Visual function with monofocal versus multifocal IOLs

Purpose: To assess visual outcome in four groups: one multifocal intraocular lens (IOL), one monofocal IOL, and two phakic, one older and one younger. Setting: Department of Ophthalmology, National Health Service, Puerta de Hierro University Clinic, Madrid, Spain. Methods: This prospective study comprised 70 aphakic eyes, 42 with a multifocal and 28 with a monofocal IOL, and 42 phakic eyes, 21 older than 60 years and 21 younger than 60 years. The phakic groups served as a double control. Main outcome measures were corrected and uncorrected distance and near visual acuities, contrast and glare sensitivity, and clinical and subjective complications. Results: There were no significant differences between the monofocal and multifocal IOL groups in uncorrected or corrected distance Visual acuity. Near visual acuity in the multifocal group, with and without distance correction, was significantly better than in the monofocal group. Near vision with addition was similar between the two IOL groups. There were no significant differences between the monofocal and multifocal IOL groups in contrast sensitivity at the 96 and 50% thresholds. Between-group differences of less than one Began line were found at the 25 and 11% thresholds. The phakic groups had better contrast sensitivity. The older phakic group's results were closer to those of the IOL groups. There were no significant complications. Conclusion: Distance acuity and contrast sensitivity were similar in the monofocal and multifocal IOL groups; however, the multifocal group had significantly better near acuity. The younger phakic group had significantly better contrast sensitivity than the other groups.