A Comparative Evaluation of Visual, Refractive, and Patient-Reported Outcomes of Three Diffractive Trifocal Intraocular Lenses
Robert Edward T. Ang, MD1,2, Janice Marie N. Jordan-Yu, MD2, Mark Sylvester F. Agas, MD1, Ryan S. Torres, MD1, Emerson M. Cruz, MD1
1Asian Eye Institute
8th Floor PHINMA Plaza, Rockwell Center, Makati City, Philippines
2Cardinal Santos Medical Center Department of Ophthalmology,
10 Wilson St. Greenhills West, San Juan, Philippines
Correspondence: Robert Edward T. Ang, MD
Asian Eye Institute
8th Floor PHINMA Plaza, Makati City, Philippines
Disclosure: The authors report no financial interest related to this study or any products described in this paper.
Objective: To compare the visual, refractive, and patient-reported outcomes of eyes implanted with one of 3 trifocal intraocular lenses (IOLs).
Methods: This is a cross-sectional, comparative, non-interventional study wherein subjects implanted with FineVision Micro F, AT LISA tri 839MP or AcrySof IQ PanOptix trifocal IOL after phacoemulsification were recruited. Manifest refraction, uncorrected and corrected visual acuity (VA) at distance, intermediate and near vision, contrast sensitivity, modulated transfer function (MTF) values and questionnaire answers were compared among the 3 groups using analysis of variance (ANOVA).
Results: Fifty-seven (57) eyes were included in the study: 21 eyes with FineVision (group A), 21 eyes with LISA tri (group B), and 15 eyes with PanOptix IOL (group C). The post-operative mean manifest spherical equivalent was -0.01D, -0.07D, and 0.05D, respectively (p=0.083). Uncorrected distance VA and best-corrected distance VA were similar among the groups. Groups A and C had better uncorrected and corrected intermediate VA at 80 cm and at 60 cm compared to group B. Group A had significantly better uncorrected near visual acuity than groups B and C (p=0.032). Mesopic contrast sensitivity testing showed group C had higher contrast sensitivities without glare in at the spatial frequency of 6 CPD (p=0.038) and with glare at 3 CPD (p=0.039) and at 12 CPD (p=0.009). MTF average height analysis showed that the group A had significantly superior resolution in far targets compared to groups B and C (p=0.001). At near targets, groups A and C had better resolutions compared to group B (p=0.017). There was no significant difference in patient satisfaction for far, intermediate and near VA among the groups.
Conclusion: Eyes implanted with any of the 3 trifocal IOL designs achieved excellent uncorrected and best-corrected distance, intermediate and near vision. FineVision and PanOptix provided significantly better intermediate vision than LISA tri at both 80 cm and 60 cm testing distance. FineVision had better near visual outcomes than PanOptix and LISA tri. Patient satisfaction was high in all 3 trifocal IOLS.
Keywords: trifocal intraocular lenses, AT LISA tri 839MP, AcrySof IQ Panoptix, FineVision Micro F, modulated transfer functions (MTF)–average height, Strehl ratio, visual Strehl optical transfer function (VSOTF)