Abstract
Purpose: :
To determine whether implantation of a multifocal IOL with a modified addition at lens plane (ReSTOR +3 Alcon laboratories, Inc) results in better intermediate visual acuity with similar performance at distance and near compared to ReSTOR + 4 (Alcon laboratories, Inc) which has similar design but higher addition at lens plane.
Methods: :
In this prospective randomized double masked comparative study 16 patients were implanted bilaterally with the ReSTOR +3 and 16 patients were implanted bilaterally with ReSTOR +4. Monocular distance best corrected visual acuity (BCVA) (4.0 m), near (40.0 cm) and intermediate (70.0, 60.0, 50.0 cm) acuities, binocular defocus curve and contrast sensitivity under photopic and mesopic conditions and reading speed were measured at 6 months postoperatively. Patients completed a quality-of-life questionnaire and an interactive functional evaluation using real-life props.
Results: :
There was no statistically significant difference between groups in monocular best distance-corrected distance and near visual acuity at 6 months after surgery (p=0.548 and p=0.717 respectively). ReSTOR + 3 group performed better at distance-corrected intermediate visual acuity at 60cm (p=0.040) and 70 cm (p=0.015) compared to ReSTOR + 4. There was no statistically significant difference between groups at 50 cm (p=0.082). Binocular defocusing curves with - 2.00 diopters lens exhibited a better trend in the ReSTOR +3 group. There were no statistically significant between-group difference in contrast sensitivity under photopic and mesopic conditions at all spatial frequencies. There was a statistically significant difference considering best reading distance between ReSTOR +3 (39.7 ± 1.45 cm) and ReSTOR +4 (31.6 ± 1.01 cm) (p=0.007). The maximum reading speed and the critical print size was similar in both groups (p=0.32 and p=0.72 respectively). Rates of spectacle freedom and satisfaction were high in both groups.
Conclusions: :
Both groups had similar performance for distance-corrected distance and near visual acuity. ReSTOR + 3 group had a better performance at intermediate distance mainly at 60 and 70 cm compared to ReSTOR +4 group. ReSTOR + 3 group seems to have a more comfortable reading distance with similar reading speed compared ReSTOR +4 group.
Clinical Trial: :
www.clinicaltrials.gov NCT00876707
Keywords: intraocular lens • optical properties • cataract