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Patrick P. Marvan, Max Rasp, Veronika Reischl, Theresa Rueckl, Alois K. Dexl; Reading Performance Of Monofocal And Multifocal IOL's, Results After 12 Months. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6198.
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Current studies concerning the combined surgical treatment of cataract and presbyopia just focus on the comparison of different multifocal IOL’s (mf-IOL) but miss the comparison to the present gold standard : the monofocal IOL. In this study we therefore tested a standard monofocal IOL (AT.Smart 46S), a refractive mf-IOL (Rezoom), a diffractive mf-IOL (AT.Lisa 366D) and a apodized diffractive mf-IOL (ReSTOR SN6AD3) against each other. Aim of our study was to evaluate if the design of different IOL’s can really offer a life without glasses.
This randomized, evaluator-blinded, multicenter-study (ESCRS-Grant) included 240 patients in 2 different centers (Alicante/Spain & Salzburg/Austria; 30 patients per study group and center). After bilateral Phaco and IOL-Implantation the outcome regarding the reading acuity and reading speed (Salzburg Reading Desk) and contrast sensitivity (VSRC CST 1800) for photopic and scotopic conditions was compared 12 month postoperatively.
Emmetropia was reached in all 4 groups (+/- 0,5 D). The best results regarding the reading acuity with best distance correction (as an indicator for the efficiency of the multifocal design) provided the AT-Lisa 366D with 0,25±0,13 logRAD, followed by the ReSTOR SN6AD3 with 0,36±0,12 logRAD. The Rezoom gained 0,40±0,08 logRAD, and the monofocal AT.Smart 46 S 0,53±0,15 logRAD. Halo's and glare where mainly assigned in the group with the refractive multifocal design (Rezoom).
The diffractive AT.Lisa 366D provided the best results regarding the reading performance with distance correction, followed by the ReSTOR SN6AD3. The good contrast sensitivity and the reduced photopic phenomena can be explained by the improved lens design with rounded diffractive steps for the AT.Lisa 366D (SMP-technology) and the apodized design (ReSTOR). Most of the patients where very satisfied with their individual results. Attention should be payed to a good patient selection and guidance, with a remark to the adaptation period within the first months after implantation of mf-IOL's.
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