Diffractive multifocal intraocular lenses: reading performance and quality of life evaluation

ABSTRACT Purpose: To evaluate the reading performance and changes in quality of life after cataract surgery with multifocal diffractive (IOLs) implantation Setting: Section of Ophthalmology - Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Italy; Eye Clinic - Department of Preclinical and Clinical Pharmacology, University of Florence, Italy. Methods: 160 Consecutive eyes of cataract patients were divided into two groups. One group (20 patients, 40 eyes) received aspheric monofocal IOLs (Acrysof SN60WF). One group (60 patients, 120 eyes) was implanted with a diffractive aspheric multifocal IOL produced by different manufacturers: 20 patients with Acrysof RESTORE SN6AD3 -with a +4 sph addiction, 20 patients with Acrysof RESTORE SN6AD1 with a +3 sph addiction, and 20 patients with AMO Tecnis ZMA00 with a +4 sph addiction. Visual acuity and constrast sensitivity outcomes were evaluate after a 6 months follow up. Additionally reading performance (MN Read chart and REX test chart), a 42 item quality of life questionnaire (National Eye Institute Refractive Quality of Life questionnaire, NEI RQL-42) and a similar 14 items questionnaire (VF14) were determined. Results: Significant improvement after surgery in uncorrected (for MIOLs) and corrected distance and near visual acuity (for standar monofocal IOLs) was observed in both groups (p<0.05). The mean reading acuity with correction in the monofocal group was better than the multifocal groups without correction. In the latter, under mesopic light conditions, the Tecnis ZMA00 reached better performances in terms of reading ability and contrast sensitivity than the two Acrysof MIOLs. The quality of life index related to uncorrected reading ability significantly improved n the MIOLs group compared to standard IOLs. The NEI-RLQ 42 and the VF-14 questionnaires results indicated a better quality of life with multifocal IOLs. Conclusions: Overall satisfaction and spectacle independance were comparable in all MIOLs groups The improved reading performance in MIOLs groups had a positive effect on the patients quality of life postoperatively. MN Read chart and REX Test chart are useful tools to evaluate the near visual performance with multifocal IOLs and correlate with a better quality of life postoperatively.