Functional vision after cataract removal with multifocal and accommodating intraocular lens implantation: prospective comparative evaluation of Array multifocal and 1CU accommodating lenses

PURPOSE: To compare the efficacy (functional vision, spectacle dependence) of the Array multifocal intraocular lens (IOL) (Advanced Medical Optics) and the 1CU accommodating IOL (HumanOptics AG). SETTING: Hartswood Hospital, Brentwood, United Kingdom. METHODS: This prospective study comprised patients scheduled to have standard phacoemulsification surgery with IOL implantation. Patients expressing a preference for spectacle independence were allocated to the Array multifocal IOL group. Those expressing no preference received the 1CU accommodating IOL. Efficacy measures included distance and near uncorrected visual acuity (UCVA), dynamic retinoscopy, and patient-reported spectacle independence. RESULTS: Seventeen patients (34 eyes) had bilateral implantation of the Array multifocal IOL, and 5 patients (9 eyes) had implantation of the 1CU accommodating IOL. Six to 18 months after surgery, 82.4% of eyes in the multifocal IOL group and 77.8% in the accommodating IOL group achieved a distance UCVA of 20/20 (Snellen) or better; the difference between groups was not significant. However, a significantly greater proportion in the multifocal IOL group than in the accommodating IOL group (76.5% versus 44.4%) achieved a near UCVA of N5 (Snellen 20/40) or better (P=.0068). Sixteen patients (94.1%) with Array IOLs and 2 patients (50.0%) with 1CU IOLs reported spectacle independence. Dynamic retinoscopy showed that the mean accommodative effect in the 1CU group was 0.44 diopter. CONCLUSIONS: In this single-surgeon single-site study, a greater proportion of Array multifocal IOL recipients than 1CU IOL recipients achieved functional near visual acuity. Only 1 patient with an Array IOL required corrective spectacles at the last visit.