Comparison of visual function and patient satisfaction with AcrySof ReSTORSN6AD1 multifocal intraocular compared to monofocal intraocular lenses 5

Cover Page


Purpose. To compare the visual function and patient satisfaction in patients after implantation of the AcrySof ReSTOR SN6AD1 multifocal intraocular lens (IOL) and after implantation of the AcrySof SA60AТ spherical monofocal IOL and Akreos АО aspheric monofocal IOL in cataract surgery.

Materials. 34 patients had SN6AD1 multifocal (group 1, 48 eyes), 19 patients had Akreos АО monofocal aspheric (group 2, 30 eyes) and 13 patients had AcrySof SA60AТ monofocal spherical (group 3, 18 eyes) IOL implantations. Patients with multifocal IOL were closely paired in age, sex, and ocular findings with patients who had monofocal IOL implantation. Six months postoperatively uncorrected/corrected distance visual acuity (UDVA/CDVA), uncorrected intermediate (60 cm) and near (35 cm) visual acuity (UNVA), the defocus curve, contrast sensitivity and a quality-of-life questionnaire were evaluated. Furthermore, independence from glasses and the presence of optical phenomena were assessed.

Results. Patients in group 2 had statistically better UDVA than in group 1 (p = 0,037). There was no significant difference in the mean uncorrected intermediate and best corrected distance visual acuities between the groups. UNVA was better in group 1 than in groups 2, 3 (p < 0,0001). Photopic contrast sensitivity for high spatial frequencies was better for the groups 2 and 3. Glare was reported by 5,9% in the multifocal group. Halos occurred in 32,4% of patients in group 1. No one reported unwanted visual symptoms in monofocal groups.

Conclusion. Multifocal IOLs provided higher spectacle independence and satisfactory functional vision over a broad range of distances but were associated with increased subjective visual symptoms, reduced photopic contrast sensitivity for high spatial frequencies and distance visual quality compared with the monofocal IOLs.

Aisa S Alchinova

Author for correspondence.
FSBEI HE I.P. Pavlov SPbSMU MOH Russia
Russian Federation

resident, Department of Ophthalmology

Ksenia Yu Morina
FSBEI HE I.P. Pavlov SPbSMU MOH Russia
Russian Federation

resident, Department of Ophthalmology

Vyacheslav V Rakhmanov
FSBEI HE I.P. Pavlov SPbSMU MOH Russia
Russian Federation

PhD, assistant, Department of Ophthalmology

Vitaly V Potemkin
FSBEI HE I.P. Pavlov SPbSMU MOH Russia
Russian Federation

PhD, professor assistant, Department of Ophthalmology

Kirill V Khripun
Ophthalmologic Center of City hospital No 2
Russian Federation

PhD, ophthalmologist

Elena V Meshveliani
FSBEI HE I.P. Pavlov SPbSMU MOH Russia
Russian Federation

resident, Department of Ophthalmology

Elena V Ageeva
FSBEI HE I.P. Pavlov SPbSMU MOH Russia
Russian Federation

resident, Department of Ophthalmology

  • Анисимова С.Ю., Анисимов С.И., Загребельная Л.В. Алгоритм выбора метода интраокулярной коррекции афакии с учётом сопутствующей пресбиопии и астигматизма // Современные технологии катарактальной и рефракционной хирургии: Материалы конференции. – М., 2010. – С. 24–30. [Anisimova SYu, Anisimov SI, Zagrebel’naya LV. Algoritm vybora metoda intraokulyarnoy korrektsii afakii s uchetom soputstvuyushchey presbiopii i astigmatizma. Sovremennye tekhnologii kataraktal’noy i refraktsionnoy khirurgii: (Conference proceedings). Moscow; 2010:24-30. (In Russ.)]
  • Беликова Е.И., Антонюк С.В., Бугаенко И.А. Сравнительные результаты хирургической коррекции пресбиопии с использованием мультифокальных и аккомодирующих интраокулярных линз // Современные технологии катарактальной и рефракционной хирургии: Материалы конференции. – М., 2010. – С. 31–36. [Belikova EI, Antonyuk SV, Bugaenko IA. Sravnitel’nye rezul’taty khirurgicheskoy korrektsii presbiopii s ispol’zovaniem mul’tifokal’nykh i akkomodiruyushchikh intraokulyarnykh linz. Sovremennye tekhnologii kataraktal’noy i refraktsionnoy khirurgii. (Conference proceedings). Moscow; 2010:31-36. (In Russ.)]
  • Малюгин Б.Э., Морозова Т.А. Исторические аспекты и современное состояние проблемы мультифокальной интраокулярной коррекции // Офтальмохирургия. – 2004. – № 3. – С. 23–29. [Malyugin BE, Morozova TA. A Review of Historical Aspects and Modern Trends in Multifocal Intraocular Correction. Ophthalmic surgery. 2004;(3):23-29. (In Russ.)]
  • Тахтаев Ю.В., Балашевич Л.И. Хирургическая коррекция гиперметропии и пресбиопии рефракционно-дифракционными псевдоаккомодирующими интраокулярными линзами AcrySof ReSTOR // Офтальмохирургия. – 2005. – № 3. – С. 12–16. [Takhtaev YuV, Balashevich LI. Khirurgicheskaya korrektsiya gipermetropii i presbiopii refraktsionno-difraktsionnymi psevdoakkomodiruyushchimi intraokulyarnymi linzami AcrySof ReSTOR. Ophthalmic surgery. 2005;(3):12-16. (In Russ.)]
  • Шамшинова А.М., Волков В.В. Функциональные методы исследования в офтальмологии. – М.: Медицина, 1999. – 416 с. [Shamshinova AM, Volkov VV. Funktsional’nye metody issledovaniya v oftal’mologii. Moscow: Meditsina; 1999. 416 p. (In Russ.)]
  • Alfonso JF, Fernandez-Vega L, Baamonde MB, et al. Correlation of pupil size with visual acuity and contrast sensitivity after implantation of an apodized diffractive intraocular lens. J Cataract Refract Surg. 2007;33(3):430-438. doi: 10.1016/j.jcrs.2006.10.051.
  • Alio JL, Abdelghany AA, Fernández-Buenaga R. Enhancements after cataract surgery. Curr Opin Ophthalmol. 2015;26(1):50-55. doi: 10.1097/ICU.0000000000000111.
  • Cochener B, Lafuma A, Khoshnood B, et al. Comparison of outcomes with multifocal intraocular lenses: a meta-analysis. Clin Ophthalmol. 2011;7(5):45-56.
  • Datiles MB, Gancayco T. Low myopia with low astigmatic correction gives cataract surgery patients good depth of focus. Ophthalmology. 1990;97(7):922-926. doi: 10.1016/S0161-6420(90)32480-6.
  • Elder MJ, Murphy C, Sanderson GF. Apparent accommodation and depth of field in pseudophakia. J Cataract Refract Surg. 1996;22(5):615-619. doi: 10.1016/S0886-3350(96)80020-4.
  • Elgohary MA, Beckingsale AB. Effect of illumination on visual function after monofocal and multifocal intraocular lens implantation. Eye. 2006;20(2):144-149. doi: 10.1038/sj.eye. 6701820.
  • Fukuyama M, Oshika T, Amano S, Yoshitomi F. Relationship between apparent accomodation and corneal multifocality in pseudophakic eyes. Ophthalmology. 1999;106(6):1178-1181. doi: 10.1016/S0161-6420(99)90259-2.
  • Maurino V, Allan BD, Rubin GS, et al. Quality of vision after bilateral multifocal intraocular lens implantation: a randomized trial-AT LISA 809M versus AcrySof ReSTOR SN6AD1. Ophthalmology. 2015;122(4):700-710. doi: 10.1016/j.ophtha.2014.10.002.
  • Mu J, Chen H, Li Y. Comparison study of visual function and patient satisfaction in patients with monovision and patients with bilateral multifocal intraocular lenses. Zhonghua Yan Ke Za Zhi. 2014;50(2):95-99.
  • Nakazawa M, Ohtsuki K. Apparent accommodation in pseudophakic eyes after implantation of posterior chamber intraocular lenses. Am J Ophthalmol. 1983;(96):4:435-438.
  • Petermeier K, Szurman P. Subjective and objective outcome following implantation of the apodized diffractive AcrySof ReSTOR. Ophthalmologe. 2007;104(5):399-404. doi: 10.1007/s00347-007-1511-3.
  • Rocha KM, Soriano ES, Chamon W, et al. Spherical aberration and depth of focus in eyes implanted with aspheric and spherical intraocular lenses: a prospective randomized study. Ophthalmology. 2007;114(11):2050-2054. doi: 10.1016/j.ophtha.2007.01.024.
  • Soda M, Yaguchi S. Effect of decentration on the optical performance in multifocal intraocular lenses. Ophthalmologica. 2012;227(4):197-204. doi: 10.1159/000333820.
  • Vingolo EM, Grenga P, Iacobelli L, Grenga R. Visual acuity and contrast sensitivity: AcrySof ReSTOR apodized diffractive versus AcrySof SA60AT monofocal intraocular lenses. J Cataract Refract Surg. 2007;33(7):1244-1247. doi: 10.1016/j.jcrs.2007.03.052.
  • Wilkins MR, Allan BD, Rubin GS, et al. Randomized trial of multifocal intraocular lenses versus monovision after bilateral cataract surgery. Moorfields IOL Study Group. Ophthalmology. 2013;120(12):2449-2455. doi: 10.1016/j.ophtha.2013.07.048.
  • Woodward MA, Randleman JB, Stulting RD. Dissatisfaction after multifocal intraocular lens implantation. J Cataract Refract Surg. 2009;35(6):992-997. doi: 10.1016/j.jcrs.2009.01.031.


Abstract - 77

PDF (Russian) - 72

Copyright (c) 2016 ECO-vector LLC

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

ISSN 1998-7102 (Print)
ISSN 2412-5423 (Online)