Visual function and patient satisfaction: Comparison between bilateral diffractive multifocal intraocular lenses and monovision pseudophakia

Purpose: To compare visual function and patient satisfaction in patients with bilateral diffractive multifocal intraocular lenses (IOLs) and patients with monofocal IOL monovision.

Setting: Department of Ophthalmology, Henry Ford Health System, Detroit, Michigan, USA.

Design: Cohort study.

Methods: This study comprised consecutive bilateral cataract patients having implantation of AcrySof ReSTOR SN60D3 multifocal IOLs or AcrySof SN60WF IOLs as monovision between July 2007 and June 2009. Parameters analyzed 3 months postoperatively included binocular uncorrected distance, intermediate, and near visual acuities; stereo vision; spectacle independence; subjective visual symptoms; and patient satisfaction. Patients were administered the Visual Function Questionnaire-25 preoperatively and postoperatively.

Results: The multifocal IOL group comprised 21 patients and the monovision group, 22 patients. Although bilateral uncorrected distance vision and near vision were slightly better in the multifocal IOL group than in the monovision group, there was no statistically significant difference between the 2 groups. The monovision group had better intermediate vision than the multifocal IOL group and had less difficulty using computers without glasses; the differences between the 2 groups were statistically significant. Patients with monovision had a slightly higher overall satisfaction score, significantly fewer complaints, and less out-of-pocket cost.

Conclusions: Pseudophakic monovision achieved distance vision and near vision that were comparable to those with bilateral multifocal IOLs without the inherent risk for disturbing visual symptoms associated with multifocal IOLs. Monovision patients also had significantly better intermediate vision and less difficulty using computers without glasses.