Influence of astigmatism on multifocal and monofocal intraocular lenses

PURPOSE: To examine the influence of astigmatism on the visual acuity of pa tients with multifocal and monofocal intraocular lenses. METHODS: Thirty eyes of 30 patients who underwent five-zone refractive mult ifocal intraocular lens implantation and 30 eyes of 30 age-matched patients who had monofocal intraocular lens implantation were included. The visual acuities of these patients at 5.0, 3.0, 2.0, 1.0, 0.7, 0.5, and 0.3 m were measured by means of an all-distance vision tester after addition of a cyli ndrical lens of 0, 0.5, 1.0, 1.5, 2.0, and 2.5 diopters, RESULTS: Mean visual acuity at all distances decreased in proportion to the diopters of astigmatism in both the multifocal and monofocal intraocular l ens groups. When astigmatism was 0.5, 1.0, or 1.5 diopters, distance visual acuity in the multifocal group was significantly worse than that in the mo nofocal group; with astigmatism of 2.0 diopters or more, intermediate visua l acuity was also worse in the multifocal group. In contrast, near visual a cuity in the multifocal group was significantly better than that in the mon ofocal group at all astigmatic diopters, When astigmatism was within 1.0 di opter, visual acuity in the multifocal group reached 20/29 at distance and 20/50 at near. Mean contrast sensitivity was also worse in the multifocal g roup than in the monofocal group. CONCLUSIONS: Both distance and intermediate visual acuity deterioration cau sed by astigmatism was greater with a multifocal intraocular lens than with a monofocal intraocular lens, whereas near visual acuity was better with t he multifocal intraocular lens. When astigmatism was within 1.0 diopter, ey es with a multifocal intraocular lens achieved good visual acuity at both d istance and near, (C) 2000 by Elsevier Science Inc. All rights reserved.