Double-Pass System (Optical Quality Analysis System) for Analysis of the Multifocal Function of a Diffractive Multifocal Inlraocular Lens (Acrysof ReSTOR®) Compared to a Monofocal Intraocular Lens (Acrysof IQ®))

In this study, we objectively determined whether the ReSTOR as a multifocal IOL (intraocular lens) has a multifocal function compared to the IQ as a monofocal IOL in vivo by OQAS (Optical Quality Analysis System). Eighteen patients who had cataract surgery with implantation of ReSTOR (27 eyes) and 15 patients with IQ (21 eyes), were included inthis study. Uncorrected distance visual acuity (UCDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UCNVA)and distance corrected near visual acuity (DCNVA) were measured. After setting the artificial pupil size to 3 mm, we performed 'Optical quality'. We inputted defocusdiopters of (objective spherical refraction)(far), (objective spherical refraction-1.25 D)(intermediate),(objective spherical refraction-2.5 D)(near), and (objective spherical refraction-3.5 D)(very near) into 'selected spherical refraction' simulating theoptical quality at far, intermediate, and near distance. We changed the pupil size to 5 mm and repeated thesame measurements. The UCDVA and CDVA did not show significant differences between the 2 groups. But, theUCNVA and DCNVA of the ReSTOR group were better than those of the IQ group (p=0.000, p=0.000). For 3 mm pupil, at far distance, modulation transfer function (MTF) cut off and point spread function (PSF) width at 50% of ReSTOR were worse than those of IQ (p=0.039, p=0.020). At intermediate distance, MTF cut off, Strehl ratio and PSF width at 50% of ReSTOR were worse than those of IQ (p=0.001, p=0.001, p=0.000). At near distance, MTF cut off of ReSTOR was worse than that of IQ (p0.033). At very near distance, MTF cut off and Strehl ratio of ReSTOR were worse than those of IQ (p=0.002, p=0.002), but PSF width at 50% of ReSTOR was better than that of IQ. For 5 mm pupil, most parameters at each distance, there was no significant difference between the 2 groups. Only PSF width at 50% of ReSTOR were worse than those of IQ at intermediate distance (p=0.013). It was impossible to show the multifocal function of ReSTOR compared to the IQ byOQAS.