Visual performance of Acrysof ReSTOR compared with a monofocal intraocular lens following implantation in cataract surgery

The aim of this study was to compare the visual performance of Acrysof ReSTOR and Acrysof Natural intraocular lenses (IOLs) following cataract surgery. A randomized prospective study was performed in which 64 eyes (51 patients) were divided randomly into two groups. Monofocal IOLs (Acrysof Natural) were implanted into 34 eyes (27 patients) and multifocal IOLs (Acrysof ReSTOR) were implanted into 30 eyes (24 patients) using phacoemulsification surgery. The corrected distance visual acuity, near visual acuity, pseudoaccommodation, contrast sensitivity (CS) and wavefront analysis were measured at 1 week, 1 month and 3 months after surgery. The distance vision of the monofocal and ReSTOR patients improved equally with glasses (P<0.05). A greater improvement in near vision without glasses was observed in the ReSTOR-implanted patients (P<0.01). The CS values of the multifocal IOL group were significantly lower than those of the monofocal IOL group for all spatial frequencies tested (P<0.05). The spherical aberration was significantly higher in the multifocal IOL group compared with the monofocal IOL group (P<0.05). We observed no differences in coma between the two groups. The difference in the amplitude of pseudoaccommodation between the two groups was statistically significant (-3.14 +/- 0.91 D in the ReSTOR group vs. -1.03 +/- 0.33 D in the Natural group, P<0.01). The improvement in near vision was significantly more evident in the ReSTOR patients. Compared with the monofocal IOL lens, the multifocal lens is able to increase the amplitude of pseudoaccommodation. However, increased spherical aberration may contribute to lower CS values in the multifocal IOL group.