Trifocal, Trifocal Toric IOLs Do Not Affect Spectral-Domain OCT Measurements

Researchers compared these advanced lens options to monofocal IOLs.

Compared with monofocal intraocular lenses (IOLs), trifocal and trifocal toric IOLs did not induce further changes on spectral-domain optical coherence tomography (OCT), according to research results published in the Journal of Glaucoma. 

Researchers conducted a crossover study to determine if trifocal or trifocal toric IOLs affect measurements of retinal parameters gathered via spectral-domain OCT. Patients at a single clinic in Madrid who underwent routine cataract surgery and implantation of 2 versions of the same model of trifocal IOL — toric and nontoric — were included in the study and were compared with patients implanted with a monofocal IOL. 

The study cohort included 150 eyes from 150 participants (mean age, 69.1±7.9 years) divided into 1 of 3 groups: monofocal IOL (n=50), trifocal IOL (n=50), and trifocal toric IOL implantation (n=50). 

Investigators evaluated numerous parameters, including macular thickness, retinal nerve fiber layer (RNFL), and macular volume; results of a multivariate regression showed no significant influence of estimated coefficients across any of these parameters (macular thickness B=0.144 µm/y; RNFL B=-0.027 µm/y; macular volume B=-0.005 µm3/y). 

Mean pre- and postoperative signal strength values for all 3 groups were also evaluated. In the monofocal IOL group, signal strength increased after implantation and was similar following both trifocal and trifocal toric IOL implantation (P <.001, P =.07, and P =.023). 

Across the 3 IOL groups, there were statistically significant differences in macular difference and macular volume (P <.0001 for all cases); RNFL thickness showed no statistically significant differences before and after surgery (P >.05 for all groups). 

Mean values for differences in macular thickness, macular volume, and RNFL thickness before and after surgery were also similar, with no statistically significant differences for any of the 3 groups (P >.05 for all). 

“Some OCT measurements may undergo changes after the implantation of monofocal, trifocal, and/or trifocal IOLs. However, the results of this study suggest that trifocality and toricity for astigmatic correction with the trifocal IOLs under study do not induce additional changes in OCT measurements,” according to the study. “The retinal management and analysis of retinal images of these patients by means of spectral-domain OCT devices should be similar to those of patients implanted with monofocal IOLs.”  


Rementería-Capelo L, García-Pérez JL, Contreras I, Blázquez V, Ruiz-Alcocer J. Impact of trifocal and trifocal toric intraocular lenses on spectral-domain OCT retinal measurements. J Glaucoma. 2021;30(4):300-303. doi:10.1097/IJG.0000000000001743