Through-Focus Vision Performance and Light Disturbances of 3 New Intraocular Lenses for Presbyopia Correction

Abstract

Purpose To compare the through-focus visual performance in a clinical population of pseudophakic patients implanted with two new trifocal intraocular lenses (IOLs) and one extended depth of focus IOL. Methods Prospective, nonrandomized, examiner-masked case series. Twenty-three patients received the FineVision® and seven patients received the PanOptix™ trifocal IOLs. Fifteen patients received the Symfony extended depth of focus IOL. Mean age of patients was 63 ± 8 years. Through-focus visual acuity was measured from –3.00 to +1.00 D vergences. Contrast sensitivity was measured with and without a source of glare. Light disturbances were evaluated with the Light Distortion Analyzer. Results Though-focus evaluation showed that trifocal IOLs performed significantly better at near distance (33 and 40 cm), and extended depth of focus performed significantly better at intermediate distance (1.0 m). Contrast sensitivity function with glare and dysphotopsia was similar between the three IOLs and subjective response to questionnaire showed a significantly higher score (worse performance) for the extended depth of focus IOL compared to both trifocal IOLs in the bothersome subscale (p < 0.05). Conclusions Trifocal IOLs grant better performance at near distance while extended depth of focus IOL performs better at intermediate distance. Objective dysphotopsia measured with the Light Distortion Analyzer is not reduced in extended depth of focus IOL compared to trifocal IOLs.

Light disturbance with multifocal contact lens and monovision for presbyopia

“…However, some of the commercially available techniques are limited in their ability to discriminate the light disturbance in all directions or do not measure the detailed shape and irregularity features. Previous studies showed an increase of about 15-23% in light distortion by multifocal intraocular lens (IOL) when compared to monofocal IOL implantation, with trifocal IOL inducing lower values of light distortion than extended depth of focus IOL [26] or bifocal IOLs.15 So far, few studies evaluated the perception of light disturbances in multifocal CL wearers. Besides, the contribution of dominance and the difference in optical design within the same multifocal CL, as well as the binocular summation effect are not completely known [27].…”

Clinical Outcomes with a New Model of Extended Depth of Focus Intraocular Lens

“…Hamid and Sokwala [13] reported in a comparative study that the perception of halos with a trifocal IOL was more disturbing compared to EDOF IOLs. However, other authors such as Escandón-García et al [22] found in a prospective case series that objective dysphotopsia measured with a light distortion analyzer was not reduced in eyes implanted with EDOF IOLs compared to trifocal IOLs. Possibly, in some patients with specific characteristics, the tolerance to the double halo generated by trifocal IOLs [23] is similar to that associated to the halos of lower magnitude generated by EDOF IOLs.…”

Efficacy and safety of extended depth of focus intraocular lenses in cataract surgery: a systematic review and meta-analysis

“…Six studies [18][19][20][22][23][24] better with EDOF IOLs than with monofocal IOLs in the defocus levels from -1.0 to -4.0 D. VA was significantly better in trifocal IOL group than in EDOF IOL group from -2.5 to -4.0 D ( Table 2). The sensitivity analysis showed that no single study significantly changed the pooled estimate, indicating the results of defocus curves were stable.…”

“…Seven studies [10,18,[20][21][22][23][24] reported contrast sensitivity and the results are summarized in Table 3.…”

“…The U.S. FDA clinical trial reported that the median contrast scores for the EDOF IOL group were reduced compared to the monofocal control group under both conditions and each spatial frequency [24]. Pilger [18]. Two studies reported no difference in contrast sensitivity between EDOF and trifocal IOLs [22,23].…”