Comparison of clinical efficacy between multifocal and monofocal intraocular lens implantation for the treatment of cataract

Background Multifocal intraocular lens (IOL) can produce two focus distance based on the principle of diffraction-refraction,and the full range of vision is better than monofocal IOL.So multifocal IOL can provide cataract patients better far,middle and near distant vision.Objective This study was to investigate and compare the clinical efficacy between multifocal IOL and monofocal IOL implantation in the patients after cataract surgery.Methods One hundred eyes of 100 patients with cataract enrolled in Gaomi People's Hospital from June 2010 to September 2012 and were divided into the monofocal IOL group and multifocal IOL group,with the matched demographic and medical baseline characteristics between the two groups.All the patients were aware of the trial and a written informed consent was obtained from each patient prior to the surgery.Multifocal IOL (Acrysof ReSTOR SA60D3) was implanted in the multifocal IOL group,and monofocal IOL was implanted in the monofocal IOL group after phacoemulsification.Uncorrected distant visual acuity (UCDVA),best corrected distant visual acuity (BCDVA),uncorrected near visual acuity (UCNVA),best corrected near visual acuity (BCNVA),uncorrected middle distance visual acuity (UCMVA) and distant-corrected near visual acuity (DCNVA) between the two groups were observed and compared,and near stereo acuity,IOL higher-order aberrations under the pupillary diameters of 3 mm and 5 mm,optimum reading distance and reading speed were compared 3 months after surgery.The satisfaction rates of patients for each visual function district were analyzed by a questionnaire survey.Results UCNVA and DCNVA in the multifocal IOL group were significantly better than those of the monofocal IOL group 3 months after surgery,and the differences were statistically significant (t=15.48,22.44,both at P＜0.05).UCMVA at the distance of 25,30,40,50,60 cm in the multifocal IOL group were better than ones of the single IOL group (t=12.60,16.75,23.18,14.04,7.60,all at P＜0.05).Uncorrected near stereo acuity in the multifocal IOL group was (49.1 ±15.2),showing a significant reduction in comparison with (85.3 ± 18.6) of the multifocal IOL group (t=10.66,P＜0.05).The total higher-order aberrations,spherical aberration and coma under the pupil diameter of 3 mm and 5 mm were not significantly different between the two groups (all at P＞0.05).The optimal reading distance in the multifocal IOL group was (33.5 ± 4.1) cm,and was significantly shorter than (46.3 ± 5.2) cm of the monofocal IOL (t=13.67,P＜0.05).The reading speed in the multifocal IOL group was (172.5 ± 52.3) words/minute,and that in the monofocal IOL group was (108.3 ± 31.4) words/minute,with the significant difference between them (t =7.44,P＜0.05).The patients who were satisfied with the functional areas of near vision and middle-distance vision were more in the multifocal IOL group than those of the monofocal IOL group (x2=56.59,40.85,both at P＜0.05),but those in the distance vision zone between the two groups was no significant different (x2=3.09,P＞0.05).Conclusions Comparison with the monofocal IOL,multifocal IOL implantation for the treatment of cataract can obtain clear imaging both at the far-distance and middle-and near-distance.Multifocal IOL implantation can improve the life quality of cataract patients after operation. Key words: Intraocular lens/multifocal, monofocal; Cataract; Life quality