title: Effect of +3.00 diopter and +4.00 diopter additions in multifocal intraocular lenses on defocus profiles, patient satisfaction, and contrast sensitivity.
abstract: OBJECTIVE
  To evaluate the advantages and disadvantages of the new low-addition (add) (+3.00 diopter [D]) ReSTOR multifocal IOL compared with the preceding ReSTOR model with +4.00 D add.
  
  
  METHODS
  University Eye Hospital, Tuebingen, Germany.
  
  
  METHODS
  Comparative case series.
  
  
  METHODS
  Patients with a +3.00 D or +4.00 D add multifocal IOL were examined for uncorrected and distance-corrected visual acuity at distance, intermediate, and near. A defocus profile was assessed, individual reading distance and the distance for lowest intermediate visual acuity were determined. Patient satisfaction was evaluated with a standardized questionnaire. Contrast sensitivity was tested under mesopic and photopic conditions.
  
  
  RESULTS
  Uncorrected and distance-corrected intermediate visual acuities were statistically significantly better in the +3.00 D add group (24 eyes) than in the +4.00 D add group (30 eyes); distance and near visual acuities were not different between groups. The defocus profile significantly varied between groups. The +4.00 D add group had a closer reading distance (33.0 cm) than the +3.00 D add group (43.5 cm), a closer point of lowest intermediate visual acuity (65.8 cm versus 86.9 cm) and worse lowest intermediate visual acuity (20/59 ± 4.5 letters [SD] versus 20/48 ± 5.5 letters). Thus, patients in the +3.00 D add group reported being more satisfied with intermediate visual acuity. The +3.00 D add group reported more glare but less halos than the +4.00 D add group; contrast sensitivity was not different.
  
  
  CONCLUSIONS
  The lower addition resulted in a narrower defocus profile, a farther reading distance, and better intermediate visual acuity and thus increased patient satisfaction.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes.
authors.affiliation: Centre for Ophthalmology, University Eye Hospital, Eberhard-Karls University, Tuebingen, Germany. katrin.petermeier@med.uni-tuebingen.de
authors.forename: Katrin
authors.initials: K
authors.lastname: Petermeier
authors.forename: Andre
authors.initials: A
authors.lastname: Messias
authors.forename: Florian
authors.initials: F
authors.lastname: Gekeler
authors.forename: Peter
authors.initials: P
authors.lastname: Szurman
mesh_terms: D000328:Adult; D000368:Aged; D015350:Contrast Sensitivity / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008875:Middle Aged; D017060:Patient Satisfaction; D018918:Phacoemulsification; D011474:Prosthesis Design; D019591:Pseudophakia / Q000503:physiopathology*; D012030:Refractive Errors / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology