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J. De Brabander, M.D. Nijkamp, F. Hendrikse, R.M. Nuijts; Pupil Size, Visual Function and Patient Satisfaction With Monofocal and Multifocal IOLs . Invest. Ophthalmol. Vis. Sci. 2003;44(13):257.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate the relation between pupil size, scores on visual function tests and patient satisfaction with a monofocal and a multizone multifocal intraocular lens (IOL). Methods: In a randomized controlled trial 169 eyes received a monofocal and 159 a multifocal IOL. Intake criteria involved bilateral cataract, no ocular co-morbidity, refraction between -6D and +4D, astigmatism ≤ 1.5D. Pre, 2, 6 and 12 months postoperative LogMar visual acuity (VA), contrast sensitivity function (CSF) with and without glare source were recorded for distance vision. For near vision high and low contrast acuity charts were used in two light conditions. Scores on visual function were compared with measurements of pupil size using an infrared pupillometer and with patient satisfaction scores using validated questionnaires. Results: No significant differences were found in patient satisfaction between the groups of mono and multifocal IOLs. Best corrected distance and near VA was significantly (p<0.05) better with monofocal IOLs for small pupils (<2.5mm) under photopic conditions. No difference was found between mono and multifocal lenses in postoperative glare. Average CS at 12 cpd was significantly reduced with multifocal IOLs and large pupils, whereas with small pupils both lens types performed equally well. Conclusion: After mono or multifocal IOL implantation postoperative scores on visual function tests correlated poorly to patient satisfaction. Pupil size alone is a weak factor to predict success with multifocal IOLs. However, it can be used in combination with visual habits/demands to advise the individual patient on the choice between mono or multifocal lens implant.
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