Multifocal lenses are more and more used for refractive surgery, especially as presbyopic lens exchange (PRELEX). With this indication postoperative optical qualities in comparison to preoperative results should be of main concern. Therefore we examined contrast sensitivity, low contrast visual acuity, glare visual acuity and night driving ability in PRELEX patients pre- and postoperatively.

20 patients (40 eyes) after PRELEX with different multifocal lenses of the new generation (*Acri.Twin, ReSTOR, ReZoom, Tecnis ZM001) were examined preoperatively and 6 months postoperatively. Contrast sensitivity (Pelli Robson charts), low contrast visual acuity (Humphrey AR 570), glare visual acuity (Humphrey AR 570) and night driving ability (Mesoptometer II, Fa. Oculus) were tested binocularly.

Preoperative contrast sensitivity was 1.5 on average, postoperative it was 1.65. Low contrast visual acuity dropped from 68% preoperatively to 49% postoperatively, glare visual acuity from 55% to 35%. Mesoptometer measurements revealed night driving ability under strict criteria for 16 patients pre- and postoperatively as well.

The new generation multifocal lenses show limitations concerning low contrast and glare visual acuity. Whereas postoperative Mesoptometer measurements correspond with preoperative measurements.

Correction of presbyopia with multifocal lenses (PRELEX) is reliable, but also with the lenses of the newest generation it is still a compromise concerning optical qualitites.