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Mark R. Wilkins, Bruce Allan, Gary S. Rubin, Reshma Pattani, Moorfields IOL Study Group, Oliver Findl, Vincenzo Maurino; Randomised Controlled Trial Of Monovision Vs Multifocal Lenses After Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5698.
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To compare intraocular lens (IOL) related complications in patients receiving either multifocal IOLs or monofocal IOLs with the powers adjusted to produce monovision after cataract surgery.
Patients undergoing bilateral sequential phacoemulsification were randomized to receive either diffractive multifocal IOLs (Tecnis ZM900) or monofocal IOLs (Akreos AO) with 1.0-1.5 D of monovision. After 3 months of follow up patients were assessed for IOL related complications.
Between 3/1/07 and 9/30/10 212 patients were randomized, 106 to each arm. One patient failed to have any surgery. All except 1 patient were treated under the National Health Service. Eight patients were lost to follow up. Nine patients declined surgery on their second eye- 6 multifocal, 3 monovision (NS). IOL exchanges were performed on 7 (6.6%) multifocal and 0 monovision patients (p=0.02 chi squared). Five were bilateral exchanges, 2 were unilateral. Six of the 7 exchanges were due to dissatisfaction with the IOL, one unilateral exchange was performed because of poor IOL positioning. All exchanges were for monofocal lenses. LASIK to correct residual refractive error was performed on 1 eye from each treatment arm.
Following cataract surgery, IOL exchanges were significantly higher after implantation with the Tecnis ZM900 multifocal compared to implantation with Akreos AO monofocal IOLs targeting monovision.
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