Visual acuity and defocus curves with six multifocal intraocular lenses

Purpose: The purpose of this prospective, randomized, double masked, study was to compare the visual performance of patients after bilateral implantation of six different IOLs. Methods: The following IOLs were used in the study: SV25T0 (n=19), ATLISA 809M (n=18), ATLISA Tri 839MP (n=19), ZKB00 (n=20), ZLB00 (n=20) and Symfony ZXR00 (n=20). Visual performance was assessed by the monocular distance corrected visual acuity at 4m (CDVA), distance corrected intermediate visual acuity (DCIVA) at 60cm and distance corrected near visual acuity (DCNVA) at 40cm. Binocular defocus curves were obtained for a range of defocus from +1.50D to -4.50D, in 0.50D steps. Quality of life was assessed with the VF-14 questionnaire. Results: DCVA was better with the Symfony ZXR00 than with the SV25T0 (p=0.032), ATLISA Tri 839MP (p=0.032) and ATLISA 809M (p=0.018). The Symfony ZXR00 offered the best DCIVA, followed by the ZKB00. The best and worst DCNVA results corresponded to the ZLB00, and the SV25T0 and Symfony ZXR00, respectively. Defocus curves at distance were good in all groups, although the Symfony had a wider range of clear vision (-1.50D to +0.50D), with no decay. For intermediate vision, only the Symfony obtained sharp visual acuity. The ATLISA 809M, ATLISA Tri 839MP and ZLB00 were superior at near. Conclusions: The extended depth of focus of the Symfony ZXR00 offers a superior range of clear vision at far and intermediate distances than other multifocal designs, with worse results at near. Visual outcomes reflect the particular optical, geometrical and power distribution characteristics of each IOL.Peer Reviewe