COMPARISON OF VISUAL OUTCOMES FOLLOWINGPHACOEMULSIFICATION WITH MONOFOCAL ANDMULTIFOCAL INTRAOCULAR LENS DESIGNS: A PROSPECTIVE COMPARATIVE STUDY

Abstract

Background: Cataract is one of the leading causes of avoidable visual impairment worldwide. Phacoemulsification with intraocular lens implantation is the standard surgical treatment for age-related cataract. Conventional monofocal intraocular lenses provide excellent distance vision but usually leave patients dependent on spectacles for near activities. Multifocal intraocular lenses are designed to provide vision at multiple distances and potentially reduce spectacle dependence, although they may be associated with photic phenomena such as glare and halos.
Aim:To compare postoperative visual outcomes, spectacle dependence and subjective visual disturbances following phacoemulsification with implantation of monofocal and multifocal intraocular lenses.
Methods: A prospective comparative study was designed involving 100 patients with age-related cataract. Patients were divided into two groups of 50 each. Group A received a monofocal intraocular lens and Group B received a multifocal intraocular lens following uncomplicated phacoemulsification. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), postoperative spherical equivalent, spectacle dependence, glare and halos were assessed at 1 week, 1 month, and 3 months and 6 months. Statistical analysis was performed using independent-samples t-test and chi-square test.
Results: At 6 months, the mean UDVA was 0.08 ± 0.09 logMAR in the monofocal group and 0.07 ± 0.08 logMAR in the multifocal group. The difference was not statistically significant (p=0.56). Mean CDVA was 0.03 ± 0.05 and 0.03 ± 0.04 logMAR, respectively (p=0.84). However, UNVA was significantly better in the multifocal group (0.18 ± 0.10 vs 0.48 ± 0.15 logMAR; p<0.001). Spectacle independence was achieved by 76% of patients in the multifocal group compared with 24% in the monofocal group (p<0.001). Glare and halos were reported more frequently in the multifocal group.
Conclusion: Both monofocal and multifocal IOLs provided good postoperative distance visual acuity following phacoemulsification. Multifocal IOLs provided significantly better uncorrected near vision and greater spectacle independence but were associated with a higher frequency of glare and halos. Appropriate patient selection and counselling regarding the advantages and limitations of different IOL designs are essential.