Comparison of trifocal or hybrid multifocal-extended depth of focus intraocular lenses: a systematic review and meta-analysis

Zhong, Yueyang; Wang, Kai; Yu, Xiaoning; Liu, Xin; Yao, Ke

doi:10.1038/s41598-021-86222-1

Cited by 29 publications

(26 citation statements)

References 42 publications

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“…Therefore, it is indicated the postoperative level in dependence for near vision was possibly higher in the EDOF IOLs than the diffractive MIOLs. It is also consistent with the fact that EDOF IOLs, with an extended far focus area which reaches to the intermediate distance, restore distance and intermediate visual function but with restraint of near vision ( 27 – 29 ). In Ferreira et al's study ( 21 ), more patients implanted with EDOF IOLs were free from glasses than those receiving monofocal IOLs.…”

Section: Discussionsupporting

confidence: 85%

Presbyopia-Correcting Intraocular Lenses Implantation in Eyes After Corneal Refractive Laser Surgery: A Meta-Analysis and Systematic Review

et al. 2022

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PurposeTo assess the efficacy, safety, and predictability of presbyopia-correcting intraocular lenses (IOLs) in cataract patients with previous corneal refractive surgery.MethodsA systematic literature search was performed to identify studies evaluating the clinical outcomes of presbyopia-correcting IOLs implantation in cataract surgery after laser refractive surgery. Outcomes were efficacy, safety and predictability parameters.ResultsThe authors identified 13 studies, involving a total of 128 patients and 445 eyes. Presbyopia-correcting IOLs were effective at improving distance, intermediate and near visual acuity aftercataract surgery. The proportion of post-laser surgery eyes with uncorrected distance visual acuity (UDVA) ≥ 20/25 was 0.82 [95% confidence interval (CI), 0.74-0.90] and the pooled rates of spectacle independence at near, intermediate, and far distances were 0.98 (95% CI, 0.94-1.00), 0.99 (95% CI, 0.95-1.00) and 0.78 (95% CI, 0.65-0.94) respectively. The percentage of participants who suffered from halos and glare was 0.40 (95% CI, 0.25-0.64) and 0.31 (95% CI, 0.16-0.60), respectively. The predictability had a percentage of 0.66 (95% CI, 0.57-0.75) and 0.90 (95% CI, 0.85-0.96) of eyes within ±0.5 diopters (D) and ±1.0 D from the targeted spherical equivalent.ConclusionsPresbyopia-correcting IOLs provide satisfactory results in terms of efficacy, safety and predictability in patients with previous corneal refractive surgery, but have a higher risk of photopic side effects such as halos and glare.

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Section: Discussionsupporting

confidence: 85%

Presbyopia-Correcting Intraocular Lenses Implantation in Eyes After Corneal Refractive Laser Surgery: A Meta-Analysis and Systematic Review

et al. 2022

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“…It has been reported in different clinical studies that trifocal IOLs can improve distance and near vision while providing a good level of intermediate vision. This type of IOL has been reported to produce less limitation in visual function and less spectacle dependence than seen in patients implanted with bifocal or monofocal IOLs [ 1 , 2 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Different designs have been launched on the market and are available for consideration by cataract and refractive surgeons. Some reviews have shown that the use of trifocal IOLs in cataract patients improves intermediate visual acuity compared to patients implanted with bifocal IOLs [ 1 , 2 , 3 ]. The addition of a third focus, specifically designed to enhance intermediate vision, compared to classic bifocal designs has increased the use of trifocal IOLs among surgeons aiming to provide their patients with a better visual performance over the entire range of distances.…”

Section: Introductionmentioning

confidence: 99%

“…This was the primary reason for the development of trifocal IOLs: to provide pseudophakic patients with the possibility of useful vision across a wide range, thus allowing a reduction in spectacle dependence. Despite the improvement in visual acuity observed with trifocal IOLs, some complaints of glare and/or halos may be found in these types of designs [ 3 , 4 ]. There are different designs of trifocal IOLs created by IOL manufacturers and, therefore, a different design may provide different visual outcomes when implanted.…”

Section: Introductionmentioning

confidence: 99%

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Visual Performance, Satisfaction, and Spectacle Independence after Implantation of a New Hydrophobic Trifocal Intraocular Lens

Cano-Ortiz¹,

Sánchez-Ventosa²,

González-Cruces³

et al. 2022

JCM

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The main objective was to evaluate distance, intermediate, and near vision in patients who have undergone cataract extraction with bilateral implantation of a new trifocal diffractive intraocular lens (IOL), along with patient-reported outcomes (PRO). A total of 50 eyes from 25 patients after AsqelioTM Trifocal IOL (AST Products, Inc., Billerica MA, USA) implantation were assessed in this study. At 3 months after surgery, the photopic visual acuity (VA) at distance, intermediate, and near distances was measured. Binocular photopic defocus curves were also obtained. Three questionnaires to assess patients’ visual satisfaction and spectacle dependence, among other items, were completed: the Catquest-9SF, the patient-reported spectacle independence questionnaire (PRSIQ), and the patient-reported visual symptoms questionnaire (PRVSQ). The average spherical equivalent was 0.21 ± 0.37 D at 3 months post-operation, and the average absolute tolerance to defocus was 3.64 ± 0.70 D. The mean binocular uncorrected VAs for distance, intermediate, and near vision were −0.02 ± 0.09, 0.06 ± 0.08, and 0.11 ± 0.07 logMAR, respectively. The best-corrected VA was better than 0.1 logMAR for the whole range from distance to near. PROs revealed spectacle independence and general satisfaction with vision, and the incidence of photic phenomena were low. This study shows that the new bi-aspheric diffractive trifocal IOL provides a good visual performance at different distances under photopic conditions, accompanied by patient satisfaction and spectacle independence.

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“…Trifocal intraocular lens (IOL) implantation in patients submitted to cataract or clear lens surgery has improved the visual outcomes at different distances, from far to near, expanding the range of useful vision and allowing spectacle independence. The benefit of using these lenses in terms of visual performance has been pointed out in several systematic reviews and meta-analysis, where the improvement in visual acuity at intermediate distance is considerable better than that found in patients implanted with bifocal lenses [ 1 – 3 ]. Given the increasing amount of time that people over the age of 45 spend on activities that require intermediate vision, such as computer work or cooking, there is an increasing number of patients implanted with these lenses around the world who improve intermediate vision while maintaining distance vision.…”

Section: Introductionmentioning

confidence: 99%

Depth of field and visual performance after implantation of a new hydrophobic trifocal intraocular lens

et al. 2022

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Purpose To assess the depth of field (DOF) by means of defocus curve analysis applying different visual acuity criteria in patients following cataract surgery and bilateral implantation of a new trifocal diffractive intraocular lens (IOL). Methods Fifty eyes of 25 consecutive patients who underwent implantation of the Asqelio™ trifocal IOL (AST Products Inc., USA) were enrolled in this observational prospective study. Monocular subjective DOF was obtained from defocus curves with absolute and relative criteria of tolerance for different visual acuities values. Patient’s visual satisfaction, postoperative refraction and visual acuity at far, intermediate (67 cm) and near (40 cm) distances were also measured at 1 and 3-months post-surgery. Analysis of variance was used to assess differences in refractive error after the surgical procedure, and paired t-tests were used to assess differences in VA. Patient satisfaction results were reported as percentages. Results Spherical equivalent was 0.05 ± 0.23 D and residual cylinder 0.01 ± 0.23 D 3-months after the surgery. Absolute DOF obtained was 3.29 ± 0.91 D considering 0.1 LogMAR as cut-off value, and 4.82 ± 0.69 D when 0.3 logMAR as cutoff value. Relative DOF considering a drop of 0.1 logMAR from maximum visual acuity was 2.57 ± 0.82 D, and 1.27 ± 0.70 D when a drop of 0.04 logMAR was considered. Visual acuities obtained 3-months after the surgery were 0.03 ± 0.13, − 0.05 ± 0.06, 0.03 ± 0.08 and 0.04 ± 0.08 logMAR for uncorrected and best-corrected for distance, and best distance-corrected for intermediate and near distances, respectively. Average response to visual satisfaction queries was 8.24/10 at distance, 8.04/10 at intermediate, and 7.88/10 at near. Conclusions Patients implanted with this trifocal IOL showed a significant improvement in visual acuity at different distances providing wide absolute and relative DOF values. The outcomes demonstrate that this lens is predictable yielding good patient satisfaction rates.

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Comparison of trifocal or hybrid multifocal-extended depth of focus intraocular lenses: a systematic review and meta-analysis

Cited by 29 publications

References 42 publications

Presbyopia-Correcting Intraocular Lenses Implantation in Eyes After Corneal Refractive Laser Surgery: A Meta-Analysis and Systematic Review

Presbyopia-Correcting Intraocular Lenses Implantation in Eyes After Corneal Refractive Laser Surgery: A Meta-Analysis and Systematic Review

Visual Performance, Satisfaction, and Spectacle Independence after Implantation of a New Hydrophobic Trifocal Intraocular Lens

Depth of field and visual performance after implantation of a new hydrophobic trifocal intraocular lens

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