Intraindividual comparison of the effect of training on visual performance with ReSTOR and Tecnis diffractive multifocal IOLs.
Several studies have shown that after multifocal intraocular lens (IOL) implantation visual function improves gradually over a period of several months. To accelerate this learning process, a prospective, intraindividual comparative study was performed to investigate the efficacy of a special visual training program on the postoperative visual performance.



Sixteen patients with bilateral phacoemulsification and multifocal IOL implantation in both eyes (Alcon ReSTOR [n = 8] and AMO Tecnis ZM900 [n = 81) received computer-based visual training 6 weeks postoperatively based on the concept of perceptual learning of discrimination line orientations. The training was performed over 2 weeks in six sessions in one eye of each patient. The untrained fellow eye served as control. Before and after the training period and at 6 months, orientation visual acuity, distance visual acuity, contrast sensitivity, and near visual acuity for different contrast levels were assessed.



After 2 weeks of training, the mean improvement of orientation visual acuity in the trained eyes was 82%, which was significantly higher than the control eyes (P < .001). Contrast sensitivity and near vision under different contrast levels showed a significant benefit of training. The superior function of the trained eyes was still present at 6 months.



Visual performance after multifocal IOL implantation can be significantly accelerated by a specific 2-week training program. This effect is sustained over a 6-month period.
Kaymak
Hakan
H
Department of Ophthalmology, Knappschafts Hospital, Sulzbach, Germany.
Fahle
Manfred
M
Ott
Gregor
G
Mester
Ulrich
U
D000065:Accommodation, Ocular / Q000502:physiology; D000368:Aged; D015350:Contrast Sensitivity / Q000502:physiology; D004193:Discrimination Learning / Q000502:physiology*; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D018918:Phacoemulsification; D011446:Prospective Studies; D011474:Prosthesis Design; D019591:Pseudophakia / Q000503:physiopathology*; D012029:Refraction, Ocular / Q000502:physiology; D013663:Teaching / Q000379:methods; D014792:Visual Acuity / Q000502:physiology*