Multifocal intraocular lens implantation in patients with traumatic cataract.
OBJECTIVE
To evaluate the postoperative outcome and complication rate of cataract extraction with implantation of a zonal-progressive multifocal intraocular lens (IOL) for traumatic cataract.


METHODS
Prospective, nonrandomized, comparative trial.


METHODS
Fifty-one eyes of 51 subjects with traumatic cataract caused by nonpenetrating, penetrating, and perforating ocular trauma at two university institutions with more than 12 months follow-up.


METHODS
Temporal clear corneal phacoemulsification with foldable IOL implantation was performed in all eyes. In 29 subjects, a zonal-progressive optic multifocal IOL (Array SA40-N Allergan, Irvine, CA) was implanted, whereas 22 subjects received a monofocal IOL and served as controls.


RESULTS
Preoperative subjects demographics, mean postoperative spherical equivalent, astigmatism, and uncorrected and best-corrected distance visual acuity were similar in the two groups. Subjects with a multifocal IOL achieved a significantly better uncorrected near visual acuity than subjects with monofocal IOL (0.24 vs. 0.40; P = 0.0001). With distance correction only, mean near visual acuity was 0.21 vs. 0.43 (P = 0.0001). Best-corrected near visual acuity was 0.17 for both groups (P = 0.91), with +1.24 diopters (D) for the multifocal group and +2.45 D for the monofocal group (P = 0.0001). Spectacle dependency differed significantly between the two groups, with 18 (81%) subjects of the monofocal group commonly requiring an additional plus add for near tasks compared with 5 (17%) subjects in the multifocal group (P = 0.001). Stereopsis was superior in the multifocal group (P < 0.001), with 20 (69%) and 16 (55%) patients with a multifocal IOL responding positively to the Lang and Titmus tests, respectively. In the monofocal group, only eight (36%) and five (22%) subjects gave correct answers.


CONCLUSIONS
Multifocal IOL implantation is a viable alternative to monofocal pseudophakia in subjects with traumatic cataract.
Jacobi
Philipp C
PC
Department of Ophthalmology, University Eye Hospital of Cologne, Joseph-Stelzmannstrasse 9, 50931 Cologne, Germany. philipp.jacobi@uni-koeln.de
Dietlein
Thomas S
TS
Lueke
Cristoph
C
Jacobi
Felix K
FK
D000293:Adolescent; D000328:Adult; D002386:Cataract / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D015807:Eye Injuries, Penetrating / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000293:injuries* / Q000601:surgery; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000601:surgery