Comparison of additional pseudophakic multifocal lenses and multifocal intraocular lens in the capsular bag

Br J Ophthalmol. 2014 Jul;98(7):915-9. doi: 10.1136/bjophthalmol-2013-304591.


Aims: To compare the clinical results and the intraoperative and postoperative performance of an additional sulcus-fixated multifocal intraocular lens (IOL) with a conventional multifocal IOL implanted in the capsular bag.

Methods: In this prospective, randomised, monocentric study, the intraoperative and postoperative outcomes after implantation of an additional sulcus-fixated multifocal IOL (group A; 29 eyes) and a conventional, multifocal posterior chamber IOL (group B; 25 eyes) are compared. 1-year postoperatively, visual acuity, contrast sensitivity and defocus curve were determined. Patients implanted bilaterally with the same IOL filled in a questionnaire to assess patient satisfaction.

Results: Between the groups, only slight differences were found in visual acuity at all distances. All patients achieved an uncorrected distance visual acuity of 0.1 LogMAR or better and an uncorrected intermediate/near visual acuity of 0.3 LogMAR or better. Slightly better results in contrast sensitivity were achieved in group A at high spatial frequencies under almost all lighting conditions. Patient survey showed a higher degree of satisfaction of patients in group B, while a smaller proportion of group A stated to have disturbing light phenomena.

Conclusions: Only small functional differences between the examined methods were found. Both types of multifocal IOL performed well at all distances. There were no intraoperative and postoperative complications in the add-on IOL group which affirms the high safety level such as with conventional multifocal IOL in the capsular bag.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Sensitivity / physiology
  • Female
  • Humans
  • Intraoperative Complications
  • Lens Capsule, Crystalline / surgery*
  • Lens Implantation, Intraocular / methods*
  • Lenses, Intraocular*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Postoperative Complications
  • Prospective Studies
  • Pseudophakia / physiopathology*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Visual Acuity / physiology