Premium Cataract Surgery: A Systematic Review

“…Studies of more recent lenses including the Acri.LISA 366D (60), ReSTOR, ReZoom (61, 62), and Tecnis (31, 60, 61, 63) also demonstrated that monofocal controls offered the best performance particularly under adverse conditions such as at lower contrast levels or under glare conditions (32, 33, 64) or lower spatial frequency (65), under photopic but not mesopic conditions (66), or under monocular but not binocular conditions (67). Only a few studies did not find any significant differences in contrast sensitivity between monofocal and multifocal Array (68), ReSTOR (32, 69–70–71–72), Tecnis (73), or Lentis M-Plus lenses (60). One study of the Tecnis Symfony reported no differences in contrast sensitivity between the Symfony and the monofocal control at any spatial frequency (38).…”

Patient satisfaction and visual function after pseudophakic monovision

“…15 Maintaining contrast sensitivity is important because it is a determinant of near-vision performance. Figure 1 shows the near and distance uncorrected visual acuities in all 52 eyes in our study.…”

Multifocal intraocular lenses in the setting of glaucoma

“…These results suggest no difference in glare disability induced by halogen light similar to oncoming vehicle headlights for patients implanted with monofocal and multifocal IOLs. Elgohary and Beckingsale [27 ] compared best-corrected visual acuity (BCVA) and contrast sensitivity under different levels of illumination in patients who had monofocal IOLs (AMO S1 40 NB) and MFIOLs (Array IOL SA 40 N) to establish the effect of different lighting conditions on vision in the two groups of patients. They concluded that distance and near BCVA and contrast sensitivity improve with increasing illumination in patients with monofocal and multifocal IOLs, but remain comparable in the two groups under common levels of indoor illumination.…”