Visual Acuity, Contrast Sensitivity, Reading Speed, and Wavefront Analysis: Pseudophakic Eye With Multifocal IOL (ReSTOR) Versus Fellow Phakic Eye in Non-presbyopic Patients

Abstract

PURPOSE: To compare the visual performance in the Pseudophakie eye and the phakic eye in four patients who underwent unilateral intraocular lens (IOL) implantation. METHODS: Four patients presenting with unilateral cataract underwent ReSTOR (Alcon Laboratories, Ft Worth, Tex) IOL implantation in their nondominant eye, targeting emmetropia. RESULTS: Uncorrected near visual acuity was >20/32 in all operated eyes and best spectacle-corrected distance visual acuity was 20/16 for two eyes, 20/25 for one eye, and 20/32 for one eye. Reading speed was similar between the eyes, but not for critical print size. Contrast sensitivity was lower in the Pseudophakie eyes. Wavefront analysis showed no considerable difference in total high order aberrations, coma, and spherical aberration between eyes for all patients. CONCLUSIONS: In young patients with unilateral cataract surgery, unilateral multifocal IOL implantation provides satisfactory visual acuity and may be considered an alternative treatment option in this patient population. [J Refract Surg. 2006;22:303-305.]

Correlation of pupil size with visual acuity and contrast sensitivity after implantation of an apodized diffractive intraocular lens

“…However, better intermediate visual performance is expected with multifocal IOLs than with monocular IOLs. Souza et al 20 found that binocular distance-corrected intermediate visual acuity was better in patients with the ReSTOR IOL than in patients with the monofocal AcrySof SA60AT IOL (Alcon) at 50 cm, 60 cm, and 70 cm. Note how the cubic trend changes as a function of the pupil group.…”

“…Today, one widely used diffractive multifocal IOL is the AcrySof ReSTOR (Alcon). Recent studies [19][20][21][22][23] report satisfactory visual acuity and contrast sensitivity results. The relative energy between the distance and near focal points of the ReSTOR IOL changes significantly with pupil diameter, as Davison and Simpson 23 detail.…”

Optical quality of the eye after lens replacement with a pseudoaccommodating intraocular lens

“…11 Although some studies found this IOL provides a satisfactory full range of vision in terms of visual acuity and contrast sensitivity under bright and dim conditions and has a low incidence of visual disturbances after cataract surgery 12,13 and CLE, 14 others found less satisfactory results with regard to visual disturbances, with evidence of marked increases in halos and glare after IOL implantation in up to 30% of patients. [15][16][17][18] If these IOLs are to be useful in CLE surgery, postimplantation visual performance at distance and near must show significant improvement over that of the natural presbyopic eye. Distance acuity should be at least as good as that of the natural presbyopic eye and performance at intermediate and near distances, markedly superior.…”

Optical performance of monofocal and multifocal intraocular lenses in the human eye

“…[2][3][4] However, the multifocal optic can cause decreased contrast sensitivity and lead to halos and glare. [5][6][7] The measurement of the imaging quality of IOLs provided by manufacturers is based on standardized methods that evaluate IOL optical quality ex vivo [8][9][10] (in air or water) at an optical bench or by simulation using an artificial eye model. 11 Although theoretically and technically precise, the information provided by these industrial models is limited from the clinical perspective as it does not take into account the individual characteristics of the eye (corneal power, anterior chamber, axial length, pupil location and size) or the off-center elements of the eye's diopters (D).…”

“…2-4 However, the multifocal optic can cause decreased contrast sensitivity and lead to halos and glare. [5][6][7] The measurement of the imaging quality of IOLs provided by manufacturers is based on standardized methods that evaluate IOL optical quality ex vivo 8-10 …”