Clinical Outcomes With a New Continuous Range of Vision Presbyopia-Correcting Intraocular Lens

Abstract

PURPOSE: To evaluate the clinical outcomes including patient-reported outcome measures in a sample of eyes undergoing bilateral cataract surgery with implantation of a new model of presbyopia-correcting intraocular lens (IOL). METHODS: This non-randomized prospective case series enrolled 206 eyes of 103 patients undergoing phacoemulsification cataract surgery with bilateral implantation of the TECNIS Synergy IOL (Johnson & Johnson Vision). High and low contrast visual acuity, refractive, defocus curve, and patient-reported visual performance (Catquest-9SF questionnaire) outcomes were evaluated during a 3-month follow-up. RESULTS: A total of 96.1% (99 of 103) and 91.3% (94 of 103) of patients achieved binocular postoperative uncorrected distance (UDVA) and near visual acuity (UNVA) of 0.00 logMAR (20/20), respectively. Mean postoperative mesopic UNVA for both eyes was 0.14 ± 0.03 logMAR. Likewise, mean binocular UDVA and UNVA were 0.00 ± 0.03 and 0.04 ± 0.02 logMAR. An almost flat mean defocus curve was obtained, with visual acuities between 0.00 and 0.10 logMAR for most defocus levels in both eyes. A reduction of contrast led to a limited but statistically significant change in UNVA in both eyes ( P < .001). The Rasch calibrated scoring of item 2 and the Rasch calibrated mean score of the Catquest-9SF questionnaire increased significantly with surgery ( P < .001). CONCLUSIONS: This new presbyopia-correcting IOL provides a continuous range of functional focus, with a limited deterioration under mesopic conditions, which is perceived as a satisfactory outcome by the patient if proper patient selection is performed. [ J Refract Surg . 2021;37(4):256–262.]

Comparison of refractive and visual outcomes of 3 presbyopia-correcting intraocular lenses

“…This indicates that the 3 trifocal IOLs evaluated have a similar performance at near (40 cm), with mean UNVA and CNVA values similar to those reported in previous studies. 2,4,5,16,25–28 Specifically, the mean binocular postoperative logMAR UNVA values of 0.01 ± 0.09, 0.01 ± 0.07, and 0.01 ± 0.10 logMAR were found in the Synergy, PanOptix, and Finevision groups of this study, respectively. Kohnen et al reported a mean binocular postoperative UNVA of 0.07 ± 0.11 logMAR in a sample of eyes implanted with the PanOptix trifocal IOL, whereas Gabric et al reported a mean value monocular UNVA of 0.10 ± 0.07 and 0.09 ± 0.06 for right and left eyes implanted with the Synergy IOL, respectively.…”

“…These results are consistent with those from other series reporting an incidence of disabling glare or halo below 10% for different types of trifocal IOLs. 9,26–28 Monaco et al confirmed in a comparative study that the QoV questionnaire results showed no differences in dysphotopsia between 2 presbyopia-correcting IOLs (PanOptix and Symfony IOLs). 31 Recently, Gabric et al found that disturbing halos were only reported by 1.9% of a sample of 103 patients bilaterally implanted with the Synergy IOL.…”

“…In any case, the 3 trifocal IOLs evaluated showed a functional visual acuity across vergence demands from 0 to −3.00 D, with results comparable with those obtained in previous series for each trifocal IOL. 2,5,25–28 For this reason, spectacle independence at distance, intermediate, and near vision was achieved in more than 96% of patients in all 3 groups. No significant differences in the level of spectacle independence were detected among trifocal IOL groups, although, at distance, the spectacle independence rate was slightly lower in the Finevision group, which was consistent with the myopic residual spherical equivalent found in this group.…”

“…Similarly, the visual acuity was also significantly better in eyes implanted with the PanOptix IOL compared with those implanted with the POD F IOL for the defocus of −1.00 D. The UIVA and DCIVA data obtained with the 3 IOLs evaluated in this study were consistent with data reported by previous authors using the same IOL models. 2,4,5,25–28 The mean binocular postoperative DCIVA of 0.04 ± 0.12 (60 cm) logMAR was found in an international multicenter study evaluating the clinical outcomes in eyes implanted with the PanOptix IOL. 2 In another comparative study, a mean monocular postoperative DCIVA of 0.05 ± 0.10 logMAR was found in a sample of 30 eyes implanted with the POD F trifocal IOL.…”

“…These excellent visual outcomes were consistent with those reported by other authors evaluating the clinical outcomes of the same trifocal IOLs. 2,4,5,16,25–28…”