BackgroundToday, patients often expect to achieve spectacle independance after cataract surgery. New trifocal intraocular lenses have been developed to try and fullfill this demand. The purpose of this study is to report the short-term visual outcomes of a new trifocal intraocular lens (AcrySof PanOptix™).MethodsConsecutive adult patients undergoing cataract surgery with bilateral implantation of the study intraocular lens in a private practice clinic were considered for inclusion. Exclusion criteria were the presence of other ocular pathologies or preoperative astigmatism >1.5 diopters (D). Patients with intraoperative complications were excluded from analysis. One month after surgery patients underwent: monocular defocus curve; monocular and binocular uncorrected visual acuity in photopic and mesopic conditions, for far (4 m), intermediate (60 cm) and near (33 cm) distances and binocular contrast sensitivity. Patients completed a visual satisfaction questionnaire between 9 and 12 months after surgery.ResultsOne hundred and sixteen eyes of fifty-eight patients receiving bilateral implantation of the study intraocular lens were analysed. Mean binocular uncorrected visual acuity in photopic conditions was 0.03 LogMAR for far, 0.12 for intermediate and 0.02 for near distances. All patients achieved a binocular uncorrected visual acuity better than 0.3 LogMAR (20/40 Snellen equivalent) for distance and near vision and 94.8% of patients for intermediate vision. Mesopic binocular uncorrected visual acuity values were similar to photopic values. The monocular defocus curves showed that the best visual acuity was reached at a vergence of 0.00D. Visual acuity dropped slightly at −1.00D and peaked again at −2.00D. Visual acuities better than 0.2 LogMAR were maintained between −2.50D and +0.50D. Contrast sensitivity was high and similar in photopic and mesopic conditions. As regards patient-evaluated outcomes, only 2 patients (3.4%) were fairly dissatisfied with their sight after surgery. Three patients (5.1%) reported the need for spectacle correction for certain activities. All other patients (94.8%) reported never using spectacle correction.ConclusionsThe PanOptix trifocal IOL provides good short-term visual outcomes, with good intermediate performance and excellent patient-reported satisfaction. The similar values achieved in mesopic and photopic conditions in binocular uncorrected visual acuity and contrast sensitivity suggest low pupillary dependence for light distribution.Trial registration number ISRCTN60143265, retrospectively registered on the 24th of April 2017.

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Clinical relevance:The control of myopia progression is currently considered an evidence-based therapeutic need. Background: To determine the efficacy and safety of the Esencia lens, a new soft contact lens (SCL) designed to slow down myopia progression in paediatric patients. Methods: This study was a randomised, parallel, double-masked clinical trial. Seventy myopic (−0.50 to −8.75 D) boys and girls, 7-15-years of age, were randomised and allocated to one of two groups: (i) study (n = 36) or (ii) control (n = 34). Study group patients were given the Esencia lens, a progressive multifocal and reverse geometry SCL. Control group patients were given conventional SCLs. Efficacy measurements (change in cycloplegic autorefraction and axial length) were measured at baseline and at the six-month intervals over a 12-month period. Visual performance measurements were corneal power, comfort, quality of vision and contact lens fitting. Safety measures included detection of adverse events. Results: Mean changes in cycloplegic autorefraction after 12-months were −0.28 ± 0.35 D for study and −0.57 ± 0.52 D for control group patients (p = 0.02). A significantly lower increase in axial length was found in the study group (0.13 ± 0.12-mm) compared to control (0.22 ± 0.14-mm) patients (p = 0.03). Compared to control group patients, there was less myopia progression in the study group: 51 and 41 per cent in terms of cycloplegic autorefraction and axial length, respectively. No significant differences between groups for change in corneal power, comfort, vision quality and contact lens fitting were found (p > 0.05). Regarding safety, there were no serious and/or unexpected adverse events during the study. Conclusions: The Esencia lens seems to be efficacious in slowing down progression of myopia in children compared to traditional SCLs in the short term, with comparable safety features and visual outcomes.

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