Contrast Sensitivity And Modulation Transfer Function In The Pseudophakic Eyes With Multifocal And Accommodating Intraocular Lenses Implantation

PartⅠ:Modulation transfer function and contrast sensitivity of Array multifocal intraocular lens with different pupil sizePurpose:To investigate the modulation transfer function(MTF) and contrast sensitivity of Array multifocal intraocular lens(IOL) with different pupil size.Methods:Follow-up 124 patients(196 eyes) underwent Array multifocal IOL(SA-40N,AMO) implantation in 2 years(from March 2006 to March 2004).38 patients(57 eyes) fulfilled the inclusion criteria.They were examed with the iTrace Visual Function Analyzer(Tracy Technologies,Texas,USA) and the Contrast Glaretester(GCT-I000,Takagi Seiko,Nagano,Japan).The MTF at the pupil diameter(PD) of 2.0,2.5,3.0,3.5,4.0 and 4.5 mm was evaluated using iTrace3.1 software,respectively.After dividing the patients into two groups by PD＜3.5 mm and PD＞3.5 mm,compared the visual acuity(UCVA,BCVA and DCNVA),wavefront aberration and contrast sensitivity function(CSF) between the two groups.Results:When the pupil diameter increased from 2.0mm to 3.5 mm,MTF statistically decreased(P=0.000-0.025);when the pupil diameter changed between 3.5 mm and 4.5 mm,MTF kept at the same level(P＞0.05).PD＞3.5mm group had better DCNVA(P=0.049) and greater spherical aberration(P=0.006).No significant difference was found in CSF between the two groups.Conclusions:With a zonal progressive multifocal intraocular lens implanted,pupil size statistically influenced the patients' MTF and near visual acuity.No correlation was found between CSF and pupil diameter. PartⅡ:The modulation transfer function and near visual quality with Array, 1CU and ReSTOR lens implanted after phacoemulsificationPurpose:To evaluate the modulation transfer function(MTF ) and near visual quality of Array(refractive multifocal ),1CU(accommodating) and ReSTOR(diffractive multifocal) intraocular lens(IOL).Methods:Follow-up the patients underwent these three IOLs implantation after cataract extraction in the resent year by the end of Apr.2006.42 patients(58 eyes) fulfilled the criteria including Array 16 patients(22 eyes),1CU 13 patients(19 eyes) and ReSTOR 13 patients(17 eyes).Pupil diameter(PD),wavefront aberration and accommodative amplitude were examed with the iTrace Visual Function Analyzer (Tracy Technologies,Texas,USA),using iTrace3.1 software to analyze the MTF with the pupil diameter of 2.0,2.5,3.0,3.5 and 4.0 mm,respectively.Contrast sensitivity(CS) with and without glare were measured with the Contrast Glaretester (GCT- 1000,Takagi Seiko,Nagano,Japan).A full assessment was made of UCVA, BCVA and DCNVA.Results:Under small pupil condition(2 and 2.5 mm ),the MTF of the three IOLs were at the same level(P＞0.1);For a 3 mm pupil,the MTF of 1CU and ReSTOR were better than Array except at 10 cpd(P=0.039～0.095);and For a 3.5 and 4 mm pupil, the MTF of ReSTOR was better than Array at all spatial frequencies(P=0.002～0.062 ). No significant difference was found between 1CU and the other two IOLs.The patients in the ReSTOR group had the best near visual acuity(P＜0.05) and 76.47% patients achieved a DCNVA better than J3.Under mesopic condition,near CS in the Array group was better than 1CU and ReSTOR at higher spatial frequencies.The accommodative amplitude of 1CU was 0.99±1.42 diopters.Conelusions:Patients with ReSTOR IOL implanted had the best visual performances of these three IOLs designed for presbyopia correction.But it still had some problems to be solved.