Abstract:

Objective To compare the vision performance of foldable monofocal intraocular lens (IOLs) (AcrySof Natural) with foldable multifocal IOLs (ReSTOR) implantation in cataract surgery in the elderly. Methods Fifty-one patients (64 eyes) with age-related cataract were selected, and were implanted with foldable multifocal IOLs (ReSTOR) (observation group, 24 patients, 30 eyes) or foldable monofocal IOLs (AcrySof Natural)(control group, 27 patients, 34 eyes). The best corrected distant vision acuity, uncorrected near vision acuity, amplitude of pseudoaccommodation, contrast sensitivity and wavefront aberration were measured 1 week, 1 month and 3 month after surgery. Results Three months after surgery, there was no significant difference in the percent of patients with best corrected distant vision acuity ≥4.7 between observation group and control group (93.3% vs 73%, P＞0.05), there were significant differences in the percent of patients with uncorrected near vision acuity ≥4.5 between observation group and control group (86.6% vs 11.1%, P<0.05), and there were significant differences in the amplitude of pseudoaccommodation between observation group and control group [(-3.14±0.91) D vs (-1.03±0.33) D, P＜0.01]. One week, 1 month and 3 months after surgery, there were significant differences in contrast sensitivity between two groups for all spatial frequencies (P<0.05). The wavefront aberration examinations revealed that there were significant differences in root mean square value and Z04(P＜0.05) and there was no significant difference in Z-13 and Z13 between two groups at small pupils (P＞0.05), and there were significant differences in root mean square value and Z-13 between two groups at big pupils (P＜0.05).  Conclusion Foldable multifocal IOLs (ReSTOR) implantation may lead to favorable distant and near vision acuity, and may effectively increase the amplitude of psedoaccommodation compared with foldable monofocal IOLs (AcrySof Natural). However, foldable multifocal IOLs (ReSTOR) implantation may lead to increased high-order aberration and decreased contrast sensitivity.

Key words: cataract, contrast sensitivity, wavefront aberration, multifocal intraocular lens, pseudoaccommodation