Visual performances with monofocal, accommodating, and multifocal intraocular lenses in patients with unilateral cataract

Am J Ophthalmol. 2010 Nov;150(5):609-18. doi: 10.1016/j.ajo.2010.05.023. Epub 2010 Aug 5.


Purpose: To compare the visual performance of patients with unilateral cataract following implantation of monofocal, accommodating, refractive, and diffractive multifocal intraocular lenses (IOL).

Design: Prospective nonrandomized clinical trial.

Methods: Eighty-seven patients with unilateral cataract were enrolled in 4 groups for phacoemulsification and IOL implantation. Twenty-four patients had monofocal (Alcon Acrysof) (group 1), 21 patients had accommodating (Human Optics 1CU) (group 2), 22 patients had diffractive multifocal (Tecnis ZM900) (group 3), and 20 patients had refractive multifocal (AMO Rezoom) (group 4) IOL implantations. Ages of patients were between 40 and 70. Parameters analyzed at the 18th postoperative month were subjective refractions, monocular and binocular distance, intermediate and near uncorrected visual acuities, monocular distance and near best-corrected visual acuities, monocular distance-corrected intermediate and near visual acuities, stereopsis, visual complaints, and spectacle dependency.

Results: No significant difference was observed between distance and near best-corrected visual acuities of IOL groups, and between intermediate visual acuities of groups 2, 3, and 4. Groups 3 and 4 had statistically better near vision than the other groups (P < .05). No significant difference was observed between near visual acuities of groups 3 and 4. Number of patients with better stereoscopic function, spectacle independence, and complaints of halo in groups 3 and 4 was significantly higher than in other groups (P < .05).

Conclusions: Multifocal IOLs provide better stereopsis, higher spectacle independence rates, and satisfactory functional vision over a broad range of distances in presbyopic patients with unilateral cataract compared with the monofocal and accommodating IOLs.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Biometry
  • Cataract / complications
  • Cataract / physiopathology
  • Cataract / rehabilitation*
  • Depth Perception / physiology*
  • Female
  • Humans
  • Lens Implantation, Intraocular*
  • Lenses, Intraocular*
  • Male
  • Middle Aged
  • Phacoemulsification
  • Presbyopia / complications
  • Presbyopia / physiopathology
  • Presbyopia / rehabilitation*
  • Prospective Studies
  • Prosthesis Design
  • Pseudophakia / physiopathology*
  • Vision, Binocular
  • Visual Acuity / physiology*