Refractive and Visual Outcomes at Postoperative Year 2 in a Randomized Clinical Comparison of Accommodating and 2 Multifocal IOLs
Narrative Responses:
Purpose
To evaluate visual and refractive outcomes at postoperative year 2 in patients implanted bilaterally with 1 of 3 types of presbyopia-correcting intraocular lenses (IOLs): the accommodative Crystalens AO IOL (Bausch + Lomb), the ReSTOR +3 multifocal IOL (Alcon), and the Tecnis Multifocal IOL (Abbott Medical Optics).
Methods
This prospective, randomized, patient-masked study enrolled 79 patients (158 eyes) with less than 1.25 D of corneal astigmatism who were eligible for routine cataract surgery. Patients were randomized to bilateral implantation with Crystalens AO, ReSTOR +3, or Tecnis Multifocal IOLs during phacoemulsification. Patients were followed through postoperative month 24. The primary outcome measures included contrast sensitivity, refraction (manifest refraction spherical equivalent, MRSE) and binocular high- and low-contrast uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuity.
Results
At postoperative year 2, mean MRSE (D) was −0.37 for Crystalens, +0.03 for ReSTOR+3, and +0.03 for Tecnis. Mean high-contrast visual acuity (UDVA, UIVA, UNVA) was (20/21, 20/21, 20/25) for Crystalens, (20/22, 20/25, 20/22) for ReSTOR+3, and (20/22, 20/26, 20/23) for Tecnis. Mean low-contrast visual acuity (UDVA, UIVA, UNVA) was (20/32, 20/31, 20/47) for Crystalens, (20/39, 20/42, 20/43) for ReSTOR+3, and (20/37, 20/42, 20/45) for Tecnis. There were no significant differences between IOLs in contrast sensitivity at year 2. The Nd:YAG capsulotomy rate was 20, 4, and 6 in the Crystalens, ReSTOR+3, and Tecnis groups, respectively.
Conclusion
Outcomes were stable over 2 years. High-contrast UDVA was similar among groups, low-contrast UDVA was better with Crystalens than ReSTOR+3, high- and low-contrast UIVA were better with Crystalens than both multifocals, high-contrast UNVA was better with ReSTOR+3 than Crystalens, and low-contrast UNVA was similar among groups.