title: Add-on sulcus-based versus primary in-the-bag multifocal intraocular lens: intraindividual study.
abstract: OBJECTIVE
  To compare the clinical outcomes of add-on sulcus-based multifocal and standard in-the-bag multifocal intraocular lens (IOL) implantation.
  
  
  METHODS
  Twenty-one patients with unilateral monofocal pseudophakia underwent add-on sulcus-based Acri. LISA 536D multifocal IOL (Carl Zeiss Meditec, Jena, Germany) implantation (add-on multifocal IOL group) and contralateral phacoemulsification with in-the-bag Acri.LISA 376D multifocal IOL (Carl Zeiss Meditec) implantation (primary multifocal IOL group). Uncorrected distance visual acuity, uncorrected near visual acuity, corrected distance visual acuity, distance-corrected near visual acuity, photopic (90 cd/m(2)) distance, near contrast sensitivity, mesopic (5 cd/m(2)) distance contrast sensitivity with and without glare, wavefront aberrations, and complications were measured 6 months postoperatively.
  
  
  RESULTS
  Primary in-the-bag multifocal IOLs provided slightly but significantly better uncorrected distance visual acuity (0.08 ± 0.10 vs 0.17 ± 0.15 logMAR, P = .028), uncorrected near visual acuity (0.09 ± 0.17 vs 0.18 ± 0.11 logMAR, P = .005), and corrected distance visual acuity (0.01 ± 0.04 vs 0.04 ± 0.05 logMAR, P = .038). There were no significant differences in distance-corrected near visual acuity, photopic or mesopic contrast sensitivity under different conditions, and wavefront aberrations. Complications included pigment dispersion in one eye (4.8%) and pupillary capture in 2 eyes (9.5%) of the add-on multifocal IOL group.
  
  
  CONCLUSIONS
  The secondary add-on sulcus-based multifocal IOL provided useful pseudoaccommodation with vision quality similar to the primary in-the-bag multifocal IOL. The technique should be considered in patients diagnosed as having unilateral or bilateral monofocal pseudophakia seeking near spectacle independence.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Muñoz
authors.forename: César
authors.initials: C
authors.lastname: Albarrán-Diego
authors.forename: Lurdes
authors.initials: L
authors.lastname: Belda
authors.forename: Stephanie
authors.initials: S
authors.lastname: Rohrweck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055253:Color Vision / Q000502:physiology; D015350:Contrast Sensitivity / Q000502:physiology*; D005260:Female; D019466:Glare; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D055254:Night Vision / Q000502:physiology; D018918:Phacoemulsification; D011446:Prospective Studies; D019591:Pseudophakia / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*