Visual outcomes with a single-optic accommodating intraocular lens and a low-addition-power rotational asymmetric multifocal intraocular lens

PURPOSE: To compare the visual outcomes and intraocular optical quality in patients with a low-addition (add) power multifocal refractive intraocular lens (IOL) with rotational asymmetry and a single-optic accommodating IOL. SETTING: Vissum Instituto Oftalmológico de Alicante, Miguel Hérnandez University, Alicante, Spain. DESIGN: Prospective comparative nonrandomized consecutive case series. METHODS: Consecutive cataract patients had implantation of a low-add-power refractive multifocal IOL with rotational asymmetry (Lentis-Mplus LS-312 MF15) (multifocal group) or a single-optic accommodating IOL (Crystalens HD) (accommodating group). Distance and near visual acuities were evaluated. Ocular optical quality, intraocular aberrations, defocus curve, and contrast sensitivity were evaluated postoperatively. RESULTS: Of the 66 eyes (40 patients; age 61 to 81 years), 31 were in the multifocal group and 35 were in the accommodating group. Postoperatively, both groups had a significant improvement in the uncorrected and corrected distance visual acuities and uncorrected (UNVA) and corrected near (CNVA) near visual acuities (P <.01). Distance-corrected near visual acuity was significantly better in the multifocal group postoperatively (P ≤.04). No significant differences in UNVA and CNVA were detected postoperatively (P ≥.09). In the defocus curve, the multifocal group had significantly better visual acuities at several defocus levels. The accommodating group had better contrast sensitivity under photopic conditions at all spatial frequencies (P ≤.04). The multifocal group had significantly higher postoperative intraocular tilt (P <.01). CONCLUSIONS: Both IOLs restored distance vision. The refractive multifocal IOL provided better near visual rehabilitation.