Purpose To compare clinical outcomes after implantation of TECNIS diffractive multifocal intraocular lenses (IOLs) with different add powers. Design Prospective, comparative, interventional case series. Methods Subjects underwent cataract extraction and diffractive multifocal IOL implant. Subjects had an additional add power of +2.75 diopters (D) (Group 1, 23 eyes), +3.25 D (Group 2, 21 eyes), or +4.00 D (Group 3, 21 eyes). Evaluations were performed 1 and 3 months following cataract surgery, including measurement of monocular uncorrected distance visual acuity (UDVA), refractive error (manifest refraction [MR]), and monocular uncorrected near visual acuity (UNVA) at 33, 40, and 50 cm. At 3 months, internal aberrations and contrast sensitivity were evaluated and subjects completed a questionnaire on outcomes satisfaction, visual symptoms, and spectacle use. Results Sixty-five eyes (43 subjects) were included. After surgery, no significant differences between groups were observed in UDVA and MR values. UNVA at 33 cm was best in Group 3 (1 month: P =.032; 3 months: P =.031). Three months after surgery, UNVA was best in Group 1 at 50 cm (P =.017). No significant differences in internal aberration and contrast sensitivity were observed between groups and surgical satisfaction was worst in Group 3 (P =.001). A total of 87.0%, 85.7%, and 76.9% had spectacle independence in Groups 1, 2, and 3, respectively (P =.080). Conclusions TECNIS diffractive multifocal IOLs with lower add powers provide good vision over longer working distances and excellent distant vision. Subjects with lower add power had greater satisfaction, more spectacle independence, and fewer visual symptoms than those with +4.00 D add.
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