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

Abstract

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.

Contrast Sensitivity and Patient Reported Outcomes After Bilateral Implantation of a Bi-Aspheric Hydrophobic Trifocal Diffractive Intraocular Lens

“…With regard to the patient reported outcomes ( Tables 3 and 4 ), the results are in agreement with those reported by Palomino-Bautista et al 30 and Cano-Ortiz et al 31 with the same IOL. In the Palomino-Bautista et al 30 study, where patients were asked to score their satisfaction level, as well as the level of halo perception and bothersomeness, on a scale from 0 to 10, the average response was 8.32 (out of 10) with regard to overall satisfaction with vision after surgery, and 4.36 (out of 10) with regard to halo bothersomeness.…”

“…With regard to the patient reported outcomes ( Tables 3 and 4 ), the results are in agreement with those reported by Palomino-Bautista et al 30 and Cano-Ortiz et al 31 with the same IOL. In the Palomino-Bautista et al 30 study, where patients were asked to score their satisfaction level, as well as the level of halo perception and bothersomeness, on a scale from 0 to 10, the average response was 8.32 (out of 10) with regard to overall satisfaction with vision after surgery, and 4.36 (out of 10) with regard to halo bothersomeness. In the Cano-Ortiz et al 31 study, where the Catquest-9SF and visual symptoms questionnaires were used, all patients reported being satisfied with their vision at present (reporting a mean score of 3.60±0.50 out of 4), with 20% reporting some difficulties with vision in daily life and 80% no difficulty at all (mean score reported was 3.80±0.41 out of 4).…”

Clinical Outcomes of a Bi-Aspheric Trifocal Diffractive Intraocular Lens

“…A direct comparison with earlier studies on this trifocal IOL at this specific follow-up was unfeasible, as, to the best of the authors’ knowledge, this represents the inaugural investigation evaluating the performance of this IOL at the 6-month mark post-implantation. Palomino-Bautista et al 6 analyzed the depth-of-focus and visual performance on 25 consecutive patients implanted with this IOL model at 1- and 3-months after implantation. At 3 months postop, they found mean values of −0.05±0.06, 0.03±0.08 and 0.04 and 0.08 logMAR for CDVA, CDIVA and CDNVA, respectively.…”

“…Considering an absolute depth-of-focus as the range of visual acuity values ≤0.3 logMAR, 15 considered as an adequate standard of distance vision for driving, it was about 4.50D from +1.00 to −3.50D. Palomino-Bautista et al 6 obtained a mean monocular value of 4.82±0.69D when the same 0.3 logMAR cutoff value was considered, and Cano-Ortiz et al 7 a binocular value of 3.64±0.70D considering a 0.1 logMAR threshold. The curves obtained in the present study show a peak at 0D of defocus (distance vision) with an average visual acuity around 0 logMAR, followed by a smooth decline up to −1.00D of defocus (equivalent to 1 m) and another peak at about −2.00D (equivalent to 50 cm) with a visual acuity better than 0.10 logMAR.…”

Major clinical considerations of the use of hydrophobic intraocular lenses in patients with cataracts: a brief systematic review

“…The average response to visual satisfaction queries was 8.24/10 at a distance, 8.04/10 at intermediate, and 7.88/10 at close range. Therefore, patients implanted with this trifocal IOL showed a significant improvement in visual acuity at different distances, providing broad absolute and relative values of depth of field, with good patient satisfaction rates [23].…”