Comparison of Acri.Smart Multifocal IOL, Crystalens AT-45 Accommodative IOL, and Technovision PresbyLASIK for Correcting Presbyopia

PURPOSE: To compare the visual outcomes of two intraocular lenses (IOLs) (Acri. Smart [multifocal] and AT-45 [accommodative]) for correction of distance and near visual acuity with a LASIK procedure for presbyopia (presbyLASIK) and a control group fitted with a standard distance-correcting monofocal IOL (Acrysof). METHODS: Distance and near decimal visual acuities were measured under similar conditions before and 6 months postoperatively in 45 patients (87 eyes) who comprised four groups: Acri. Smart IOL, AT-45 IOL, presbyLASIK, and control (monofocal IOL). All acuity measures were standardized at 20 m (distance, projected chart) and 40 cm (near). All visual acuity measures were taken in the same ambient light conditions and contrast. All data were collected in a randomized, masked style. RESULTS: Pre- and postoperative distance mean visual acuities for the Acri. Smart IOL, AT-45 IOL, presbyLASIK, and controls groups, respectively, were 0.15 +/- 0.21 and 0.66 +/- 0.35; 0.31 +/- 0.14 and 0.68 +/- 0.28; 0.35 +/- 0.15 and 0.80 +/- 0.33; and 0.32 +/- 0.18 and 0.59 +/- 0.29. Pre- and postoperative near mean visual acuities for the Acri. Smart IOL, AT-45 IOL, presbyLASIK, and control groups, respectively, were 0.13 +/- 0.21 and 0.62 +/- 0.35; 0.43 +/- 0.22 and 0.51 +/- 0.27; 0.15 +/- 0.20 and 0.68 +/- 0.33; and 0.40 +/- 0.29 and 0.30 +/- 0.13. Distance and near visual acuities improved significantly after surgery (P < .05) except near acuities for the AT-45 IOL and control groups. CONCLUSIONS: For these patients, distance and near acuities improved with presbyLASIK and Acri. Smart IOLs when compared with controls. In those patients treated with the AT-45 IOL, average distance visual acuity improved but not near visual acuity.