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Felix K. Jacobi, MD; Jochen Kammann, MD; Karl W. Jacobi, MD; Ute Großkopf, MD; Karin Walden, MD

Arch Ophthalmol. 1999;117:17-23.

Objective  To evaluate visual results after bilateral implantation of multifocal intraocular lenses (IOLs) with asymmetrical light distribution for the far and near focus.

Methods  Twenty-nine patients underwent bilateral implantation of silicone-optic, foldable, diffractive IOLs in a prospective, 2-center, noncontrolled interventional study. Each patient had a distant-dominant multifocal IOL implanted in 1 eye and a near-dominant multifocal IOL implanted in the fellow eye. Refractive and visual results, including contrast acuity and binocular visual function, were determined. Patients were questioned for postoperative spectacle usage.

Results  Visual and contrast acuity in the dominant focus of either lens was superior to that in the nondominant focus at 3.5 to 12 months postoperatively, ie, performance was best at distance for the distant-dominant and at near for the near-dominant lens. In binocular viewing, the monocular maximal results added up to an improved binocular visual performance. Binocular visual function was within normal limits. Eighty percent of patients reported no use of spectacles at any time postoperatively.

Conclusions  Bilateral implantation of asymmetrical diffractive IOLs is an effective alternative for restoring simultaneous distance and near vision with a potential for improved contrast sensitivity compared with conventional multifocal IOLs.

From the Department of Ophthalmology, University of Giessen, Giessen, (Drs F. Jacobi, K. Jacobi, and Großkopf), and the Department of Ophthalmology, St Johannes Hospital, Dortmund (Drs Kammann and Walden), Germany.

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