Factors for good near and distance visual outcomes of multifocal intraocular lens with inferior segmental near add

Purpose: This study was conducted to investigate factors related to postoperative good near and distance visual outcomes in the Lentis Mplus LS-313 MF20 (Oculentis Gmbh, Berlin, Germany) intraocular lens (IOL)-implanted eye. Methods: A retrospective cross-sectional study analyzed a total of 198 eyes of 198 patients. Patients with 20/20-or-more uncorrected distance visual acuity (UDVA, 5 m) and J2-or-more uncorrected near visual acuity (UNVA, 40 cm) were distributed into the good visual outcome (GVO) group (n = 96), and the remaining patients were distributed into the moderate visual outcome (MVO) group (n = 102). Differences between the two groups were compared for patient age, preoperative measurements (kappa distance, kappa angle, and pupil size), and postoperative measurements (residual sphere, cylinder, and spherical equivalent) to explore factors related to good visual outcomes after IOL implantation. Results: The average age of the GVO group (56.2 years) was significantly lower than that of the MVO group (58.6 years), and the average kappa distance of the former was significantly smaller than that of the latter. However, there were no significant differences between the two groups in kappa angle and pupil size. Notably, multivariate binary regression analysis revealed that multiple factors including age, residual cylinder, and spherical equivalent were associated with good visual outcomes. Based on the receiver operating characteristic curve, cutoff values regarded as good visual outcome following cataract surgery were calculated to be − 0.38 CD in residual cylinder and − 0.32 D in residual spherical equivalent. Conclusions: Patients with implanted Lentis Mplus LS-313 MF20 IOL who are young, had small kappa distance, and had low levels of postoperative residual cylinder and spherical equivalent tended to exhibit good vision at both near and distance. These results imply that surgeons should minimize postoperative residual cylinder and spherical equivalent to provide good visual outcomes to patients with implanted Lentis Mplus LS-313 MF20 IOL.