With Trifocal IOL, 90% Achieve Spectacle Independence

The lens offers distance, intermediate and near vision.

Many patients are unaware that they may still need eyeglasses for near work after cataract surgery, and accordingly some express interest in a multifocal intraocular lens (IOL) to obtain spectacle independence. A prospective investigation assesses 30 participants’ refractive outcomes, satisfaction, and spectacle independence using PanOptix® (Alcon), the only trifocal IOL currently approved in the US, according to the study published in Clinical Ophthalmology.

The PanOptix lens is designed for intermediate vision at approximately 60 cm, suited to computer viewing. In the current single-center analysis, toric or nontoric PanOptix IOLs were implanted bilaterally during the participants’ cataract surgeries between May 2020 and February 2021. At their 1- and 3-month follow-up exams, visual acuity was tested at 60 cm, in addition to 4 m for distance, and 40 cm for near focus. All completed the Patient Reported Spectacle Independence Questionnaire (PRSIQ) 3 months after surgery. 

Researchers noted no significant differences in refractive outcomes between those with toric and nontoric lenses (P >.19). Of 60 eyes, 51 (85%) achieved refraction equal to or better than 0.50 D, and ≤0.50 D of cylinder. Mean logMAR was sharpest at intermediate focus —uncorrected and corrected — but differences varied by no more than half a line. “Best distance corrected visual acuity was better than uncorrected acuity at all test distances, though again the mean differences at all distances were 2 letters or less,” the analysis explains.

PRSIQ results showed that 26 (87%) participants did not need eyeglasses for near work, and only 1 patient used spectacles for distance vision. Of the 30, 90% indicated they no longer wore spectacles, or wore them “only a little” among the several focus lengths. Also, more than 90% stated they were “mostly” or “completely” satisfied with their overall sight, as well as vision when not using glasses or contacts for the 3 distances.

After 1 month, 2 patients underwent bilateral YAG capsulotomy, and 6 more were slated to receive this procedure at 3 months. This number is somewhat high, according to the study, but it represents the clinic’s directive to reduce scattered light that affects vision quality. With multifocal IOLs, vision disturbances typically necessitate YAG more often than decreased acuity. No significant adverse events were noted in this study. 

The mean age of participants was 67 years. All completed the 3-month follow-up, although 2 patients were absent from their 1-month exam. Limitations of the investigation included a small sample size at a single center, and no assessment of low contrast acuity. Conversely, a strength is the combination of objective and subjective data.

Previous research suggests that with multifocal IOLs, independence from eyeglasses occurs less often for near than at other distances. However, “the current study showed 90% of [participants] wore glasses little or none of the time for near work, while the figure was 95% in those [participants] with a correction within 0.50 D of intended with ≤0.50 D of refractive cylinder,” the study adds.

Disclosures: This research was supported by Alcon. The study authors have declared affiliations with biotech, pharmaceutical, and/or medical device companies. Please see the original reference for a full list of authors’ disclosures.


Blehm C, Potvin R. Reported patient satisfaction and spectacle independence following bilateral implantation of the panoptix® trifocal intraocular lens. Clin Ophthalmol. 2021;15(7):2907-2912. doi:10.2147/OPTH.S323337