Visual and refractive outcomes after implantation of a fully diffractive trifocal lens
Identifieur interne : 000C81 ( Pmc/Curation ); précédent : 000C80; suivant : 000C82Visual and refractive outcomes after implantation of a fully diffractive trifocal lens
Auteurs : Béatrice Cochener [France] ; Jérome Vryghem [Belgique] ; Pascal Rozot [France] ; Gilles Lesieur [France] ; Steven Heireman [Belgique] ; Johan A. Blanckaert ; Emmanuel Van Acker [Belgique] ; Sofie GhekiereSource :
- Clinical Ophthalmology (Auckland, N.Z.) [ 1177-5467 ] ; 2012.
Abstract
The purpose of this study was to record the visual outcomes of patients treated by six surgeons after implantation of a trifocal lens.
The setting for this study comprised six ophthalmology units and eye clinics in Belgium and France, with a coordinating center in France, and data management and statistical analysis in France and Belgium. Ninety-four eyes from 47 patients were implanted with a trifocal FineVision® intraocular lens by six surgeons. Monocular and binocular, uncorrected and best distance-corrected, and photopic and mesopic visual acuity was measured, as well as the defocus curve between +4 D and −4 D with best distance correction.
Near and far monocular visual acuities were similar to the data published after bifocal intraocular lens implantation. Intermediate vision was improved, and was demonstrated by scores of near visual acuity as well as far visual acuity with defocus −1.5 D-add lens. Far vision is maintained in mesopic conditions.
The trifocal intraocular lens provides good far, intermediate, and near visual acuity.
Url:
DOI: 10.2147/OPTH.S32343
PubMed: 22969289
PubMed Central: 3437955
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Johan A. Blanckaert<affiliation><nlm:aff id="af5-opth-6-1421">Ophthalmology Department, Jan Yperman Ziekenhuis, Ieper</nlm:aff>
<wicri:noCountry code="subfield">Ieper</wicri:noCountry>
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<affiliation><nlm:aff id="af5-opth-6-1421">Ophthalmology Department, Jan Yperman Ziekenhuis, Ieper</nlm:aff>
<wicri:noCountry code="subfield">Ieper</wicri:noCountry>
</affiliation>
Le document en format XML
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The purpose of this study was to record the visual outcomes of patients treated by six surgeons after implantation of a trifocal lens.</p>
</sec>
<sec><title>Methods</title>
<p>The setting for this study comprised six ophthalmology units and eye clinics in Belgium and France, with a coordinating center in France, and data management and statistical analysis in France and Belgium. Ninety-four eyes from 47 patients were implanted with a trifocal FineVision<sup>®</sup>
intraocular lens by six surgeons. Monocular and binocular, uncorrected and best distance-corrected, and photopic and mesopic visual acuity was measured, as well as the defocus curve between +4 D and −4 D with best distance correction.</p>
</sec>
<sec><title>Results</title>
<p>Near and far monocular visual acuities were similar to the data published after bifocal intraocular lens implantation. Intermediate vision was improved, and was demonstrated by scores of near visual acuity as well as far visual acuity with defocus −1.5 D-add lens. Far vision is maintained in mesopic conditions.</p>
</sec>
<sec><title>Conclusion</title>
<p>The trifocal intraocular lens provides good far, intermediate, and near visual acuity.</p>
</sec>
</div>
</front>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Ophthalmol</journal-id>
<journal-id journal-id-type="iso-abbrev">Clin Ophthalmol</journal-id>
<journal-id journal-id-type="publisher-id">Clinical Ophthalmology</journal-id>
<journal-title-group><journal-title>Clinical Ophthalmology (Auckland, N.Z.)</journal-title>
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<issn pub-type="ppub">1177-5467</issn>
<issn pub-type="epub">1177-5483</issn>
<publisher><publisher-name>Dove Medical Press</publisher-name>
</publisher>
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<article-meta><article-id pub-id-type="pmid">22969289</article-id>
<article-id pub-id-type="pmc">3437955</article-id>
<article-id pub-id-type="doi">10.2147/OPTH.S32343</article-id>
<article-id pub-id-type="publisher-id">opth-6-1421</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Case Series</subject>
</subj-group>
</article-categories>
<title-group><article-title>Visual and refractive outcomes after implantation of a fully diffractive trifocal lens</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Cochener</surname>
<given-names>Béatrice</given-names>
</name>
<xref ref-type="aff" rid="af1-opth-6-1421">1</xref>
<xref ref-type="corresp" rid="c1-opth-6-1421"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Vryghem</surname>
<given-names>Jérome</given-names>
</name>
<xref ref-type="aff" rid="af2-opth-6-1421">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rozot</surname>
<given-names>Pascal</given-names>
</name>
<xref ref-type="aff" rid="af3-opth-6-1421">3</xref>
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<contrib contrib-type="author"><name><surname>Lesieur</surname>
<given-names>Gilles</given-names>
</name>
<xref ref-type="aff" rid="af4-opth-6-1421">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Heireman</surname>
<given-names>Steven</given-names>
</name>
<xref ref-type="aff" rid="af2-opth-6-1421">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Blanckaert</surname>
<given-names>Johan A</given-names>
</name>
<xref ref-type="aff" rid="af5-opth-6-1421">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Van Acker</surname>
<given-names>Emmanuel</given-names>
</name>
<xref ref-type="aff" rid="af6-opth-6-1421">6</xref>
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<contrib contrib-type="author"><name><surname>Ghekiere</surname>
<given-names>Sofie</given-names>
</name>
<xref ref-type="aff" rid="af5-opth-6-1421">5</xref>
</contrib>
</contrib-group>
<aff id="af1-opth-6-1421"><label>1</label>
Ophthalmology Department, University Hospital CHU, Brest, France</aff>
<aff id="af2-opth-6-1421"><label>2</label>
Brussels Eye Doctors, Brussels, Belgium</aff>
<aff id="af3-opth-6-1421"><label>3</label>
Ophthalmology Department, Clinique Monticelli, Marseille</aff>
<aff id="af4-opth-6-1421"><label>4</label>
Centre Ophtalmologique Iridis, Albi, France</aff>
<aff id="af5-opth-6-1421"><label>5</label>
Ophthalmology Department, Jan Yperman Ziekenhuis, Ieper</aff>
<aff id="af6-opth-6-1421"><label>6</label>
Ophthalmology Department, Clinique Saint Joseph, Lobbes, Belgium</aff>
<author-notes><corresp id="c1-opth-6-1421">Correspondence: Béatrice Cochener, Ophthalmology Department, Bâtiment 2bis, University Hospital CHU Morvan 5, Avenue Foch, 29609 Brest Cedex, France, Tel +33 2 9822 3440, Fax +33 2 9822 3440, Email <email>beatrice.cochener@ophtalmologiechu29.fr</email>
</corresp>
</author-notes>
<pub-date pub-type="collection"><year>2012</year>
</pub-date>
<pmc-comment>Dove Press titles changed from ppub to collections in 2009.
Fake ppub written to satisfy Coll Date Type=ppub</pmc-comment>
<pub-date pub-type="ppub"><year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>03</day>
<month>9</month>
<year>2012</year>
</pub-date>
<volume>6</volume>
<fpage>1421</fpage>
<lpage>1427</lpage>
<permissions><copyright-statement>© 2012 Cochener et al, publisher and licensee Dove Medical Press Ltd.</copyright-statement>
<copyright-year>2012</copyright-year>
<license><license-p>This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><sec><title>Background</title>
<p>The purpose of this study was to record the visual outcomes of patients treated by six surgeons after implantation of a trifocal lens.</p>
</sec>
<sec><title>Methods</title>
<p>The setting for this study comprised six ophthalmology units and eye clinics in Belgium and France, with a coordinating center in France, and data management and statistical analysis in France and Belgium. Ninety-four eyes from 47 patients were implanted with a trifocal FineVision<sup>®</sup>
intraocular lens by six surgeons. Monocular and binocular, uncorrected and best distance-corrected, and photopic and mesopic visual acuity was measured, as well as the defocus curve between +4 D and −4 D with best distance correction.</p>
</sec>
<sec><title>Results</title>
<p>Near and far monocular visual acuities were similar to the data published after bifocal intraocular lens implantation. Intermediate vision was improved, and was demonstrated by scores of near visual acuity as well as far visual acuity with defocus −1.5 D-add lens. Far vision is maintained in mesopic conditions.</p>
</sec>
<sec><title>Conclusion</title>
<p>The trifocal intraocular lens provides good far, intermediate, and near visual acuity.</p>
</sec>
</abstract>
<kwd-group><kwd>trifocal intraocular lens</kwd>
<kwd>multifocal intraocular lens</kwd>
<kwd>cataract surgery</kwd>
<kwd>diffractive intraocular lens</kwd>
</kwd-group>
</article-meta>
</front>
<body><sec><title>Introduction</title>
<p>Over the past 20 years, many new options that permit freedom from spectacles after cataract surgery have emerged, and could significantly reduce public health care costs.<xref ref-type="bibr" rid="b1-opth-6-1421">1</xref>
The options include multifocal intraocular lenses,<xref ref-type="bibr" rid="b2-opth-6-1421">2</xref>
which have been shown to achieve better outcomes than accommodative intraocular lenses,<xref ref-type="bibr" rid="b3-opth-6-1421">3</xref>
,<xref ref-type="bibr" rid="b4-opth-6-1421">4</xref>
despite compromise in the light energy allocated to each focal point. Moreover, multifocal intraocular lenses do not decrease stereopsis, even though bifocal intraocular lens implantation simultaneously generates defocused and focused images on the retina.<xref ref-type="bibr" rid="b5-opth-6-1421">5</xref>
Patients have reported that diffractive intraocular lenses provide satisfactory visual comfort.<xref ref-type="bibr" rid="b6-opth-6-1421">6</xref>
</p>
<p>Artigas et al<xref ref-type="bibr" rid="b7-opth-6-1421">7</xref>
and Maxwell et al<xref ref-type="bibr" rid="b8-opth-6-1421">8</xref>
have both reported that diffractive bifocal optics have a better modulation transfer function than refractive bifocal optics. Felipe et al<xref ref-type="bibr" rid="b9-opth-6-1421">9</xref>
also showed that modulation transfer function correlates with visual acuity. In particular, they demonstrated that the limited modulation transfer function peak at 1.5 D corresponding to intermediate vision is responsible for the poor intermediate vision outcomes of bifocal intraocular lenses. Indeed, up until now, diffractive multifocal intraocular lenses were only bifocal, with a focus allocated to far vision and another allocated to near vision. Depending on the depth of field and the addition power chosen for near vision, these intraocular lenses do provide some intermediate visual acuity, that nevertheless remains inadequate,<xref ref-type="bibr" rid="b10-opth-6-1421">10</xref>
–<xref ref-type="bibr" rid="b14-opth-6-1421">14</xref>
as observed by Felipe et al.<xref ref-type="bibr" rid="b9-opth-6-1421">9</xref>
</p>
<p>FineVision<sup>®</sup>
(Physiol, Liege, Belgium) is a diffractive implant with three focal points for far, intermediate, and near vision. Because this optic design is completely new and because it is necessary to assess the independence of this intraocular lens with respect to surgeon skills and measurements, we report here the early results after implantation of the FineVision intraocular lens by six surgeons.</p>
</sec>
<sec sec-type="materials|methods"><title>Materials and methods</title>
<sec sec-type="methods"><title>Study design</title>
<p>This was a prospective, nonrandomized, observational study. The research follows the tenets of the Declaration of Helsinki, and an institutional review board approved the protocol. Data for the first 47 patients implanted with the FineVision intraocular lens are presented here. Prior to implantation, all patients were warned of the risks associated with multifocal intraocular lenses and informed that their ophthalmological data would be analyzed.</p>
</sec>
<sec><title>Intraocular lens</title>
<p>The FineVision is a multifocal aspheric intraocular lens made of 25% hydrophilic material with a yellow chromophore embedded in the matrix polymer (<xref ref-type="fig" rid="f1-opth-6-1421">Figure 1</xref>
). The single-piece 4-loop haptics intraocular lens has a total diameter of 10.75 mm, an optic body diameter of 6.15 mm, and 5 degrees of haptic angulation. The FineVision is a fully diffractive intraocular lens that combines two diffractive gratings, one with a +1.75 D addition and one with a +3.5 D addition.<xref ref-type="bibr" rid="b15-opth-6-1421">15</xref>
Its optic is designed to allocate 43% of the light energy to far vision, 28% to near vision, and 15% to intermediate vision, at a 3 mm pupil aperture. The remaining 14% of light energy is lost, but this is a minimal loss when compared with the energy lost by other diffractive patterns (18% for standard bifocal diffractive intraocular lenses). To improve night vision, the distribution of light energy varies with pupil aperture, favoring far vision for larger pupils. Available spherical powers range from 10 D to 30 D in 0.5 D increments. An A constant (SRK/T) of 118.9 (interferometry) has been used.</p>
</sec>
<sec sec-type="subjects"><title>Patients</title>
<p>In total, 47 patients (94 eyes) were bilaterally implanted with the FineVision intraocular lens between March 2010 and November 2010 during standard cataract surgery. Depending on the surgeon, different incision sizes were used (<xref ref-type="table" rid="t1-opth-6-1421">Table 1</xref>
).</p>
</sec>
<sec><title>Preoperative examination</title>
<p>Preoperative investigations consisted of a slit-lamp examination, assessment of visual acuity, measurements of intraocular pressure and axial length, and keratometry. All patients requested independence from spectacles and were informed in detail about the possibility of multifocal intraocular lens implantation. Patients with ocular comorbidity or corneal astigmatism greater than 0.75 D were excluded from implantation.</p>
</sec>
<sec><title>Postoperative follow-up</title>
<p>Postoperative follow-up consisted of measuring monocular and binocular uncorrected visual acuity and best distance-corrected visual acuity for far, intermediate, and near vision under scotopic conditions (500 lux). Distance visual acuity was assessed in decimals using Early Treatment Diabetic Retinopathy Study (ETDRS) charts. Near and intermediate visual acuities were assessed using a Parinaud near visual chart at 35 cm and 65 cm, respectively. The Parinaud chart is a scale from 1 to 14 which is proportional to the minimum angle of resolution (MAR) measurement (score 1 is best). Binocular best distance-corrected defocus curves were performed using ETDRS charts and addition lenses ranging from 4 D to −4 D with incremental steps of 0.5 D.</p>
<p>Four surgeons (PR, JV, BC, JB) also assessed monocular and binocular visual acuities for far, intermediate, and near vision in mesopic conditions (10 lux). In addition, two surgeons (JCV, GL) assessed contrast vision by measuring visual acuity at 25% and 10% contrast. The acronyms for the different testing conditions of the visual acuity are given by the Kohnen.<xref ref-type="bibr" rid="b16-opth-6-1421">16</xref>
Illumination conditions were controlled using the Amprobe LM-120 light meter (Amprobe Test Tools, Everett, FL). Lighting conditions and charts were kept identical for all surgeons, so that all patients would have equal potential for visual and refractive outcome. Standard clinical tests, including measurement of intraocular pressure and slit-lamp examinations, were also performed. All surgeons were alert for adverse visual events such as halos, ghosting images, or glare, and recorded these events when they were observed.</p>
</sec>
<sec sec-type="methods"><title>Statistical analysis</title>
<p>Descriptive statistics were performed by means of average, standard deviation, median, minimum and maximum, and box plots using Excel and Analyse-it Excel addin (Analyse-it Software Ltd, Leeds, UK).</p>
</sec>
</sec>
<sec sec-type="results"><title>Results</title>
<p>The patient population comprised 26 females and 21 males. The mean patient age at surgery was 64 ± 8 years. Mean preoperative visual data are listed in <xref ref-type="table" rid="t2-opth-6-1421">Table 2</xref>
. Mean interval between implantation of the first and second eyes was about one month. In one case, one haptic broke during injection. The intraocular lens was nevertheless well centered and remained stable over time. No other peroperative complication was reported. <xref ref-type="fig" rid="f1-opth-6-1421">Figure 1</xref>
shows an example of the intraocular lens after implantation.</p>
<p>After about one week (11 ± 14 days), mean intraocular pressure was 13.9 ± 1.7 mmHg, mean uncorrected visual acuity was logMAR 0.08 ± 0.10, and mean best spectacle-corrected visual acuity was logMAR 0.03 ± 0.05. One patient was lost to follow-up after 2 weeks. At the last consultation, his visual acuity was logMAR 0.04 and logMAR 0.1.</p>
<p>After 6 months, the average intraocular pressure was 13.4 ± 1.7 mmHg. <xref ref-type="table" rid="t3-opth-6-1421">Tables 3</xref>
–<xref ref-type="table" rid="t5-opth-6-1421">5</xref>
show monocular visual and refractive outcomes, binocular visual and refractive outcomes, and mesopic monocular and binocular outcomes, respectively. The values are summarized and compared in the box plot in <xref ref-type="fig" rid="f2-opth-6-1421">Figure 2</xref>
. This graph clearly shows that using the best distance correction demonstrated consistent outcomes around the average. The binocular uncorrected defocus curve is shown in <xref ref-type="fig" rid="f3-opth-6-1421">Figure 3</xref>
. There is a continuum in visual acuity, with a slight decrease between far and near vision due to the fact that lighting conditions stayed the same during the whole measurement. The mean best distance-corrected binocular visual acuity was logMAR 0.03 ± 0.06 with 25% contrast and logMAR 0.12 ± 0.10 with 10% contrast. None of the patients reported seeing ghosting images.</p>
</sec>
<sec sec-type="discussion"><title>Discussion</title>
<p>The present paper describes the clinical results after implantation of the FineVision intraocular lens in the first 47 patients. In particular, the study focused on the ability of the brain to use a third focal point by testing vision at 65 cm and at 4 m with a −1.0 D to −1.5 D addition. Indeed, optical bench studies have shown that the FineVision intraocular lens provides a third focal point.<xref ref-type="bibr" rid="b15-opth-6-1421">15</xref>
</p>
<p>Notably, unremarkable outcomes were reported by the only peer-reviewed publication on a trifocal intraocular lens (MIOL-Record lens) that is currently available.<xref ref-type="bibr" rid="b17-opth-6-1421">17</xref>
In their report, mean distance-corrected decimal visual acuity was 0.86 ± 0.23 and mean distance-corrected near decimal visual acuity was 0.89 ± 0.12, and the distance-corrected intermediate decimal visual acuity of 0.6 ± 0.2 did not improve with respect to reported outcomes with bifocal intraocular lenses.</p>
<p>This was very important to check the safety (the ability to give good near and intermediate vision) and efficiency (by enhancing the intermediate vision) of the FineVision IOL. The study was not designed with a control group because no standard exists in the form of a trifocal intraocular lens. Furthermore, a large number of studies on bifocal intraocular lenses have already been done and can be used as a control group. <xref ref-type="table" rid="t6-opth-6-1421">Table 6</xref>
summarizes the studies of bifocal intraocular lenses in which intermediate visual acuity was tested.</p>
<p>Qualitative comparison of the far, intermediate, and near visual acuity of the FineVision intraocular lens with previously published outcomes of bifocal diffractive intraocular lenses (<xref ref-type="table" rid="t6-opth-6-1421">Table 6</xref>
) can be made.<xref ref-type="bibr" rid="b14-opth-6-1421">14</xref>
The FineVision intraocular lens seems to improve intermediate visual acuity in comparison with other studies, without decreasing the capacity for near vision and slightly decreasing or improving far vision, depending on the studies.</p>
<p>We have not corrected intermediate visual acuity with a working distance of 65 cm, as proposed by De Vries et al.<xref ref-type="bibr" rid="b12-opth-6-1421">12</xref>
This can be done by dividing by 2 the MAR scores as the optotype is twice further, that is removing log 2 to the log- MAR scores in intermediate vision.</p>
<p>Holladay and Prager<xref ref-type="bibr" rid="b19-opth-6-1421">19</xref>
stated that decimal visual acuity should not be averaged because the steps between lines are not equivalent. We have expressed all our data in logMAR, which is recognized as the standard, standard deviation of the decimal visual acuity as it remains for most surgeons and in half of the publications the use.</p>
<p>One could argue that the binocular defocus curve does not give accurate information about the bifocality or trifocality of the lens because a patient with monovision (emmetropic eye and myopic eye) with presbyopia or monofocal lens (without accommodation capacity) in a binocular defocus curve would give two apparent foci. Nevertheless, most of publications give the binocular defocus curve, except de Vries et al<xref ref-type="bibr" rid="b12-opth-6-1421">12</xref>
and Schmidinger et al.<xref ref-type="bibr" rid="b22-opth-6-1421">22</xref>
When compared with bilateral defocus curves obtained after bifocal intraocular implantation, vision in the intermediate range seems to be improved because the usual decrease of the intermediate range of visual acuity is not observed here.</p>
<p>The FineVision intraocular lens was designed to work in conjunction with the pupil aperture.<xref ref-type="bibr" rid="b15-opth-6-1421">15</xref>
This was clearly demonstrated in vivo, because far vision is kept while near vision and intermediate vision decrease in mesopic conditions (<xref ref-type="table" rid="t5-opth-6-1421">Table 5</xref>
). The FineVision showed outcomes similar to that of a bifocal intraocular lens for the low-contrast ETDRS tests. Indeed, Toto et al<xref ref-type="bibr" rid="b11-opth-6-1421">11</xref>
found a mean visual acuity of logMAR 0.40 ± 0.18 with the Tecnis ZM900 +4 D fully diffractive intraocular lens and logMAR 0.33 ± 0.09 with the partially diffractive Acrysof Restor +3 D under 10% contrast. De Vries et al<xref ref-type="bibr" rid="b12-opth-6-1421">12</xref>
found logMAR 0.01 ± 0.09 under 25% contrast and logMAR 0.10 ± 0.13 under 10% contrast with the Acrysof Restor +3 D. They found logMAR 0.07 ± 0.05 (25% contrast) and logMAR 0.16 ± 0.08 (10% contrast) with the Acrysof Restor +4 D. This outcome was expected because half of the energy for the intermediate focal point is recovered from the lost energy of the bifocal diffractive profile.<xref ref-type="bibr" rid="b15-opth-6-1421">15</xref>
</p>
</sec>
<sec><title>Conclusion</title>
<p>The outcomes of the present study show that there is a real intermediate vision after implantation of the FineVision lens with no loss of far and near vision. Nevertheless, they suggest that the brain can effectively use a third focal point. It has been proposed that the outcomes of multifocal intraocular lenses can improve over time due to neuroadaptation and brain plasticity.<xref ref-type="bibr" rid="b20-opth-6-1421">20</xref>
However, in our opinion, there is some confusion regarding refractive and diffractive intraocular lenses. Because the outcomes of refractive intraocular lens (with concentric rings) have a pupil dependence, neural adaptation to these intraocular lenses involves learning to control the pupil aperture. In contrast, with fully diffractive intraocular lenses, the image is focused whatever the pupil diameter. Nevertheless, the patient must become accustomed to the blurred intermediate vision zone, which is another form of neural adaptation. The clinical defocus curve of the FineVision intraocular lens reveals that the image it obtains is sharp at any focal distance. Thus, this paper shows that, over a very short period of time, patients can use all of the possibilities of the FineVision intraocular lens, namely the three focal points, in photopic and mesopic conditions. Outcomes after a longer time will be published, but we considered it very important to publish an interim analysis of the pilot study, given that the FineVision is the first trifocal diffractive intraocular lens.</p>
</sec>
</body>
<back><fn-group><fn id="fn1-opth-6-1421"><p><bold>Disclosure</bold>
</p>
<p>The authors report no conflicts of interest in this work.</p>
</fn>
</fn-group>
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<floats-group><fig id="f1-opth-6-1421" position="float"><label>Figure 1</label>
<caption><p>Slit lamp photograph of a patient eye implanted with the FineVision<sup>®</sup>
intraocular lens.</p>
</caption>
<graphic xlink:href="opth-6-1421f1"></graphic>
</fig>
<fig id="f2-opth-6-1421" position="float"><label>Figure 2</label>
<caption><p>Box plot of the uncorrected and distance-corrected distance, intermediate and near visual acuity.</p>
<p><bold>Abbreviations:</bold>
UCVA, uncorrected visual acuity; UIVA, uncorrected intermediate visual acuity; UNVA, uncorrected near visual acuity; CDVA, corrected distance visual acuity; DCIVA, distance-corrected intermediate visual acuity; DCNVA, distance corrected near visual acuity.</p>
</caption>
<graphic xlink:href="opth-6-1421f2"></graphic>
</fig>
<fig id="f3-opth-6-1421" position="float"><label>Figure 3</label>
<caption><p>The FineVision binocular best distance-corrected defocus curve (binocular outcomes of 27 patients).</p>
</caption>
<graphic xlink:href="opth-6-1421f3"></graphic>
</fig>
<table-wrap id="t1-opth-6-1421" position="float"><label>Table 1</label>
<caption><p>Number of eyes implanted by each surgeon, and incision size that each used</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1">Surgeon</th>
<th align="left" valign="top" rowspan="1" colspan="1">Implanted eyes (n)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Incision size (mm)</th>
</tr>
</thead>
<tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">PR</td>
<td align="left" valign="top" rowspan="1" colspan="1">20</td>
<td align="left" valign="top" rowspan="1" colspan="1">1.8–2.2</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">JV</td>
<td align="left" valign="top" rowspan="1" colspan="1">12</td>
<td align="left" valign="top" rowspan="1" colspan="1">1.9</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">GL</td>
<td align="left" valign="top" rowspan="1" colspan="1">20</td>
<td align="left" valign="top" rowspan="1" colspan="1">1.8</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">BC</td>
<td align="left" valign="top" rowspan="1" colspan="1">30</td>
<td align="left" valign="top" rowspan="1" colspan="1">1.8</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">JB</td>
<td align="left" valign="top" rowspan="1" colspan="1">8</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.4</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">EVA</td>
<td align="left" valign="top" rowspan="1" colspan="1">4</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.2</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="t2-opth-6-1421" position="float"><label>Table 2</label>
<caption><p>Preoperative clinical data</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th>
<th align="left" valign="top" rowspan="1" colspan="1">Mean ± SD</th>
<th align="left" valign="top" rowspan="1" colspan="1">Range</th>
<th align="left" valign="top" rowspan="1" colspan="1">Eyes (n)</th>
</tr>
</thead>
<tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Intraocular pressure (mmHg)</td>
<td align="center" valign="top" rowspan="1" colspan="1">14.63 ± 2.57</td>
<td align="left" valign="top" rowspan="1" colspan="1">10–20</td>
<td align="left" valign="top" rowspan="1" colspan="1">91</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Visual acuity (decimal)</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.72 ± 0.25</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.16–1</td>
<td align="left" valign="top" rowspan="1" colspan="1">89</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Visual acuity (logMAR)</td>
<td align="center" valign="top" rowspan="1" colspan="1">0.18 ± 0.19</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.80–0.00</td>
<td align="left" valign="top" rowspan="1" colspan="1">89</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Axial length (mm)</td>
<td align="center" valign="top" rowspan="1" colspan="1">23.13 ± 1.17</td>
<td align="left" valign="top" rowspan="1" colspan="1">20.53–26.15</td>
<td align="left" valign="top" rowspan="1" colspan="1">89</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Mean corneal K readings (D)</td>
<td align="center" valign="top" rowspan="1" colspan="1">43.77 ± 1.32</td>
<td align="left" valign="top" rowspan="1" colspan="1">41.13–46.75</td>
<td align="left" valign="top" rowspan="1" colspan="1">90</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Mean corneal astigmatism (D)</td>
<td align="center" valign="top" rowspan="1" colspan="1">−0.40 ± 0.23</td>
<td align="left" valign="top" rowspan="1" colspan="1">−1.29–0</td>
<td align="left" valign="top" rowspan="1" colspan="1">90</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Intraocular lens power (D)</td>
<td align="center" valign="top" rowspan="1" colspan="1">21.69 ± 3.15</td>
<td align="left" valign="top" rowspan="1" colspan="1">12–30</td>
<td align="left" valign="top" rowspan="1" colspan="1">94</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="tfn1-opth-6-1421"><p><bold>Abbreviations:</bold>
SD, standard deviation; MAR, minimum angle of resolution.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="t3-opth-6-1421" position="float"><label>Table 3</label>
<caption><p>Monocular visual and refractive outcomes</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th>
<th colspan="4" align="left" valign="top" rowspan="1">Uncorrected</th>
<th colspan="4" align="left" valign="top" rowspan="1">Best distance-corrected</th>
</tr>
<tr><th align="left" valign="top" rowspan="1" colspan="1"></th>
<th colspan="4" align="left" valign="top" rowspan="1"><hr></hr>
</th>
<th colspan="4" align="left" valign="top" rowspan="1"><hr></hr>
</th>
</tr>
<tr><th align="left" valign="top" rowspan="1" colspan="1"></th>
<th colspan="2" align="left" valign="top" rowspan="1">3 months</th>
<th colspan="2" align="left" valign="top" rowspan="1">6 months</th>
<th colspan="2" align="left" valign="top" rowspan="1">3 months</th>
<th colspan="2" align="left" valign="top" rowspan="1">6 months</th>
</tr>
</thead>
<tbody><tr><td colspan="9" align="left" valign="top" rowspan="1"><bold>Distance visual acuity</bold>
</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Decimal</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.86 ± 0.19</td>
<td align="left" valign="top" rowspan="1" colspan="1">90 eyes</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.86 ± 0.19</td>
<td align="left" valign="top" rowspan="1" colspan="1">92 eyes</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.93 ± 0.13</td>
<td align="left" valign="top" rowspan="1" colspan="1">91 eyes</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.94 ± 0.13</td>
<td align="left" valign="top" rowspan="1" colspan="1">91 eyes</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">LogMAR</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.08 ± 0.11</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.08 ± 0.12</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.03 ± 0.06</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.03 ± 0.06</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td colspan="9" align="left" valign="top" rowspan="1"><bold>Intermediate visual acuity</bold>
</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Parinaud</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.90 ± 1.53</td>
<td align="left" valign="top" rowspan="1" colspan="1">82 eyes</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.97 ± 1.58</td>
<td align="left" valign="top" rowspan="1" colspan="1">82 eyes</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.81 ± 1.31</td>
<td align="left" valign="top" rowspan="1" colspan="1">89 eyes</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.90 ± 1.34</td>
<td align="left" valign="top" rowspan="1" colspan="1">83 eyes</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">LogMAR</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.08 ± 0.11</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.08 ± 0.12</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.07 ± 0.10</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.08 ± 0.10</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td colspan="9" align="left" valign="top" rowspan="1"><bold>Near visual acuity</bold>
</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Parinaud</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.04 ± 0.90</td>
<td align="left" valign="top" rowspan="1" colspan="1">90 eyes</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.03 ± 0.87</td>
<td align="left" valign="top" rowspan="1" colspan="1">86 eyes</td>
<td align="left" valign="top" rowspan="1" colspan="1">1.92 ± 0.69</td>
<td align="left" valign="top" rowspan="1" colspan="1">91 eyes</td>
<td align="left" valign="top" rowspan="1" colspan="1">1.91 ± 0.61</td>
<td align="left" valign="top" rowspan="1" colspan="1">91 eyes</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">LogMAR</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.01 ± 0.07</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.01 ± 0.06</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.00 ± 0.05</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.00 ± 0.05</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Spherical equivalent (D)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.03 ± 0.43</td>
<td align="left" valign="top" rowspan="1" colspan="1">88 eyes</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.08 ± 0.43</td>
<td align="left" valign="top" rowspan="1" colspan="1">86 eyes</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="tfn2-opth-6-1421"><p><bold>Abbreviation:</bold>
MAR, minimum angle of resolution.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="t4-opth-6-1421" position="float"><label>Table 4</label>
<caption><p>Binocular distance, and intermediate and near visual acuity</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th>
<th colspan="4" align="left" valign="top" rowspan="1">Uncorrected</th>
<th colspan="4" align="left" valign="top" rowspan="1">Best distance-corrected</th>
</tr>
<tr><th align="left" valign="top" rowspan="1" colspan="1"></th>
<th colspan="4" align="left" valign="top" rowspan="1"><hr></hr>
</th>
<th colspan="4" align="left" valign="top" rowspan="1"><hr></hr>
</th>
</tr>
<tr><th align="left" valign="top" rowspan="1" colspan="1"></th>
<th colspan="2" align="left" valign="top" rowspan="1">3 months</th>
<th colspan="2" align="left" valign="top" rowspan="1">6 months</th>
<th colspan="2" align="left" valign="top" rowspan="1">3 months</th>
<th colspan="2" align="left" valign="top" rowspan="1">6 months</th>
</tr>
</thead>
<tbody><tr><td colspan="9" align="left" valign="top" rowspan="1"><bold>Distance visual acuity</bold>
</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Decimal</td>
<td align="right" valign="top" rowspan="1" colspan="1">0.97 ± 0.19</td>
<td align="center" valign="top" rowspan="1" colspan="1">45 patients</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.98 ± 0.19</td>
<td align="left" valign="top" rowspan="1" colspan="1">45 patient</td>
<td align="right" valign="top" rowspan="1" colspan="1">1.01 ± 0.17</td>
<td align="center" valign="top" rowspan="1" colspan="1">44 patients</td>
<td align="right" valign="top" rowspan="1" colspan="1">1.01 ± 0.17</td>
<td align="center" valign="top" rowspan="1" colspan="1">44 patients</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">LogMAR</td>
<td align="right" valign="top" rowspan="1" colspan="1">0.02 ± 0.09</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.02 ± 0.09</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="right" valign="top" rowspan="1" colspan="1">0.00 ± 0.07</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="right" valign="top" rowspan="1" colspan="1">0.00 ± 0.07</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td colspan="9" align="left" valign="top" rowspan="1"><bold>Intermediate visual acuity</bold>
</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Parinaud</td>
<td align="right" valign="top" rowspan="1" colspan="1">2.51 ± 1.02</td>
<td align="center" valign="top" rowspan="1" colspan="1">40 patients</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.61 ± 1.13</td>
<td align="left" valign="top" rowspan="1" colspan="1">40 patients</td>
<td align="right" valign="top" rowspan="1" colspan="1">2.52 ± 1.27</td>
<td align="center" valign="top" rowspan="1" colspan="1">41 patients</td>
<td align="right" valign="top" rowspan="1" colspan="1">2.55 ± 1.25</td>
<td align="center" valign="top" rowspan="1" colspan="1">41 patients</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">LogMAR</td>
<td align="right" valign="top" rowspan="1" colspan="1">0.05 ± 0.08</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.05 ± 0.08</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="right" valign="top" rowspan="1" colspan="1">0.05 ± 0.09</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="right" valign="top" rowspan="1" colspan="1">0.05 ± 0.09</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td colspan="9" align="left" valign="top" rowspan="1"><bold>Near visual acuity</bold>
</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Parinaud</td>
<td align="right" valign="top" rowspan="1" colspan="1">1.80 ± 0.54</td>
<td align="center" valign="top" rowspan="1" colspan="1">44 patients</td>
<td align="left" valign="top" rowspan="1" colspan="1">1.81 ± 0.54</td>
<td align="left" valign="top" rowspan="1" colspan="1">44 patients</td>
<td align="right" valign="top" rowspan="1" colspan="1">1.78 ± 0.56</td>
<td align="center" valign="top" rowspan="1" colspan="1">44 patients</td>
<td align="right" valign="top" rowspan="1" colspan="1">1.79 ± 0.55</td>
<td align="center" valign="top" rowspan="1" colspan="1">44 patients</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">LogMAR</td>
<td align="right" valign="top" rowspan="1" colspan="1">−0.01 ± 0.04</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.00 ± 0.04</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="right" valign="top" rowspan="1" colspan="1">−0.01 ± 0.04</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
<td align="right" valign="top" rowspan="1" colspan="1">−0.01 ± 0.04</td>
<td align="center" valign="top" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="tfn3-opth-6-1421"><p><bold>Abbreviation:</bold>
MAR, minimum angle of resolution.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="t5-opth-6-1421" position="float"><label>Table 5</label>
<caption><p>Monocular and binocular visual acuity in mesopic conditions for far, intermediate, and near vision</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="3" colspan="1">Visual acuity in mesopic conditions</th>
<th colspan="3" align="left" valign="top" rowspan="1">3 months</th>
<th colspan="3" align="left" valign="top" rowspan="1">6 months</th>
</tr>
<tr><th colspan="3" align="left" valign="top" rowspan="1"><hr></hr>
</th>
<th colspan="3" align="left" valign="top" rowspan="1"><hr></hr>
</th>
</tr>
<tr><th align="left" valign="top" rowspan="1" colspan="1">Decimal (far) or Parinaud (intermediate and near)</th>
<th align="left" valign="top" rowspan="1" colspan="1">LogMAR</th>
<th align="left" valign="top" rowspan="1" colspan="1">Eye (n)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Decimal (far) or Parinaud (intermediate and near)</th>
<th align="left" valign="top" rowspan="1" colspan="1">LogMAR</th>
<th align="left" valign="top" rowspan="1" colspan="1">Eye (n)</th>
</tr>
</thead>
<tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">CDVA</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.92 ± 0.12</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.04 ± 0.06</td>
<td align="left" valign="top" rowspan="1" colspan="1">64</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.92 ± 0.12</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.04 ± 0.06</td>
<td align="left" valign="top" rowspan="1" colspan="1">64</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">DCIVA</td>
<td align="left" valign="top" rowspan="1" colspan="1">3.86 ± 1.39</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.15 ± 0.10</td>
<td align="left" valign="top" rowspan="1" colspan="1">64</td>
<td align="left" valign="top" rowspan="1" colspan="1">3.86 ± 1.39</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.15 ± 0.10</td>
<td align="left" valign="top" rowspan="1" colspan="1">64</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">DCNVA</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.89 ± 1.09</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.08 ± 0.08</td>
<td align="left" valign="top" rowspan="1" colspan="1">64</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.89 ± 1.09</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.08 ± 0.08</td>
<td align="left" valign="top" rowspan="1" colspan="1">64</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Binocular CDVA</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.93 ± 0.10</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.03 ± 0.10</td>
<td align="left" valign="top" rowspan="1" colspan="1">26</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.93 ± 0.10</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.03 ± 0.10</td>
<td align="left" valign="top" rowspan="1" colspan="1">26</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Binocular DCIVA</td>
<td align="left" valign="top" rowspan="1" colspan="1">3.86 ± 1.82</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.15 ± 0.14</td>
<td align="left" valign="top" rowspan="1" colspan="1">26</td>
<td align="left" valign="top" rowspan="1" colspan="1">3.86 ± 1.82</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.15 ± 0.14</td>
<td align="left" valign="top" rowspan="1" colspan="1">26</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Binocular DCNVA</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.94 ± 0.90</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.08 ± 0.07</td>
<td align="left" valign="top" rowspan="1" colspan="1">26</td>
<td align="left" valign="top" rowspan="1" colspan="1">2.94 ± 0.90</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.08 ± 0.07</td>
<td align="left" valign="top" rowspan="1" colspan="1">26</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="tfn4-opth-6-1421"><p><bold>Abbreviations:</bold>
CDVA, corrected distance visual acuity; DCIVA, distance-corrected intermediate visual acuity; DCNVA, distance-corrected near visual acuity; MAR, minimum angle of resolution.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="t6-opth-6-1421" position="float"><label>Table 6</label>
<caption><p>Visual outcomes of diffractive intraocular lenses in different studies</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th>
<th align="left" valign="top" rowspan="1" colspan="1"></th>
<th colspan="2" align="left" valign="top" rowspan="1">CDVA (logMAR)</th>
<th colspan="2" align="left" valign="top" rowspan="1">DCIVA (logMAR)</th>
<th colspan="2" align="left" valign="top" rowspan="1">DCNVA (logMAR)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Eyes</th>
</tr>
</thead>
<tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Alcon Acrysof +4 D</td>
<td align="left" valign="top" rowspan="1" colspan="1">Alfonso et al<xref ref-type="bibr" rid="b14-opth-6-1421">14</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.08 ± 0.1</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.15 ± 0.19</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.05 ± 0.06</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">20</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Alcon Acrysof +4 D<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Alfonso et al<xref ref-type="bibr" rid="b14-opth-6-1421">14</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.1 ± 0.1<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.3 ± 0.1<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 ± 0.15<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">20</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Alcon Acrysof +4 D</td>
<td align="left" valign="top" rowspan="1" colspan="1">De Vries et al<xref ref-type="bibr" rid="b12-opth-6-1421">12</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.01 ± 0.06</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.31 ± 0.13</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.14 ± 0.11</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">46</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Alcon Acrysof +4 D<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">De Vries et al<xref ref-type="bibr" rid="b12-opth-6-1421">12</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.05<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.4<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.15<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">46</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Alcon Acrysof +4 D</td>
<td align="left" valign="top" rowspan="1" colspan="1">Blaylock et al<xref ref-type="bibr" rid="b10-opth-6-1421">10</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.00 ± 0.05</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.36 ± 0.1</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.07 ± 0.08</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">37</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Alcon Acrysof +3 D</td>
<td align="left" valign="top" rowspan="1" colspan="1">Alfonso et al<xref ref-type="bibr" rid="b14-opth-6-1421">14</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.06 ± 0.05</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.02 ± 0.13</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.08 ± 0.04</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">20</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Alcon Acrysof +3 D<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Alfonso et al<xref ref-type="bibr" rid="b14-opth-6-1421">14</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.1 ± 0.1<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.25 ± 0.1<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.05 ± 0.1<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">20</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Alcon Acrysof +3 D</td>
<td align="left" valign="top" rowspan="1" colspan="1">De Vries et al<xref ref-type="bibr" rid="b12-opth-6-1421">12</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.04 ± 0.09</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.19 ± 0.2</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.08 ± 0.11</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">68</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Alcon Acrysof +3 D<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">De Vries et al<xref ref-type="bibr" rid="b12-opth-6-1421">12</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.05<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.2<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.05</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">68</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Alcon Acrysof +3 D</td>
<td align="left" valign="top" rowspan="1" colspan="1">Alió et al<xref ref-type="bibr" rid="b18-opth-6-1421">18</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.10 ± 0.13</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.11 ± 0.14</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Zeiss AcriLISA +3.75 D</td>
<td align="left" valign="top" rowspan="1" colspan="1">Alfonso et al<xref ref-type="bibr" rid="b14-opth-6-1421">14</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.08 ± 0.08</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.15 ± 0.15</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.02 ± 0.08</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">20</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Zeiss AcriLISA +3.75 D<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Alfonso et al<xref ref-type="bibr" rid="b14-opth-6-1421">14</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.1 ± 0.1<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Binocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.3 ± 0.1<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 ± 0.15<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">20</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Zeiss AcriLISA +3.75 D</td>
<td align="left" valign="top" rowspan="1" colspan="1">Alió et al<xref ref-type="bibr" rid="b18-opth-6-1421">18</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.04 ± 0.09</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.3(<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
)</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.17 ± 0.34</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Zeiss AcriLISA +3.75 D</td>
<td align="left" valign="top" rowspan="1" colspan="1">Can et al<xref ref-type="bibr" rid="b21-opth-6-1421">21</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.01 ± 0.02</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.14 ± 0.06</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.06 ± 0.20</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Reviol +3.75 D</td>
<td align="left" valign="top" rowspan="1" colspan="1">Can et al<xref ref-type="bibr" rid="b21-opth-6-1421">21</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.02 ± 0.05</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.11 ± 0.07</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.01 ± 0.03</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">Present study</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.03 ± 0.06</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.08 ± 0.10</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.00 ± 0.05</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">90</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">AMO Tecnis ZM900</td>
<td align="left" valign="top" rowspan="1" colspan="1">Toto et al<xref ref-type="bibr" rid="b11-opth-6-1421">11</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">−0.01 ± 0.08</td>
<td align="left" valign="top" rowspan="1" colspan="1">Monocular</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.3<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.04<xref ref-type="table-fn" rid="tfn6-opth-6-1421">*</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">14</td>
</tr>
<tr><td align="left" valign="top" rowspan="1" colspan="1">MIOL-RECORD-3 (decimal notation)</td>
<td align="left" valign="top" rowspan="1" colspan="1">Voskresenskaya<xref ref-type="bibr" rid="b17-opth-6-1421">17</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.86 ± 0.23</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.6 ± 0.2</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">0.89 ± 0.12</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">36</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="tfn5-opth-6-1421"><p><bold>Note:</bold>
</p>
</fn>
<fn id="tfn6-opth-6-1421"><label>*</label>
<p>Indicates that the number was extracted from the published defocus curve.</p>
</fn>
<fn id="tfn7-opth-6-1421"><p><bold>Abbreviations:</bold>
CDVA, corrected distance visual acuity; DCIVA, distance-corrected intermediate visual acuity; DCNVA, distance-corrected near visual acuity; MAR, minimum angle of resolution.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
</record>
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