Comparison of visual outcomes of a diffractive trifocal intraocular lens and a refractive bifocal intraocular lens in eyes with axial myopia: a prospective cohort study

Abstract

Background To assess and compare the efficacy, safety, accuracy, predictability and visual quality of a diffractive trifocal intraocular lens (IOL) and a refractive rotationally asymmetric bifocal IOL in eyes with axial myopia. Methods This prospective cohort study enrolled patients with implantation of the diffractive trifocal IOL or the refractive bifocal IOL. Eyes were divided into four groups according to the IOL implanted and axial length. Manifest refraction, uncorrected and corrected visual acuity at far, intermediate and near distances, prediction error of spherical equivalent (SE), contrast sensitivity and aberrations were evaluated three months after surgery. Results In total, 80 eyes of 80 patients were included: 20 eyes in each group. Three months postoperatively, the corrected distance visual acuity of two trifocal groups were significantly better than the axial myopia bifocal group (P = 0.007 and 0.043). There was no significant difference of postoperative SE (P = 0.478), but the SE predictability of the trifocal IOL was better, whether in axial myopia groups (P = 0.015) or in control groups (P = 0.027). The contrast sensitivity was similar among four groups. The total aberration, higher order aberration and trefoil aberration of bifocal groups were significantly higher (all P < 0.001). Conclusions The diffractive trifocal IOL and the refractive bifocal IOL both provided good efficacy, accuracy, predictability and safety for eyes with axial myopia. By contrast, the trifocal IOL had a better performance in corrected distance visual acuity and visual quality. Trial registration The study was retrospectively registered and posted on clinicaltrials.gov at 12/02/2020 (NCT04265846).

Extended depth of focus IOL in eyes with different axial myopia and targeted refraction

“…Besides, we found that reflected from the similar CDVA among groups, EDOF IOLs offered reliable efficacy for the eye with various postoperative residual myopic refraction, even for the eyes targeted between − 2.25 to -1.50. Sun [ 19 ] and Steinwender [ 14 ] emphasized the superior corrected distance visual acuity achieved with the diffractive trifocal IOL. Sun et al [ 20 ] reported that trifocal IOL offered stable and satisfactory visual outcomes for eyes with long AL.…”

Agreement between Two Devices for Measuring Pupil Diameter in Patients Implanted with Multifocal Intraocular Lenses

“…Previous clinical studies on MIOLs have used this device to report PP. For instance, Tañá-Sanz et al [ 14 ] reported a mean pupil size of 2.4 mm in a sample of patients with a mean age of 72 years, and Sun et al [ 15 ] reported a mean pupil size of 3.3 mm in a sample of patients with a mean age of 66 years. Other authors have also used Pentacam for reporting PP in their studies with mean pupil sizes in the range of 2.4 to 3.3 mm depending on the mean age of the sample [ 16 , 17 , 18 , 19 ].…”