Yonsei Med J.  2007 Aug;48(4):627-633. 10.3349/ymj.2007.48.4.627.

Comparison of Higher-Order Aberration and Contrast Sensitivity in Monofocal and Multifocal Intraocular Lenses

• Kim CY
• Chung SH
• Kim TI
• Cho YJ
• Yoon G
• Seo KY

• KMID: 2158167
• DOI: http://doi.org/10.3349/ymj.2007.48.4.627

Abstract

PURPOSE
The visual performance of pseudophakic eyes depends on the type of intraocular lenses (IOLs) that are implanted. Aspherical and multifocal IOLs have recently been developed to improve visual quality after cataract surgery, but multifocal IOLs can be associated with decreased contrast sensitivity (CS), halos, and glare. This study compares the visual performance of monofocal and multifocal IOLs by measurement of higher-order aberrations (HOAs) and CS values. MATERIALS AND METHODS: HOAs and CS values of 42 eyes with implanted monofocal IOLs and 40 eyes with implanted multifocal IOLs were measured preoperatively and more than 6 months after surgery. In the multifocal IOL group, HOAs and CS values were also measured with addition of a trial lens of -0.5 diopter (D) to evaluate the compensatory effect on spherical aberration. RESULTS: CS values of the multifocal IOL group were significantly lower than those of the monofocal IOL group for all spatial frequencies tested (p<0.01), and the spherical aberration was significantly higher in the multifocal IOL group than in the monofocal IOL group (p<0.001). Addition of a -0.5 D lens to the multifocal IOL group decreased the difference in CS between the two groups (p=0.003). CONCLUSION: Increased spherical aberration may contribute to lower CS in the multifocal IOL group. In such cases, CS can be improved by addition of a -0.5 D lens to compensate for the spherical aberration.

Keyword

Higher-order aberration; spherical aberration; contrast sensitivity; multifocal IOL

MeSH Terms

Aged
*Contrast Sensitivity
Female
Humans
Lens Implantation, Intraocular
*Lenses, Intraocular
Male
Middle Aged
Vision Tests

Figure

• 

  Fig. 1 Comparison of Contrast Sensitivity Values of Monofocal IOL, Multifocal IOL and Multifocal IOL with -0.5 D Lens.

• 

  Fig. 2 Comparison of Higher-order Aberrations of Monofocal IOL, Multifocal IOL and Multifocal IOL with -0.5 D Lens. The increased spherical aberration observed in the multifocal IOL group was decreased to a level equivalent to that of the monofocal IOL group by addition of a -0.5D lens (p = 0.750). *Statistically significant difference (p < 0.004).

Reference

1. Lew H, Han SH, Lee JB, Lee ES. Contrast sensitivity function of sound eye after occlusion therapy in the amblyopic children. Yonsei Med J. 2005. 46:368–371.

2. Pieh S, Weghaupt H, Skorpik C. Contrast sensitivity and glare disability with diffractive and refractive multifocal intraocular lenses. J Cataract Refract Surg. 1998. 24:659–662.

3. Eisenmann D, Jacobi FK, Dick B, Jacobi KW, Pabst W. Glare sensitivity of phakic and pseudophakic eyes. Klin Monatsbl Augenheilkd. 1996. 208:87–92.

4. Dick HB, Krummenauer F, Schwenn O, Krist R, Pfeiffer N. Objective and subjective evaluation of photic phenomena after monofocal and multifocal intraocular lens implantation. Ophthalmology. 1999. 106:1878–1886.

5. Steinert RF, Aker BL, Trentacost DJ, Smith PJ, Tarantino N. A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens. Ophthalmology. 1999. 106:1243–1255.

6. Javitt JC, Steinert RF. Cataract extraction with multifocal intraocular lens implantation: a multinational clinical trial evaluating clinical, functional, and quality-of-life outcomes. Ophthalmology. 2000. 107:2040–2048.

7. Hunkeler JD, Coffman TM, Paugh J, Lang A, Smith P, Tarantino N. Characterization of visual phenomena with the Array multifocal intraocular lens. J Cataract Refract Surg. 2002. 28:1195–1204.

8. Casprini F, Balestrazzi A, Tosi GM, Miracco F, Martone G, Cevenini G, et al. Glare disability and spherical aberration with five foldable intraocular lenses: a prospective randomized study. Acta Ophthalmol Scand. 2005. 83:20–25.

9. Uchio E, Ohno S, Kusakawa T. Spherical aberration and glare disability with intraocular lenses of different optical design. J Cataract Refract Surg. 1995. 21:690–696.

10. Yoon G, Macrae S, Williams DR, Cox IG. Causes of spherical aberration induced by laser refractive surgery. J Cataract Refract Surg. 2005. 31:127–135.

11. Montés-Micó R, Alió JL. Distance and near contrast sensitivity function after multifocal intraocular lens implantation. J Cataract Refract Surg. 2003. 29:703–711.

12. Leyland M, Zinicola E. Multifocal versus monofocal intraocular lenses in cataract surgery: a systematic review. Ophthalmology. 2003. 110:1789–1798.

13. Fukuyama M, Oshika T, Amano S, Yoshitomi F. Relationship between apparent accommodation and corneal multifocality in pseudophakic eyes. Ophthalmology. 1999. 106:1178–1181.

14. Oshika T, Mimura T, Tanaka S, Amano S, Fukuyama M, Yoshitomi F, et al. Apparent accommodation and corneal wavefront aberration in pseudophakic eyes. Invest Ophthalmol Vis Sci. 2002. 43:2882–2886.

15. Ravalico G, Baccara F, Rinaldi G. Contrast sensitivity in multifocal intraocular lenses. J Cataract Refract Surg. 1993. 19:22–25.

16. Winther-Nielsen A, Corydon L, Olsen T. Contrast sensitivity and glare in patients with a diffractive multifocal intraocular lens. J Cataract Refract Surg. 1993. 19:254–257.

17. Lee JM, Seo KY, Kim EK. Comparison of optical aberrations and contrast sensitivity between monofocal and multifocal intraocular lens. J Korean Ophthalmol Soc. 2002. 43:1882–1886.

18. Heo JY, Kim YH, Joo CK. Clinical results of AMO ARRAY^® multifocal intraocular Lens. J Korean Ophthalmol Soc. 1999. 40:978–986.

19. Bellucci R. Multifocal intraocular lenses. Curr Opin Ophthalmol. 2005. 16:33–37.