Visual outcomes after cataract surgery with implantation of a+3.00 D or+4.00 D aspheric diffractive multifocal intraocular lens: Comparative study

PURPOSE: To compare the visual performance after cataract surgery with implantation of +3.00 diopter (D) or +4.00 D aspheric multifocal intraocular lenses (IOLs). SETTING: Department of Ophthalmology, Maastricht University Medical Center, The Netherlands. METHODS: This prospective study compared the results of bilateral cataract surgery with implantation of a +3.00 D AcrySof ReSTOR SN6AD1 IOL or a +4.00 D AcrySof ReSTOR SN6AD3 IOL. The main outcome measures were binocular uncorrected (UDVA) and corrected distance visual acuities, binocular uncorrected (UNVA) and corrected near visual acuities, binocular uncorrected (UIVA) and corrected intermediate visual acuities, preferred working distance, straylight and contrast sensitivity levels, and wavefront aberrometry measurements. RESULTS: The +3.00 D IOL was implanted in 68 eyes and the +4.00 D IOL, in 46 eyes. The UIVA was significantly better in the +3.00 D IOL group than in the +4.00 D IOL group at 40, 50, 60, and 70 cm. The preferred working distance for near tasks was significantly lower in the +3.00 D IOL group (38.9 cm) than in the +4.00 D IOL group (31.0 cm). The UDVA was better in the +3.00 D IOL group; the UNVA at the preferred working distance was similar in the 2 groups. Contrast sensitivity and intraocular straylight levels were also similar. The mean levels of higher-order and spherical aberrations were lower in the +3.00 D IOL group. CONCLUSION: Cataract surgery with the +3.00 D IOL resulted in better intermediate vision than with the +4.00 D model without compromising distance and near visual acuity.