title: Visual performance of an apodized diffractive multifocal intraocular lens with +3.00-d addition: 1-year follow-up.
abstract: OBJECTIVE
  To determine whether implantation of a multifocal intraocular lens (IOL) with a lower addition (+3.00 diopters [D]) at the lens plane results in better intermediate visual acuity 1 year after surgery compared with a multifocal IOL with higher addition (+4.00 D).
  
  
  METHODS
  This prospective, randomized, double-masked study included 80 eyes from 40 patients. Twenty patients were implanted bilaterally with the ReSTOR +3.00-D add IOL and 20 patients were implanted bilaterally with the ReSTOR +4.00-D add IOL. Primary outcome measures were distance, intermediate, and near visual acuity. Secondary outcomes were defocus curves, best reading distance, mesopic and photopic contrast sensitivity, quality of life, and spectacle independence. Monocular and binocular visual acuity were measured as uncorrected and corrected distance visual acuity at 4 m, uncorrected near and distance-corrected near visual acuity at 40 cm, and uncorrected intermediate visual acuity and distance-corrected intermediate visual acuity at 50, 60, and 70 cm.
  
  
  RESULTS
  Twelve months postoperatively, no statistically significant difference between groups in distance and near visual acuity was noted. The ReSTOR +3.00-D add group performed better than the ReSTOR +4.00-D add group at all intermediate distances studied. The ReSTOR +4.00-D group chose a reading distance 8 cm closer than the +3.00-D group. Both groups performed similarly with respect to contrast sensitivity, quality of life, and spectacle independence rates.
  
  
  CONCLUSIONS
  Patients implanted with a multifocal IOL with lower addition (ReSTOR +3.00 D) had better performance at intermediate distances compared with the ReSTOR +4.00-D add IOL with similar performance for distance and near visual acuity, contrast sensitivity, and quality of life.
authors.affiliation: Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44114, USA. marconysanthiago@hotmail.com
authors.forename: Marcony R
authors.initials: MR
authors.lastname: Santhiago
authors.forename: Steven E
authors.initials: SE
authors.lastname: Wilson
authors.forename: Marcelo V
authors.initials: MV
authors.lastname: Netto
authors.forename: Rodrigo F
authors.initials: RF
authors.lastname: Espíndola
authors.forename: Ravindra A
authors.initials: RA
authors.lastname: Shah
authors.forename: Ramon C
authors.initials: RC
authors.lastname: Ghanem
authors.forename: Samir J
authors.initials: SJ
authors.lastname: Bechara
authors.forename: Newton
authors.initials: N
authors.lastname: Kara-Junior
mesh_terms: D000368:Aged; D002387:Cataract Extraction; D003867:Depth Perception / Q000502:physiology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology*; D011680:Pupil / Q000502:physiology; D011788:Quality of Life; D012029:Refraction, Ocular / Q000502:physiology*; D011795:Surveys and Questionnaires; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology*