Near vision restoration with refractive lens exchange and pseudoaccommodating and multifocal refractive and diffractive intraocular lenses: comparative clinical study.
OBJECTIVE
To evaluate near visual performance after implantation of a pseudoaccommodating intraocular lens (IOL) (Crystalens AT-45, eyeonics) or a multifocal IOL (refractive model, AMO Array; diffractive model, AcriTec TwinSet) after lens surgery.


METHODS
Instituto Oftalmologico de Alicante, Miguel Hernandez University, Alicante, Spain.


METHODS
Forty patients were included in this prospective clinical comparative study. The patients were divided into 3 groups according to the type of IOL implanted. Group 1 included 24 eyes (12 patients) implanted with the Crystalens IOL; Group 2, 32 eyes (16 patients) with the Array IOL, and Group 3, 24 eyes (12 patients) with the TwinSet IOL. Bilateral phacoemulsification and IOL implantation were performed in all patients, and the follow-up was 1 year. The postoperative main visual outcome evaluations were uncorrected and best corrected distance and near visual acuities, mean add for near, and best distance-corrected near acuity.


RESULTS
In Group 1, the mean uncorrected near acuity was 20/40 preoperatively and 20/25 after 1 year. The mean preoperative best distance-corrected near acuity was 20/32 and 20/25 after 1 year. In Group 2, the mean uncorrected near acuity was 20/40 and 20/25, respectively. The mean preoperative best distance-corrected near acuity was 20/32 and 20/25 after 1 year. In Group 3, the mean uncorrected near acuity was 20/63 preoperatively; after 1 year, it was approximately 20/25. The mean best distance-corrected near acuity was 20/50 and 20/25, respectively. A neodymium:YAG laser capsulotomy was performed for posterior capsule opacification when required, with no change in the refractive outcome.


CONCLUSIONS
Implantation of multifocal and pseudoaccommodating IOLs provides adequate near vision restoration. The TwinSet IOL provided faster recovery of near vision than the other 2 IOLs. The Crystalens IOL provided less postoperative visual phenomena with favorable near vision. The Array IOL achieved the most comfortable distance and near vision.
Alió
Jorge L
JL
Instituto Oftalmológico de Alicante, Department of Refractive Surgery, Miguel Hernández University, Alicante, Spain. jlalio@oftalio.com
Tavolato
Marco
M
De la Hoz
Fernando
F
Claramonte
Pascual
P
Rodríguez-Prats
José-Luis
JL
Galal
Ahmed
A
D000065:Accommodation, Ocular / Q000502:physiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011305:Presbyopia / Q000503:physiopathology / Q000601:surgery; D011446:Prospective Studies; D011474:Prosthesis Design; D019591:Pseudophakia / Q000503:physiopathology*; D020127:Recovery of Function; D012086:Reoperation; D014792:Visual Acuity / Q000502:physiology*