Visual outcomes and safety after bilateral implantation of a trifocal presbyopia correcting intraocular lens in a Korean population: a prospective single-arm study

Abstract

Background To investigate the 3-month postoperative performance and safety after implantation of a trifocal intraocular lens (IOL) in a Korean population. Methods This was a clinical, prospective, multicenter, single-arm study. Forty-four subjects (88 eyes) with bilateral cataract with expected postoperative corneal astigmatism of < 1.00 diopter (D) and no ocular disease or eye condition underwent bilateral implantation of the AcrySof IQ® PanOptix IOL (TFNT00). Postoperative examination at 3 months included binocular defocus curve; binocular best corrected distance visual acuity (BCDVA); monocular/binocular uncorrected VA (UCVA) at distance (4 m), intermediate (60 cm), and near (40 cm); contrast sensitivity under photopic conditions with/without glare; and subjective outcomes, including satisfaction and spectacle independence. Results Binocular defocus curve at 3 months after bilateral implantation showed VA of 0.1 logMAR or better from + 0.5 D through − 2.5 D. Binocular BCDVA mean ± SD at 4 m was − 0.05 ± 0.07 logMAR. Binocular and monocular UCVA was 0.03 ± 0.1 and 0.08 ± 0.12 logMAR (4 m), − 0.00 ± 0.11 and 0.05 ± 0.13 logMAR (60 cm), and 0.03 ± 0.12 and 0.09 ± 0.13 logMAR (40 cm), respectively. Contrast sensitivity with glare was 1.67 ± 0.13, 1.91 ± 0.17, 1.54 ± 0.21, and 1.14 ± 0.20 log units at 3, 6, 12, and 18 cycles/degree, respectively. At near and intermediate distances, 84 and 77% of subjects reported good/excellent satisfaction, and 84 and 91% of subjects reported spectacle independence, respectively. Conclusions In a Korean population, visual performance of the trifocal TFNT00 IOL 3 months postoperatively was < 0.1 logMAR for binocular UCVA at all distances, with high subject satisfaction and spectacle independence. Trial registration www.ClinicalTrials.gov ( NCT03268746 ). Registered August 31, 2017.

Comparative analysis of a presbyopia-correcting intraocular lens that combines extended depth-of-focus and bifocal profiles with a standard monofocal intraocular lens

“…The defocus curve is a good means of assessing the DOF of the presbyopia-correcting IOL as a visual achievement indicator [32][33][34]. The ZFR00 provided a smooth defocus curve with a broader landing area than the ZCB00 (Fig.…”

Comparison of Visual Performance and Patient Satisfaction After Multifocal Intraocular Lens Implantation and During Multifocal Contact Lens Wear After Monofocal Intraocular Lens Implantation: A Pilot Study

“…3.25 D near add powers. It uses zeroth, second, and third diffractive orders for distance, intermediate, and near foci, respectively, and the energy at the first diffractive order is redistributed to optimize optical performance at three focal points [4][5][6][7][8][9][10][11][12]. Postoperatively, steroidal (0.1% betamethasone), antibiotic (1.5% levofloxacin), diclofenac sodium (0.1% bromfenac) medications were topically administered for 2 weeks, with the dose being steadily reduced after that.…”

“…However, considering the prevalence of visual display terminals such as smartphones and personal computers, intermediate vision plays an essential role in overall optical performance in daily activities nowadays. Therefore, trifocal IOLs have recently been developed to rectify such drawbacks of bifocal IOL to improve intermediate vision and thus have been reported to be effective for continuously attaining near-to-far vision without spectacle correction [4][5][6][7][8][9][10][11][12]. Nevertheless, multifocal IOL explantation and subsequent monofocal IOL implantation were rare but sometimes necessary, possibly because of a loss of CS function such as waxy vision, photic phenomena, or neural adaptation failure [6].…”

“…Indeed, there are ongoing concerns about the loss of CS after diffractive multifocal IOL implantation and during refractive multifocal CL wear. Still, it has been demonstrated that trifocal IOLs are almost comparable to monofocal IOLs in terms of CS function, possibly because they are designed to effectively use 88% of the available light intensity [8][9][10]12]. Furthermore, it has been reported that wearing bifocal CLs slightly reduced CS at high spatial frequencies, but that CS function remained within the normal range in these eyes [19,20].…”

“…Multifocal IOL implantation been has shown to be effective for attaining good near and far vision, thus reducing spectacle dependence of cataract patients [1][2][3]. Especially trifocal IOLs have been reported to provide good near, intermediate, and far vision and subsequent high patient satisfaction in recent years [4][5][6][7][8][9][10][11][12]. However, some patients are dissatisfied with their vision quality, possibly due to glare, halo, starburst, refractive errors, concomitant eye diseases, or neural adaptation failure [13][14][15].…”