Contrast sensitivity and high-order aberration after cataract surgery with Diffractive multifocal intraocular lens implantation

Objective To compare high-order aberration and contrast sensitivity in pseudophakic eye with a diffractive muitifocal intraocular lens(IOL)or a conventional monofoeal IOL.Methods In this comparative trial,the 72 patients(109 eyes)of multifocal group were implanted with apodized diffractive IOL (AcrySof ReSTOR)and the 88 patients(130 eyes)of control group were given with a monofocal IOL (AcrySof SA60AT),respectively.The distance visual acuity,near visual acuity,rate of spectacle freedom,contrast sensitivity and high-order aberration were measured.The follow-up time was from 6 to 24 months.Results Contrast sensitivity in monofocal group was better at all spatial frequencies under photopic,mesopic and mesopic with glare conditions.Contrast sensitivity was statistically different at median spatial frequencies under photopic conditions and at median and high spatial frequencies under mesopic with glare conditions (P＜0.05).The postoperative ocular root-mean-square(RMS)values were higher in multifocal group for 3rd-order coma aberrations,4th-order aberration and total higher-order aberrations(HOAs)for a 6.0 mm pupil,and there was no statistical difference between two groups(P＞0.05).Far visual acuity in two groups was similar.Without correction,101 eyes(91.8%)in multifocal group and 12 eyes(9.2%)in monofocal group achieved J3 or better for near vision,respectively.The patients who never need for spectacles were 89.9%(98 eyes)in multifolcal IOL group and 9.2%(12 eyes)in monofocal IOL group.Conclusions Although contrast sensitivity of patients with muitifocal IOL implantation was worse than with monofocal IOL at some spatial frequencies,higher-order aberrations were not higher and visual disturbances were slightly.Patients in multifocal IOL group can get good far and near uncorrected visual acuity and 89.9% of patients were freedom of spectacle. Key words: Diffractive; Multifocal; lntraocular lens; Aberration; Contrast sensitivity