Binocular Visual Function With Staged Implantation of Diffractive Multifocal Intraocular Lenses With Three Add Powers

Purpose: To evaluate the binocular visual function and depth of focus after staged implantation of diffractive multifocal intraocular lenses (MIOLs) with 3 different add powers following cataract removal. Design: Prospective comparative case series. Methods: Setting: Institutional. Study Population: Both eyes of 56 patients that underwent staged implantation of bifocal IOLs. Intervention: In the first eye, MIOLs with a +4.0-diopter (D) add power were implanted. Based on outcomes at 1 week postoperatively and patient preference for near vision, 1 of 3 near add powers—+4.0 D (group MM), +3.25 D (group ML), or +2.75 D (group MK)—was implanted in the fellow eye. Main Outcome Measure(s): Three months postoperatively, the binocular uncorrected and distance-corrected visual acuities (BUCVA and BDCVA, respectively) at 5.0, 1.0, 0.5, 0.4, and 0.3 meters; binocular defocus curves; contrast sensitivity; and near stereopsis were measured. Results: The MM, ML, and MK groups included 21, 18, and 17 patients, respectively. The mean BUCVA in the MM group was significantly (P =.003) worse than that in the MK group at 0.5 meter. The BDCVAs at 0.5 meter in the ML and MK groups were significantly (P <.02) better than that in the MM group. The defocus curves with the -2.0 D refraction differed significantly (P <.001) between the MM and MK groups. The binocular contrast sensitivity and stereopsis values did not differ significantly. Conclusions: Staged implantation of different add powers obtained better binocular intermediate visual acuity without degradation of visual function.