Clinical outcomes and intraocular optical quality of a diffractive multifocal intraocular lens with asymmetrical light distribution

PURPOSE: To evaluate clinical outcomes and intraocular optical performance of a diffractive multifocal intraocular lens (IOL), Acri.Lisa 366D (Acri.Tec). SETTING: Vissum-instituto de Oftalmologico de Alicante, Alicante, Spain. METHODS: The study included 69 eyes (52 patients) with Acri.Lisa 366D IOLs. The intraocular optical quality in vivo was characterized by the difference between postoperative total and corneal optical aberrations. Visual and optical outcomes were evaluated 6 months postoperatively. The main outcomes measures were refractive defect, uncorrected and corrected distance acuities for far and near (40 cm), intraocular aberrations (root mean square [RMS]), modulation transfer function (MTF) values, point-spread function, and Strehl ratio. RESULTS: The mean spherical equivalent (SE) was + 1.22 diopters (D) +/- 3.62 (SD) preoperatively and +0.39 +/- 0.51 D/D postoperatively; 69.32% of eyes were within +/- 0.50 and 86.36%, within +/- 1.00 D. The mean acuities were as follows: uncorrected distance, 0.75 +/- 0.20; best corrected distance, 0.94 +/- 0.11; best distance-corrected near, 0.90 +/- 0.14. Near corrected acuity was J1 in 91.76% of eyes and J2 in 4.71%. The mean aberration values were total RMS, 1.45 +/- 0.73 mu m; spherical, 0.25 +/- 0.10 mu m; coma, 0.37 +/- 0.21 mu m. The mean Strehl ratio was 0.26 +/- 0.05. The mean 0.5 MTF was 1.60 +/- 0.63 cycles per degree (cpd) and the mean cutoff value, 50.25 +/- 17.18 cpd. CONCLUSIONS: The Acri.Lisa 366D diffractive multifocal IOL gave good efficacy, predictability, and safety and excellent visual acuity at distance and near. An intraocular optical performance model showed good intraocular aberration, Strehl ratio, and MTF values.