Comparison of visual performance after implantation of 3 types of intraocular lenses: accommodative, multifocal, and monofocal.

PURPOSE: To compare the performance of accommodative, multifocal, and monofocal intraocular lenses (IOLs).

METHODS: In this clinical control study, 3 types of IOL were implanted in 128 eyes of 86 patients with age-related cataract who underwent phacoemulsification. Accommodative (Tetraflex), multifocal (ZMA00), and monofocal (Akreos Advanced Optics [AO]) IOLs were implanted into 43, 40, and 45 eyes, respectively. The uncorrected, best-corrected distance, contrast sensitivity, and distance-corrected intermediate and near visual acuity (UCDVA, BCDVA, CSVA, DCIVA, and DCNVA, respectively), amplitude of pseudoaccommodation, and patient satisfaction were measured at 1, 3, and 12 months after surgery.

RESULTS: Differences in CSVA at all contrast degrees, UCDVA, and BCDVA among the 3 groups were not significant. Patients in the Akreos AO group exhibited a poorer DCIVA and DCNVA and experienced less pseudoaccommodation compared to patients in the other 2 groups at 3 and 12 months after surgery (p<0.01). Patients in the ZMA00 group exhibited a better DCIVA and experienced more pseudoaccommodation than patients in the Tetraflex group (3 months: p<0.05, 12 months: p<0.01 for both outcomes). Three months after surgery, total spectacle independence was achieved by 84.4%, 60.7%, and 17.2% of the ZMA00, Tetraflex, and Akreos AO group patients, respectively.

CONCLUSIONS: All 3 types of IOLs allowed greater distance visual acuity; however, multifocal IOLs produced better DCIVA and DCNVA and more pseudoaccommodation and spectacle independence. Accommodative IOLs ranked second. Neither accommodative nor multifocal IOLs reduced CSVA.