| PURPOSPURPOSE To compare overall visual acuity(including distance,intermediate andnear visual outcome) and subjective satisfaction in age-related cataract patientsafter phacomultification implanted with diffractive ( Alcon ReSTOR MIOL) orrefractive multifocal IOLs (AMO ReZoom MIOL),to make an evaluation ofpostoperative clinical results and safety of two kinds of multifocal intraocularlens.Methods This is a non-randomized control clinical trial. We retrospectivelyreviewed 33 patients(45 eyes)who underwent phacoemulsification for age-relatedcataract and IOL implantation in the People's Central Hospital of Huizhou City.23eyes of 15 patients were implanted with the step-progressive-diffraction foldablemultifocal IOL(Alcon ReSTOR MIOL),22 eyes of 18 patients were implanted withrefractive multifocal IOLs (AMO ReZoom MIOL). Parameters analyzed includeduncorrected distance visual acuity(UCDVA), uncorrected near visual acuity(UCNVA)and uncorrected intermediate visual acuity (40,63,100cm high and lowcontrast visual acuity) ,which were respectively tested using E StandardLogarithm Eyesight Table , standard near vision chart and Colenbrander mixedcontrast card set charts that were externally illuminated with 20 and 400lux. Thepatients who have got associated ocular diseases or complication during operationwere excluded from the study. All parameters were evaluated 3 months after surgery.A questionnaire was administered to establish patients satisfaction with theirvision, subjective visual symptoms and the effect of lighting conditions on theirvision and spectacle dependence. The outcomes were compared using t test andχ2 test.Result 33 patients were examined at three months follow-up visits postoperatively.No complication was found operatively and postoperatively. No posterioropacification (PCO).No IOL leans after dispersing pupil by silt-lamp microscope.In the ReSTOR MIOL group: UCDVA was 0.34±0.20(20lux)and 0.71±0.20(400lux),UCNVAwas 0.20±0.07(20lux) and 0.33±0.10(400lux), while in ReZoom MIOL group: UCDVA was 0.36±0.14(20lux)and 0.77±0.21(400lux),UCNV was0.20±0.08 (20lux) and0.27±0.10 (400lux).Good UCDVA were obtained and no significant difference in themean uncorrected distance visual acuity at the two illumination levels and themean uncorrected near visual acuity under 20lux illumination level was foundbetween the two groups . There was significant difference in the mean uncorrectednear visual acuity between the groups under 400lux illumination level. Under commonlevels of indoor illumination, the ReZoom MIOL group have better intermediatevision at 40,63 and 100cm than the ReSTOR MIOL group. The uncorrected distanceand near and intermediate visual acuity significantly increased with increasingillumination from 20 to 400 lux in the two groups. The ReSTOR MIOL group have higherrate of spectable independence than the ReZoom MIOL group (82.61% versus 45.45%)(P < 0.01) when reading. Questionnaire scores were comparable in both groups. Therewas no significant difference in the satisfactory uncorrected distance vision(78.26% vs 72.73% ,p>0.05)between the two groups,There was significant differencein the satisfactory uncorrected intermediate distance vision (39.13% vs81.82%,p<0.01) and the satisfactory uncorrected near vision (86.96% vs36.36%,p<0.01)between the two groups.ConlusConlusion The Acrysof ReSTOR apodized diffractive multifocal intraocular lens andRezoom reffractive multifocal intraocular lens may provide an excellent distancevisual acuity after surgery early stage, but the diffractive IOLs (ReSTOR MIOL)proved better at near vision and higher rate spectacle independence and worse atintermediate vision than the refractive IOLs(ReZoom MIOL).SO, we should selectintraocular lens depending on the different requirements of patients.
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