Visual outcomes three and six months after implantation of diffractive and refractive multifocal IOL combinations

Introduction
Purpose: To evaluate 3 and 6 months binocular visual outcomes after cataract surgery using a multifocal IOL “mix and match” approach, with a refractive (ReZoom) IOL in the dominant eye and a diffractive (Tecnis) IOL in the fellow eye.

Material and methods
Three and 6 months after bilateral cataract surgery, 40 eyes of 20 patients were evaluated for binocular UDVA, UNVA and UIVA (logMAR), spectacle independence, contrast sensitivities (CS), stereoscopic vision, subjective symptoms, patient satisfaction and complications.

Results
Three months after surgery mean binocular UDVA did not differ from the six-month follow-up (-0.13 ± 0.08 vs. -0.18 ± 0.08; p = NS ). All patients achieved binocular UNVA of 0.0 at both follow-ups. Mean binocular UIVA improved significantly from 0.06 to 0.01 (p<0.027), 6 months after surgery. All patients had very function at good visual all distances and were totally spectacle independent. CS under various conditions was within normal age-matched limits at both follow-ups. For some spatial frequencies six months postoperative results were significantly better than for the 3 months follow-up (p<0.05). Stereoscopic vision was normal. A low degree of glare/halo was detected in 75% of subjects. Overall patient satisfaction was very high (9.6/10). There were no postoperative complications.

Conclusions
Mixing and matching multifocal IOLs in selected cataract patients provides an excellent visual outcome, a high level of patient satisfaction and spectacle-free visual function. A period of neuroadaptation lasting at least six months is necessary to obtain better visual function results.