Influence of +3.00 D and +4.00 D near addition on functional outcomes of a refractive multifocal intraocular lens model

Purpose To clinically evaluate different near additions (adds) (+3.00 diopters [D] and +4.00 D) of the M-flex 630F refractive multifocal intraocular lens (IOL). Setting Departments of Ophthalmology, University of Heidelberg, Germany, and Lithuanian University of Health Sciences, Kaunas, Lithuania. Design Clinical prospective nonrandomized unmasked study. Methods Preoperatively, cataract patients were assigned to receive bilateral +3.00 D IOLs, +4.00 D IOLs, or +3.00 D (dominant eye) and +4.00 D (nondominant eye) IOLs. Follow-up examinations were performed up to 6 months postoperatively and included refraction, visual acuity (near at 40 cm and distance), the defocus curve, contrast sensitivity, and a subjective questionnaire. Results Fifty-two patients were enrolled. No significant differences were found in the visual acuity results ( P >.05). Four to 6 months postoperatively, the following median uncorrected and corrected distance visual acuity, uncorrected and distance-corrected near visual acuity, and corrected near visual acuity (logMAR) were found in all patients: −0.08, −0.12, 0.20, 0.10, and 0.10. Ninety-eight percent of patients reported being satisfied. The highest near peak versus the biggest intermediate decline in the median monocular defocus curves comparing +3.00 D and +4.00 D multifocal IOLs (logMAR) were 0.16 at 40 cm versus 0.22 at 33 cm ( P =.24) and 0.38 at 66 cm versus 0.54 at 50 cm ( P Conclusion Compared with the +4.00 D add, the +3.00 D near add gave better intermediate results in the defocus curve without compromising distance or near visual acuity. Financial Disclosure Drs. Rabsilber, Holzer, and Auffarth have received travel reimbursement and lecture fees from Rayner Intraocular Lenses Ltd. No other author has a financial or proprietary interest in any material or method mentioned.