[Clinical observation of visual performance in patients with a apodized diffractive multifocal intraocular lens].

OBJECTIVE: To evaluate and compare the visual performance between the patients with the diffractive multifocal and monofocal intraocular lens (IOL). METHODS: It was a prospective nonrandomized controlled study. Sixty-five patients (80 eyes) received phacoemulsification and IOL implantation were divided into two groups, 41 patients (50 eyes) in the multifocal group, and 24 patients (30 eyes) in the monofocal group. Three months or longer after surgery, the results of the uncorrected distance, intermediate and near vision; the best-corrected distance, intermediate and near vision; the intermediate and near vision after the distance vision corrected; the contrast sensitivity and the wave-front aberrations were recorded. The subjective visual performance after surgery was evaluated by the questionnaire. The chi-square test was applied to compare categorical variables, and the independent-samples t test was used to compare the measure data. RESULTS: The difference of the uncorrected distance, intermediate vision; the best-corrected distance, intermediate and near vision; intermediate vision after the distance vision corrected between the multifocal and monofocal groups was no statistical significance. The uncorrected near vision (0.82 +/- 0.20 vs 0.33 +/- 0.14, t = 8.99, P = 0.000) and the near vision after the distance vision corrected (0.83 +/- 0.17 vs 0.32 +/- 0.11, t = 9.83, P = 0.000) were statistically better in the multifocal group than the monofocal group. Photopic contrast sensitivity at high spatial frequency (18 c/d) and mesopic sensitivity with glare at medium frequency (6 c/d) was statistically lower in the multifocal group (P < 0.05). The total aberration and spherical aberration of the multifocal group were smaller than the monofocal group (t = 3.74, P = 0.00; t = 3.56, P = 0.00). The spectacle independent rate of multifocal and monofocal group were 70.73% (29/41) and 8.33% (2/24) respectively (chi(2) = 23.63, P = 0.00). The mild and moderate glare and halo were existent in both groups (chi(2) = 0.50, P = 0.78).Moderate visual disturbances were reported 24% (12/50) in the multifocal group and 26.67% (8/30) in the monofocal group.No serious glare and halo phenomenon were reported. CONCLUSIONS: Compared with the monofocal intraocular lens, the diffractive multifocal intraocular lens could provide a satisfactory recovery of vision function and good visual performance except the slight decrease of the contrast sensitivity.