All-Distance Visual Acuity and Contrast Visual Acuity in Eyes with a Refractive Multifocal Intraocular Lens with Minimal Added Power

Purpose To compare visual acuity (VA) from far to near distances, photopic and mesopic contrast VA, and contrast VA in the presence of a glare source (glare VA), between eyes with a new refractive multifocal intraocular lens (IOL) with added power of only +3.0 diopters and those with a monofocal IOL. Design Comparative, nonrandomized, interventional study. Participants Forty-four eyes of 22 patients who were scheduled for implantation of a refractive multifocal IOL (Hoya SFX MV1; Tokyo, Japan) and 44 eyes of 22 patients scheduled for implantation of a monofocal IOL. Intervention All patients underwent phacoemulsification with bilateral implantation of either multifocal or monofocal IOLs. Main Outcome Measures At approximately 3 months after surgery, monocular and binocular VA from far to near distances was measured using the all-distance vision tester (Kowa AS-15; Tokyo, Japan), whereas photopic and mesopic contrast VA and glare VA were examined using the Contrast Sensitivity Accurate Tester (Menicon CAT-2000, Nagoya, Japan). Pupillary diameter and the degree of IOL decentration and tilt were correlated with VA at all distances. Results Mean VA in both the multifocal and monofocal IOL groups decreased gradually from far to near distances. When comparing the 2 groups, however, both uncorrected and best distance-corrected intermediate VA at 0.5 m and near VA at 0.3 m in the multifocal IOL group were significantly better than those in the monofocal IOL group ( P≤ 0.0037), although there was no significant difference in far VA or in intermediate VA at 0.7 and 1.0 m. Photopic and mesopic contrast VA and glare VA were similar between the 2 groups. In both the multifocal and monofocal IOL groups, no significant correlation was found between VA at any distance and pupillary diameter or between VA and the degree of IOL decentration and tilt. Conclusions A new refractive multifocal IOL with minimal added power provides significantly better intermediate and near VA than does a monofocal IOL; contrast VA and glare VA are not impaired with this multifocal IOL. Visual acuity at all distances with this IOL is not correlated with pupillary diameter or with IOL decentration and tilt. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.