Comparison of reading performance after bilateral implantation of multifocal intraocular lenses with +3.00 or +4.00 diopter addition

Abstract

PURPOSE: To compare reading ability after cataract surgery and bilateral implantation of multifocal intraocular lenses (IOLs) with a +3.00 diopter (D) addition (add) or a +4.00 D add. SETTING: Department of Ophthalmology, University of São Paulo, São Paulo, Brazil. DESIGN: Prospective comparative study. METHODS: Patients scheduled for cataract surgery were randomly assigned to bilateral implantation of an aspheric AcrySof ReSTOR multifocal IOL with a +3.00 diopter (D) addition (add) or a +4.00 D add. The reading speed, critical print size, and reading acuity were measured binocularly with best correction using MNREAD acuity charts 6 months after surgery. Patients were tested with the chart at the best patient-preferred reading distance and at 40 cm. Binocular uncorrected and best distance-corrected visual acuities at far and near were also measured. RESULTS: The study enrolled 32 patients. At the best reading distance, the results were similar between the 2 IOL groups in all reading parameters. When tested at 40 cm, reading speed at all print sizes from 0.3 to 0.0 (all P<.001), critical print size (P<.001), and reading acuity (P = .014) were statistically significantly better in the +3.00 D IOL group than in the +4.00 D IOL group. Uncorrected and corrected visual acuities at far and near were similar between the 2 groups. CONCLUSION: Although the 2 IOL groups had similar performance in reading parameters, patients had to adjust to their best reading distance. The +3.00 D IOL performed better than the +4.00 D IOL at 40 cm.