Visual function and subjective perception of vision following bilateral implantation of monofocal and multifocal intraocular lenses: randomized controlled trial

PURPOSE: To examine monocular and binocular visual function and patient reporting outcomes following implantation of multifocal intraocular lenses (mIOLs) or monofocal intraocular lenses (IOLs), using a rigorous series of clinical assessments. SETTING: BMI Southend Hospital, United Kingdom. DESIGN: Prospective, randomized, double-masked clinical trial. METHODS: One hundred patients were randomized for bilateral implantation of either a Bi-Flex 677MY mIOL or a Bi-Flex 677AB IOL and were assessed at 3 to 6 months (V1) and 12 to 18 months (V2). Primary outcomes included distance, intermediate and near logarithm of the minimum angle of resolution (logMAR) visual acuities (VA) and defocus curve profile assessment. Secondary outcomes included reading speed, contrast sensitivity (CS), and the subjective perception of quality of vision. RESULTS: Uncorrected (mIOL, 0.10+/-0.09 logMAR; IOL, 0.09+/-0.11 logMAR) and corrected distance VA (mIOL, 0.04+/-0.06 logMAR; IOL, 0.01+/-0.07 logMAR) were comparable (p>0.05). Uncorrected near VA (p 90%) in both groups for distance tasks whereas significantly different for near tasks (mIOL, 18.45+/-16.53 logUnits; IOL, 55.59+/-22.52 logUnits). CONCLUSIONS: Unaided near visual acuity was demonstrably better with mIOLs and there was greater subjective satisfaction with quality of near vision. Halos reported by the mIOL group were significant compared to the IOL group, but did not show an adverse effect on overall satisfaction.