Near visual outcomes with single-optic and dual-optic accommodating intraocular lenses

PURPOSE: To compare the visual and ocular optical performance in eyes with a single-optic or a dual-optic accommodating intraocular lens (IOL) with particular attention to near-vision outcomes. SETTING: Vissum Instituto Oftalmologico de Alicante, Miguel Hernandez University, Alicante, Spain. DESIGN: Prospective consecutive nonrandomized interventional comparative clinical study. METHODS: Eyes with cataract were divided into 2 groups. Group A had implantation of a single-optic accommodating IOL (Crystalens HD) and Group B, of a dual-optic accommodating IOL (Synchrony). Distance and near visual acuities, contrast sensitivity, ocular aberrations, reading performance, and the defocus curve were evaluated over a 6-month postoperative follow-up. RESULTS: Group A comprised 27 eyes and Group B, 26 eyes. The patient age ranged from 59 to 82 years. Uncorrected and corrected distance visual acuities were significantly better in Group B (P <=.04). There were no significant between-group differences in near or intermediate visual vision (P >=.13). In the defocus curve, Group B had significantly better visual acuities at several levels of defocus (P <=.04). The ocular Strehl ratio and contrast sensitivity were also significantly better in Group B (P <=.04). Group A had higher postoperative total and higher-order root-mean-square aberrations (P <=.01). The incidence of posterior capsule opacification was significantly higher in Group A (40.7%) than in Group B (11.5%). CONCLUSIONS: Both IOLs restored distance visual function after cataract surgery with limitations in near visual outcomes. Eyes with the dual-optic IOL had significantly better ocular optical quality.