Depth of focus in eyes with diffractive bifocal and refractive multifocal intraocular lenses

PurposeTo evaluate monocular and binocular depth of focus in eyes with different multifocal intraocular lens (IOLs) systems.SettingDepartment of Ophthalmology, Medical University of Vienna, Vienna, Austria.MethodsIn this comparative interventional study, binocular implantation of multifocal IOLs was performed in 3 groups. In the first group, 26 eyes of 13 patients received asymmetric Acri.Twin (Acri.Tec) IOLs, a near-weighted 733D in 1 eye and a distance-weighted 737D in the fellow eye. In the second group, 26 eyes of 13 patients received a diffractive 811E IOL (Pharmacia). In the third group, 26 eyes of 13 patients received a refractive Array IOL (AMO). The visual acuity was tested monocularly and binocularly starting at 6 m in 0.50 diopter (D) defocusing steps.ResultsDistance visual acuity was best in eyes with the distance-dominated 737D IOL; eyes with the other IOLs had comparable results. Binocular distance visual acuity was comparable between the Acri.Twin group and the 811E group. The Acri.Twin group had better distance visual acuity than the Array group (P≤.048). Near visual acuity was best in eyes with the near-weighted 733D, followed by the 737D and the 811E. Patients with Array IOLs had worse visual acuities at reading distance (between 33 cm and 40 cm) (P≤.001). Patients with diffractive bifocal IOLs had better results than patients with refractive multifocal IOLs at reading distance (P≤.018).ConclusionThe diffractive IOLs performed better than refractive IOLs. Asymmetric-weighted IOLs provided better binocular depth of field.