Comparison of the visual performance and quality of vision with combined symmetrical inferonasal near addition versus inferonasal and superotemporal placement of rotationally asymmetric refractive multifocal intraocular lenses.

PURPOSE: To compare the postoperative quality of vision between different bilateral placements of near segments of rotationally asymmetric refractive multifocal intraocular lenses (IOLs) and to determine how this affects visual performance.

SETTING: Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom.

DESIGN: Retrospective comparative case series.

METHODS: The study enrolled consecutive patients having refractive lens exchange and implantation of rotationally asymmetric multifocal IOLs. Group 1 received bilateral SBL-3 IOLs and Group 2 received bilateral Lentis Mplus LS-312 MF30 IOLs, with the near segments placed inferonasally in each group. Group 3 received a Lentis Mplus LS-312 MF20 IOL in the dominant eye with the near segment positioned superotemporal and a Lenstec SBL-3 IOL positioned inferonasally in the fellow eye. Binocular uncorrected (UDVA) and corrected distance visual acuities, binocular uncorrected near (UNVA) and intermediate (UIVA) visual acuities, binocular distance-corrected near and intermediate visual acuities, and quality of vision were evaluated over 3 months postoperatively.

RESULTS: The study enrolled 180 patients (360 eyes). There was no significant difference between the groups in binocular UDVA, UIVA, and UNVA; however, there was a significant difference between the groups in quality of vision (P ≤ .001). Group 3 had significantly better overall quality of vision.

CONCLUSION: When implanting rotationally asymmetric multifocal IOLs, a combination of superotemporal placement of the near segment (+2.00 diopter [D] addition [add]) in the dominant eye with inferonasal placement of the near segment (+3.00 D add) in the fellow eye yielded consistent, high overall quality of vision and uncorrected visual acuity.

FINANCIAL DISCLOSURE: None of the authors has a financial or proprietary interest in any material or method mentioned.