Intraindividual Comparison of the Effect of Training on Visual Performance With ReSTOR and Tecnis Diffractive Multifocal IOLs

Purpose: Several studies have shown that after multifocal intraocular lens (IOL) implantation visual function improves gradually over a period of several months. To accelerate this learning process, a prospective, intraindividual comparative study was performed to investigate the efficacy of a special visual training program on the postoperative visual performance. Methods: Sixteen patients with bilateral phacoemulsification and multifocal IOL implantation in both eyes (Alcon ReSTOR [n=8] and AMO Tecnis ZM900 [n=8]) received computer-based visual training 6 weeks postoperatively based on the concept of perceptual learning of discrimination line orientations. The training was performed over 2 weeks in six sessions in one eye of each patient. The untrained fellow eye served as control. Before and after the training period and at 6 months, orientation visual acuity, distance visual acuity, contrast sensitivity, and near visual acuity for different contrast levels were assessed. Results: After 2 weeks of training, the mean improvement of orientation visual acuity in the trained eyes was 82%, which was significantly higher than the control eyes ( P <.001). Contrast sensitivity and near vision under different contrast levels showed a significant benefit of training. The superior function of the trained eyes was still present at 6 months. Conclusions: Visual performance after multifocal IOL implantation can be significantly accelerated by a specific 2-week training program. This effect is sustained over a 6-month period. [ J Refract Surg . 2008;24:287–293.]