Purpose:

To evaluate the effect of Eyeonics CrystaLens AT-45 accommodative intraocular lens (IOL) and AMO ReZoom refractive multifocal intraocular lens (MIOL) on distance and near vision, contrast sensitivity, postoperative spectacle dependence and patient satisfaction prospectively.

Material and Methods:

Thirty cataractous eyes of 23 otherwise healthy patients were enrolled in the study. The patients who were between 49 and 75 years and underwent cataract surgery between December 2003 and April 2006. Cataract extractions were performed with phacoemulsification. CrystaLens AT-45 accommodative IOL was implanted in 7 eyes of 7 patients and ReZoom MIOL was implanted in 23 eyes of 16 patients. Patients were evaluated at 1st and 6th postoperative months. For better evaluation of contrast sensitivity outcomes of MIOLs, we created a similar monofocal control group, with the same number of patients, patient age and best corrected distant visual acuity, to multifocal group.

Results:

The uncorrected visual acuities were 0.5 or better in both groups at 6th postoperative month. In accommodative IOL group no patient gained J3 or better near visual acuity, while in the multifocal group near visual acuity was J3 or better in 74% of the cases. In multifocal group 33 of the patients were spectacle free, while all of the patients in accommodative group needed to use distance and/or near spectacles. The need for spectacle was significantly lower in bilateral MIOL group than unilateral MIOL group (p=0.005). The contrast sensitivity was observed to be lower in MIOL group than control monofocal IOL group (p=0.032). The subjective patient satisfaction in both IOL groups for the results of surgery were in high levels.

Conclusion:

MIOL reduces the need for distance/near spectacle due to its good uncorrected distance/near visual acuity levels, but satisfying results are only possible with bilateral implantation of MIOLs. Accommodative IOL implanted patients were near spectacle dependent.

Keywords: Accommodative intraocular lens, multifocal intraocular lens, refractive design