Comparison of three different presbyopia-correcting intraocular lenses

Abstract

Objective (aim): to test the refractive and visual outcomes and the quality of vision after the bilateral implantation of three different multifocal intraocular lenses (MIOLs) in patients with age-related cataract. Methods: In this retrospective, comparative study including 90 eyes of 45 cataract patients, bilateral implantation of either the hydrophilic trifocal Liberty® 677MY capsular bag IOL, the hydrophilic AT LISA® tri 839M lens, or the hydrophobic AcrySof® IQ PanOptix® IOL was performed during routine cataract surgery. Refractive outcomes, visual acuities (VA) for far, intermediate and near distances, as well as visual quality, dysphotopic events and spectacle use were evaluated six months postoperatively. Results: VA curves were similar for the three MIOLs, however the Liberty lens seemed to be superior for far and near, while AT LISA tri provided somewhat better VA in the intermediate range. Refractive correction was the most effective with the Liberty IOL (p=0.0131). Dysphotopic phenomena were usually perceived in low light conditions. Their frequency was lower with the AT LISA tri and Liberty lenses. Symptoms were significantly less disturbing for patients implanted with the Liberty lens, two-thirds of AT LISA tri and Liberty patients, while only 57% of PanOptix patients achieved spectacle independence. Conclusions: All examined MIOLs were found to be safe and efficient in presbyopia-correction of cataract patients, however different models had different advantages. The vision preferences of each patient should always be taken into consideration when choosing a MIOL, and the possible occurrence of dysphotopic events should be also clearly communicated in each case. Abbreviations: ACD = Anterior chamber depth, ANOVA = Analysis of variance, AXL = Axial length, CDVA = Corrected distance visual acuity, CYL = Cylinder; Cylindric refraction, D = Diopter, IOL = Intraocular lens, K1; K2 = Keratometry values, MIOL = Multifocal intraocular lens, n = Number of cases, n.a. = Not applicable, Postop = Postoperative, QoV = Quality of Vision, SD = Standard deviation, SEQ = Spherical equivalent, SPH = Sphere; Spherical refraction, UDVA = Uncorrected distance visual acuity, UIVA = Uncorrected intermediate visual acuity, UNVA = Uncorrected near visual acuity, VA = Visual acuity

Comparison of Clinical Outcomes, Visual Quality and Visual Function of Two Presbyopia-Correcting Intraocular Lenses Made from the Same Material, but with Different Design and Optics

“…Visual outcomes reflect the refractive results. Both IOLs provided sharp vision at multiple distances (far, intermediate, near), and the uncorrected distance, intermediate and near visual acuities are in good agreement with previously published data for these lenses [21][22][23][24][25][26][27][28]. Nevertheless, a remarkably higher proportion of eyes achieved good functional monocular vision at multiple distances with the Liberty lens compared to the plate-haptic AT LISA tri.…”

“…These results are not as good as those reported in a study by Serdiuk et al, where 97% of Liberty eyes and 71% of AT LISA tri eyes achieved a residual SEQ ≤ 0.5 D [21]. Nevertheless, a difference favoring the Liberty IOL is apparent in both studies [21]. Astigmatism outcomes in our study also showed differences between the two IOL models, with better results achieved with the Liberty IOL These results suggest that the Liberty lens is associated with more predictable refractive outcomes and a lower risk of postoperative refractive surprises.…”

“…Our results show that the residual SEQ refraction was within 0.5 D of the target in 89% of Liberty eyes and 59% of AT LISA tri eyes. These results are not as good as those reported in a study by Serdiuk et al, where 97% of Liberty eyes and 71% of AT LISA tri eyes achieved a residual SEQ ≤ 0.5 D [21]. Nevertheless, a difference favoring the Liberty IOL is apparent in both studies [21].…”

“…At 12 months following implantation, 56% of Liberty eyes and 41% of AT LISA tri eyes had a monocular distance vision of at least 20/20 (Snellen), and 89% of Liberty eyes vs. 75% of AT LISA tri eyes achieved at least 20/25. These results are inferior to those reported by both Serdiuk et al and Piovella et al [21,22]. However, the latter paper reported binocular results, which are usually more favorable than monocular visual acuities [22].…”

“…The intermediate vision results have to be interpreted with consideration of the testing distance. Some studies report data with intermediate vision measured at 80 cm, while others publish data measured at 66 cm from the eye [21,22,[28][29][30]. As the AT LISA tri lens has a +1.66 D addition and the Liberty IOL has a +1.75 D addition calculated at the IOL plane, we find it more expedient to focus on the intermediate vision data measured at 66 cm, which is roughly equivalent to a +1.50 D addition on the defocus curve.…”