Gross S., Dressler N., Krummenauer F., Dick H. B.

University Eye Hospital, Johannes Gutenberg-University, Langenbeckstr. 1, 55131 Mainz, Germany

Sometimes it is difficult to compare different IOL-designs because of the various parameters like astigmatism, posterior opacity and refraction. We compared 4 IOLs in a clinical trial, SA-40N (Allergan), SA-40NB (Allergan) 911 CeeOn Edge (Pharmacia) and a new IOL-Design.
Patients and methods: 20 volunteers, age </= 30, visual acuity >/= 20/10, corneal astigmatism </= 0.20. We determined the contrast sensitivity by Halogen Glare testing and Regan charts with and without glare. With the Reiner device we could simulate the implantation of different IOLs and the influence of pupil diameter and astigmatism.
Results: The monofocal IOLs induced a higher level of contrast sensitivity than multifocal lenses with and without glare. Without astigmatism, the differences were less clearly than with astigmatism. With glare and astigmatism the monofocal lenses showed a statistically higher contrast sensitivity as the multifocal IOLs. The SI-40 beat the 911 in the multifocal group.
Conclusion: The sharp-edge-design leads to a reduced contrast sensitivity at low contrast levels in particular in the case of pupil diameters >5mm and simultaneous glare. As expected the monofocal lenses showed a smaller loss of contrast sensitivity than multifocal lenses. The Reiner device is suitable for clinical trials to examine the influence of astigmatism, glare and pupil diameter to functional results of new IOL-designs.

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