Trifocal intraocular lenses: a comparison of the visual performance and quality of vision provided by two different lens designs

Abstract

PurposeTo compare two different diffractive trifocal intraocular lens (IOL) designs, evaluating longer-term refractive outcomes, visual acuity (VA) at various distances, low contrast VA and quality of vision.Patients and methodsPatients with binocularly implanted trifocal IOLs of two different designs (FineVision [FV] and Panoptix [PX]) were evaluated 6 months to 2 years after surgery. Best distance-corrected and uncorrected VA were tested at distance (4 m), intermediate (80 and 60 cm) and near (40 cm). A binocular defocus curve was collected with the subject’s best distance correction in place. The preferred reading distance was determined along with the VA at that distance. Low contrast VA at distance was also measured. Quality of vision was measured with the National Eye Institute Visual Function Questionnaire near subset and the Quality of Vision questionnaire.ResultsThirty subjects in each group were successfully recruited. The binocular defocus curves differed only at vergences of −1.0 D (FV better, P=0.02), −1.5 and −2.00 D (PX better, P<0.01 for both). Best distance-corrected and uncorrected binocular vision were significantly better for the PX lens at 60 cm (P<0.01) with no significant differences at other distances. The preferred reading distance was between 42 and 43 cm for both lenses, with the VA at the preferred reading distance slightly better with the PX lens (P=0.04). There were no statistically significant differences by lens for low contrast VA (P=0.1) or for quality of vision measures (P>0.3).ConclusionBoth trifocal lenses provided excellent distance, intermediate and near vision, but several measures indicated that the PX lens provided better intermediate vision at 60 cm. This may be important to users of tablets and other handheld devices. Quality of vision appeared similar between the two lens designs.

Comparison of the Visual Performance After Implantation of Bifocal and Trifocal Intraocular Lenses Having an Identical Platform

“…The trifocal FineVision IOLs were reported to perform better at -1.00, -2.00, and -2.50 D compared with the ReSTOR SV6AD2/SN6AD1 IOLs by Bilbao-Calabuig et al 4 ; at -1.00, -1.50, -2.00, and -2.50 D compared with Tecnis ZMB00 by Cochener 6 ; at -1.50 D only compared with the ReSTOR SND1T by Gundersen and Potvin 5 ; at -1.00 and -1.50 D compared with the ReSTOR SN6AD1 by Plaza-Puche and Alió 8 ; and at -1.00 D only under photopic and mesopic circumstances compared with the ReSTOR SN6AD1 by Jonker et al 3 It was demonstrated recently that a new trifocal IOL (PanOptix, Alcon Laboratories, Inc.) performed better at -1.50 and -2.00 D than the FineVision IOL. 18 The trifocal IOLs had two peaks of CDVA at distance and near, whereas there was no distinct peak in the intermediate zone of vision, as observed in our study and previous reports. 2,7 At vergences of -1.00, -1.50, and -2.00 D (corresponding to viewing distances from 1 m to 50 cm), the vision with the AT LISA tri IOL was significantly better than the AT LISA IOL.…”

Comparison between bilateral implantation of a trifocal intraocular lens and blended implantation of two bifocal intraocular lenses

“…At 80 cm, FineVision patients had better VA. From 60 cm and nearer PanOptix showed better results with a defocus curve very similar to our study. 16 Studies conducted on different commercial models of trifocal IOLs have reported good distance, intermediate and near VAs. In a study reporting 44 eyes of 22 patients implanted with FineVision (PhysIOL, Liège, Belgium) trifocal IOL, a full range of adequate vision was achieved, CS was satisfactory and there were no significant adverse photic phenomena after implantation.…”

Visual performance, reading ability and patient satisfaction after implantation of a diffractive trifocal intraocular lens

“…Even if a comparison between the outcomes of different type of trifocal and bifocal IOLs might be difficult due to the variability of follow-up intervals and testing methods between the published studies, 18 our visual acuity outcomes can be considered in line with that obtained with other trifocal IOL models. 16 , 19 A recent meta-analysis 18 considering prospective clinical trials on trifocal (including two cohort studies on AT Lisa 839 MP) and bifocal IOLs, found better intermediate visual acuity results with the trifocal IOLs, without significant differences in terms of distance and near visual acuity in comparison with bifocal IOLs. Nevertheless, the results on contrast sensitivity and subjective visual quality were less conclusive.…”