Trifocal IOLs Provide Good Functional Vision, High Spectacle Independence Rate

A newly designed hydrophilic diffractive–refractive trifocal intraocular lens (IOL) with centralized diffractive rings appears to provide good functional vision across all distances, with reduced patient symptoms of postoperative glare and halos, at a long-term follow up of 5 years after implantation during cataract surgery, according to a study published in the Journal of Cataract & Refractive Surgery.

From the prospective, longitudinal, single-center, interventional study, the authors reported 5-year visual, refractive, and patient-reported outcomes following implantation of the IOL during cataract surgery in patients with preexisting corneal astigmatism of less than 1.25 D.

In total, 100 eyes of 50 patients underwent bilateral implantation of a trifocal IOL during cataract surgery conducted by a single surgeon. Preoperative corrected distance (CDVA) and postoperative uncorrected distance visual acuity (UDVA), CDVA, uncorrected (UIVA) and corrected (CIVA) intermediate and uncorrected (UNVA) and corrected (CNVA) near visual acuity were measured. 

All patients were seen at 1 day, 1 month, 3 months, 6 months, 12 months, 24 months, and 5 years following surgery. Patients underwent contrast sensitivity and slit-lamp photography and completed a quality of vision questionnaire at months 3, 6, 12, and 24 and year 5. 

At 5 years of follow up, 74 eyes of 37 patients were analyzed. Patients demonstrated postoperative mean UDVA of 0.02±0.10 logMAR, mean CDVA of 0.04±0.07 logMAR, mean UIVA of 0.04±0.09 logMAR, mean CIVA of 0.00±0.08 logMAR, mean UNVA of 0.09±0.09 logMAR, and mean CNVA of 0.05±0.07 logMAR. The investigators found that mesopic and photopic contrast sensitivity (CS) values were in the upper third range of the age-matched normal values.

Using the quality of vision questionnaire, 70% of patients reported that they were highly satisfied with their postoperative functional vision; 24% were moderately satisfied; and 5% were less satisfied.

The primary limitation of the study was the lack of a control group for comparison.

“Our data, based on prospective, 5-year follow-up clinical study, provide evidence regarding the refractive stability and trifocal performance of Liberty 677MY. The lens confers good CS and maintains CS,” according to the research. Most patients achieved spectacle independence and dysphotopic phenomena were rarely reported.

Reference

Győry JF, Srinivasan S, Madár E, Balla L. Long-term performance of a diffractive-refractive trifocal IOL with centralized diffractive rings: 5-year prospective clinical trial. J Cataract Refract Surg. 2021;47(10):1258-1264. doi:10.1097/j.jcrs.0000000000000670