Clinical Ophthalmology (Oct 2017)
Comparison of visual outcomes after bilateral implantation of a diffractive trifocal intraocular lens and blended implantation of an extended depth of focus intraocular lens with a diffractive bifocal intraocular lens
Abstract
André Lins de Medeiros,1–4 André Gustavo de Araújo Rolim,1,2 Antonio Francisco Pimenta Motta,2,5 Bruna Vieira Ventura,3,6 César Vilar,1,2,7 Mário Augusto Pereira Dias Chaves,1–3,8 Pedro Carlos Carricondo,2,5 Wilson Takashi Hida1,2,5 1Cataract Department, Hospital Oftalmológico de Brasília, 2Cataract Department, Centro de Estudos Oftalmológicos Renato Ambrósio, Brasília, 3Cataract Department, Fundação Altino Ventura, Recife, Brazil; 4Cataract Department, University of Edinburgh, Edinburgh, UK; 5Cataract Department, Universidade de São Paulo, São Paulo, 6Cataract Department, Hospital de Olhos de Pernambuco, Recife, 7Cataract Department, Hospital de Olhos Francisco Vilar, Teresina, 8Cataract Department, ProVisão, João Pessoa, Brazil Purpose: The purpose of this study was to compare the visual outcomes and subjective visual quality between bilateral implantation of a diffractive trifocal intraocular lens, Alcon Acrysof IQ® PanOptix® TNFT00 (group A), and blended implantation of an extended depth of focus lens, J&J Tecnis Symfony® ZXR00 with a diffractive bifocal intraocular lens, J&J Vision Tecnis® ZMB00 (group B).Methods: This prospective, nonrandomized, consecutive, comparative study included the assessment of 40 eyes in 20 patients implanted with multifocal intraocular lens. Exclusion criteria were existence of any corneal, retina, or optic nerve disease, previous eye surgery, illiteracy, previous refractive surgery, high axial myopia, expected postoperative corneal astigmatism of >1.00 cylindrical diopter (D), and intraoperative or postoperative complications. Binocular visual acuity was tested in all cases. Ophthalmological evaluation included the measurement of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), and uncorrected intermediate visual acuity (UIVA), with the analysis of contrast sensitivity (CS), and visual defocus curve.Results: Postoperative UDVA was 0.01 and −0.096 logMAR (p<0.01) in groups A and B, respectively; postoperative CDVA was −0.07 and −0.16 logMAR (p<0.01) in groups A and B, respectively; UIVA was 0.14 and 0.20 logMAR (p<0.01) in groups A and B, respectively; UNVA was −0.03 and 0.11 logMAR (p<0.01) in groups A and B, respectively. Under photopic conditions group B had better CS at low frequencies with and without glare.Conclusion: Both groups promoted good quality of vision for long, intermediate, and short distances. Group B exhibited a better performance for very short distances and for intermediate and long distances ≥−1.50 D of vergence. Group A exhibited a better performance for UIVA at 60 cm and for UNVA at 40 cm. Keywords: trifocal, multifocal, pseudophakia, cataract