Prospective analysis of visual outcomes using apodized, diffractive multifocal intraocular lenses following phacoemulsification for cataract or clear lens extraction.

BACKGROUND

To evaluate efficacy, safety and predictability of apodized, diffractive multifocal intraocular lenses.

DESIGN

Prospective, observational study. PARTICIPANTS OR SAMPLE: Two hundred three patients (363 eyes) underwent surgery for cataract (54.8%) or clear lens extraction (45.2%).

METHODS

A study of consecutive patients undergoing lens extraction with insertion of the AcrySof Natural ReSTOR intraocular lens (SN60D3). Assessment included: refraction, corneal topography, biometry, monocular and binocular uncorrected and best spectacle corrected distance and near visual acuity.

MAIN OUTCOME MEASURES

Visual acuity, spectacle dependence.

RESULTS

Mean preoperative best corrected visual acuity was 6/12 (cataract) and 6/6 (clear lens extraction). One hundred sixty-one (98.2%) of the clear lens extraction group were hyperopic and presbyopic (mean spherical equivalent +4.25±3.5D). Postoperatively uncorrected visual acuity was ≥6/12 in 96.5% of eyes (51.9% ≥6/6) and ≥ N5 in 95% of eyes. At 6 months, 182 eyes (91.4%) (cataract) and 137 eyes (83.5%) (clear lens extraction) were ≤0.50 D of target spherical equivalent. Spectacle independence was reported in 81.9% (n=168). Minor halos or other visual phenomena were reported in 10.2%. No subjects required intraocular lens exchange. Safety index at 6 months was 2.5 and 1.17 for cataract and clear lens extraction, respectively.

CONCLUSIONS

The apodized, diffractive multifocal intraocular lens predictably provided excellent near uncorrected visual acuity and good distance uncorrected visual acuity following cataract and clear lens extraction surgery with a high rate of spectacle independence. A minority of subjects note halos and other visual phenomena that may be related to intraocular lens design.