Subjective photic phenomena with refractive multifocal and monofocal intraocular lenses

PURPOSE: To compare the incidence and severity of photic phenomena after the implantation of the Array(R) (Allergan) refractive multifocal intraocular lens (MIOL) and a monofocal IOL. SETTING: Multicenter study at Kiel, Mainz, Karlsruhe, and Bremerhaven, Germany. METHODS: The study comprised 231 randomly selected patients from 4 study centers. The patients had had uneventful phacoemulsification with implantation of a refractive MIOL (n = 138) or a monofocal IOL (n = 93). By questionnaire, patients were asked whether they experienced light sensations postoperatively (light streaks, halos, flare, flashes, or glare) that had not been noticed preoperatively. Additional questions evaluated whether these phenomena had changed over time and how much they affected the patients' quality of life. RESULTS: Overall, 9% of patients with a monofocal IOL and 41% of those with an MIOL reported photic phenomena that had not been noticed before cataract surgery. Halos and flare were mentioned significantly more often by patients with MIOLs than by those with monofocal IOLs. There was no significant between-group difference in the mention of flashes. Eighteen percent of patients with MIOLs and 4% with monofocal IOLs were slightly or moderately bothered by the photic phenomena, whereas 5% of patients with MIOLs and none in the monofocal group were severely disturbed by the light sensations. CONCLUSION: Subjective photic phenomena were experienced significantly more often by patients who had refractive MIOLs than by those who had monofocal IOLs. The differences in the results of the 4 study centers were probably influenced by different patient selection criteria for the implantation of MIOLs.