Comparison of visual results and quality of vision between two multifocal intraocular lenses: silicone multifocal and PMMA bifocal

Purpose: To compare visual results and quality of vision of two multifocal intraocular lenses (IOL): SA 40 N silicone zonal-progressive multifocal IOL and P 359 TUV PMMA bifocal IOL. Methods: 46 eyes were operated on for cataract. 24 IOL SA 40 N (group 1) an d 22 IOL P 359 (group 2) were implanted. Evaluation of visual results was p erformed between the first and the third month postoperatively. The quality of vision was explored in both groups by using two tests of contrast sensi tivity, an automated visual field and a questionnaire dealing with patient satisfaction and presence of halos and glare. Results: Postoperatively, a myopic shift was noted with a statistical signi ficant difference in the group 2 (p<0.05). The predictability was good in b oth groups (mean refractive error<1 D). Mean corrected distance visual acui ty was similar in-groups 1 and 2 (0.6). Mean distance-corrected near visual acuity was statistically better in the group 2 (p<0.05). We noted in both groups a loss of contrast sensitivity statistically more important in the g roup 2 (p<0.001). Where the automated perimetry is concerned, no statistica l differences were encountered. 35% of patients(group 1) and 29% (group 2) were very satisfied with the results of their surgery. Halos and glare were noted in 8% (group 1) and 9% (group 2) of the patients. Conclusion: The new concept of multifocality is increasing in practice of c ataract surgery because of the reduction of spectacle dependency and the hi gh level of patient satisfaction. However, the occurrence of halos and glar e suggest a limitation of these indications of multifocal IOL, particularly for night driving patients.