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  • Written By: Lisa B. Arbisser, MD
    Cataract/Anterior Segment

    This prospective study found that monocular implantation of a diffractive multifocal IOL for unilateral cataract provided better binocular near and intermediate visual acuity and spectacle independence than unilateral monofocal IOL implantation.

    However, distance contrast sensitivity and glare visual acuity were worse with the multifocal IOL.

    By in large, most people feel that monocular multifocal IOLs aren't well tolerated, but clearly they do have some significant advantages for near vision and spectacle independence in patients who can tolerate the unilateral halos and decrease in contrast sensitivity associated with them.

    This study recruited patients with unilateral cataract scheduled for implantation of a diffractive multifocal IOL and age-matched patients scheduled for implantation of a monofocal IOL. They ranged in age from 40 to 69 years.

    Three months postoperatively, mean binocular near and intermediate visual acuity were significantly better in the multifocal group than in the monofocal group, although there was no significant difference in uncorrected or corrected visual acuity at other distances.

    Binocular photopic contrast visual acuity and glare visual acuity at low contrasts and mesopic glare visual acuity were significantly worse in the multifocal group than in the monofocal group (P ≤ 0.0147). However, near stereoacuity was similar between the groups. Spectacle independence was significantly better in the multifocal group than in the monofocal group (P ≤ 0.0006).

    Additionally, patient satisfaction was substantially higher in the multifocal IOL patients than in the monofocal IOL patients.