Contrast sensitivity with bifocal intraocular lenses is halved, as measured with the Freiburg Vision Test (FrACT), yet patients are happy

  • Alexandra AntonEmail author
  • Daniel Böhringer
  • Michael Bach
  • Thomas Reinhard
  • Florian Birnbaum
Refractive Surgery



As the desire for spectacle independence following cataract surgery grows, so does interest in the implantation of multifocal intraocular lenses. However, glare phenomena, reduced intermediate vision and loss of image quality are known problems associated with this new generation of lenses. We compared the functional results achieved by the implantation of the diffractive-refractive Acri.LISA 366D lenses to those achieved from implanting monofocal Acri.Smart 46LC lenses.


In a retrospective data analysis we followed ten patients who received bifocal intraocular lenses (Acri.LISA 366D) and ten patients who received monofocal intraocular lenses (Acri.Smart 46LC). Lenses were always implanted in both eyes. In each group we assessed visual acuity and contrast sensitivity with the Freiburg Vison Test (FrACT) at multiple distances ranging from 0.5 to 5 m. Additionally, we assessed near vision with the Birkhaeuser charts. We also evaluated photopic phenomena and patient satisfaction using a standardised questionnaire. One patient in the Acri.LISA group and six patients in the control group missed the recommended follow-up visits.


We found good uncorrected distance and near visual acuity. Only three of nine patients wore glasses occasionally. Although their contrast sensitivity decreased by a factor of two compared to the control group, patients did not complain about visual disturbances. Patient satisfaction was predominantly high following Acri.LISA 366D implantation.


With the Acri.LISA 366D, patients demonstrate excellent near and distance vision, albeit with reduced contrast sensitivity. Acri Lisa is a viable option in patients that do not want to depend on spectacles.


Multifocal intraocular lens Visual acuity Contrast sensitivity 


Financial support

The bifocal intraocular lenses were donated by Carl Zeiss Meditec AG, Jena, Germany.

Financial disclosure

None of the authors has any proprietary or financial interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Alexandra Anton
    • 1
    Email author
  • Daniel Böhringer
    • 1
  • Michael Bach
    • 1
  • Thomas Reinhard
    • 1
  • Florian Birnbaum
    • 1
    • 2
  1. 1.Eye CenterUniversity of FreiburgFreiburgGermany
  2. 2.Eye HospitalKlinikum Bremen-Mitte GmbHBremenGermany

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