Comparison of Visual Performance after Implantation of 3 Types of Intraocular Lenses: Accommodative, Multifocal, and Monofocal

Abstract

Purpose To compare the performance of accommodative, multifocal, and monofocal intraocular lenses (IOLs). Methods In this clinical control study, 3 types of IOL were implanted in 128 eyes of 86 patients with age-related cataract who underwent phacoemulsification. Accommodative (Tetraflex), multifocal (ZMA00), and monofocal (Akreos Advanced Optics [AO]) IOLs were implanted into 43, 40, and 45 eyes, respectively. The uncorrected, best-corrected distance, contrast sensitivity, and distance-corrected intermediate and near visual acuity (UCDVA, BCDVA, CSVA, DCIVA, and DCNVA, respectively), amplitude of pseudoaccommodation, and patient satisfaction were measured at 1, 3, and 12 months after surgery. Results Differences in CSVA at all contrast degrees, UCDVA, and BCDVA among the 3 groups were not significant. Patients in the Akreos AO group exhibited a poorer DCIVA and DCNVA and experienced less pseudoaccommodation compared to patients in the other 2 groups at 3 and 12 months after surgery (p<0.01). Patients in the ZMA00 group exhibited a better DCIVA and experienced more pseudoaccommodation than patients in the Tetraflex group (3 months: p<0.05, 12 months: p<0.01 for both outcomes). Three months after surgery, total spectacle independence was achieved by 84.4%, 60.7%, and 17.2% of the ZMA00, Tetraflex, and Akreos AO group patients, respectively. Conclusions All 3 types of IOLs allowed greater distance visual acuity; however, multifocal IOLs produced better DCIVA and DCNVA and more pseudoaccommodation and spectacle independence. Accommodative IOLs ranked second. Neither accommodative nor multifocal IOLs reduced CSVA.