Comparison Between Bilateral Implantation of a Trifocal IOL and Mix-and-Match Implantation of a Bifocal IOL and an Extended Depth of Focus IOL

Purpose. To evaluate the clinical outcomes after bilateral mix-and-match cataract surgery using extended depth of focus (EDOF) and diffractive multifocal (DMF) intraocular lenses (IOLs). Setting. Asan Medical Center, Seoul, South Korea. Design. Prospective clinical study. Methods. Thirty-seven patients underwent TECNIS Symfony EDOF IOL (ZXR00) implantation in the dominant eye, and TECNIS +3.25 DMF IOL (ZLB00) implantation in the nondominant eye. Patients were followed up for 3 months; uncorrected and corrected distance visual acuity (UDVA and CDVA), uncorrected intermediate and near visual acuity (UIVA and UNVA), contrast sensitivity, defocus curves, stereopsis, and patient satisfaction were assessed. Results. At 3 months, the mean logarithm of the minimum angle of resolution (logMAR) of UDVA was 0.07 ± 0.09 in EDOF IOL eyes, 0.12 ± 0.11 in DMF IOL eyes, and 0.02 ± 0.05 in both eyes. UIVA was 0.11 ± 0.11 in EDOF IOL eyes, 0.16 ± 0.12 in DMF IOL eyes, and 0.04 ± 0.07 in both eyes. UNVA was 0.25 ± 0.15 in EDOF IOL eyes, 0.22 ± 0.16 in DMF IOL eyes, and 0.13 ± 0.13 in both eyes. Thirty patients (81.1%) were more than satisfied with near vision, and 8 patients (21.6%) complained of severe glare and halo. Spectacle independence for near vision was achieved in 34 patients (91.9%), and 31 patients (83.8%) had better than a 50-second arc of stereopsis. Conclusion. Mix-and-match cataract surgery with EDOF and DMF IOL implantation provided good visual outcomes for all distances. Additionally, excellent patient satisfaction was achieved with a high level of spectacle independence and acceptable photic phenomena.

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Clinical Outcomes After Mix-and-Match Implantation of Extended Depth of Focus and Diffractive Multifocal Intraocular Lenses

10.20944/preprints202004.0423.v1 ◽

2020 ◽

Author(s):

Jae Hyuck Lee ◽

Ho Seok Chung ◽

Su Young Moon ◽

Hun Lee ◽

Jae Yong Kim ◽

...

Keyword(s):

Visual Acuity ◽

Patient Satisfaction ◽

Cataract Surgery ◽

Clinical Outcomes ◽

Intraocular Lenses ◽

Depth Of Focus ◽

Near Vision ◽

Extended Depth Of Focus ◽

Dominant Eye ◽

Mix And Match

Purpose: To evaluate clinical outcomes after bilateral mix-and-match cataract surgery using extended depth of focus (EDOF) and diffractive multifocal (DMF) intraocular lenses (IOLs). Methods: Thirty-seven patients received Tecnis Symfony EDOF IOL (ZXR00) implantation in the dominant eye, and Tecnis +3.25 DMF IOL (ZLB00) in the non-dominant eye. Patients were followed for 3 months, and uncorrected and corrected distance visual acuity (UDVA, CDVA) , uncorrected intermediate and near visual acuity (UIVA, UNVA), contrast sensitivity, defocus curves, stereopsis, and patient satisfaction were assessed. Results: At 3 months, mean logMAR UDVA was 0.07 ± 0.09 in EDOF IOL eyes, 0.12 ± 0.11 in DMF IOL eyes, and 0.02 ± 0.05 in both eyes. UIVA was 0.11 ± 0.11 in EDOF IOL eyes, 0.16 ± 0.12 in DMF IOL eyes, and 0.04 ± 0.07 in both eyes. UNVA was 0.25 ± 0.15 in EDOF IOL eyes, 0.22 ± 0.16 in DMF IOL eyes, and 0.13 ± 0.13 in both eyes. Thirty patients(81.1%) were more than satisfied with near vision, and 8 patients(21.6%) complained of severe glare and halo. Spectacle independence for near vision was achieved in 34 patients(91.9%), and 31 patients(83.8%) had better than a 50 second arc of stereopsis. Conclusion: Mix-and-match cataract surgery with EDOF and DMF IOL implantation provided good visual outcomes through all distances. Also excellent patient satisfaction was achieved with high level of spectacle independence and minimal photic phenomena.

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Visual outcomes and patient satisfaction 1 and 12 months after combined implantation of extended depth of focus and trifocal intraocular lenses

International Ophthalmology ◽

10.1007/s10792-021-01970-3 ◽

2021 ◽

Author(s):

Richard N. McNeely ◽

Salissou Moutari ◽

Stephen Stewart ◽

Jonathan E. Moore

Keyword(s):

Intraocular Lenses ◽

Depth Of Focus ◽

Lens Extraction ◽

Extended Depth Of Focus ◽

Quality Of Vision ◽

Trifocal Iol ◽

The Mean ◽

Functional Vision ◽

Subjective Outcomes

Abstract Purpose To assess the 1-month and 12-month postoperative visual performance and subjective outcomes following combined implantation of an extended depth of focus (EDOF) intraocular lens (IOL) and a trifocal IOL. Methods The study enrolled consecutive patients undergoing refractive lens extraction or cataract surgery with combined implantation of an EDOF IOL (dominant eye) and trifocal IOL. Uncorrected (UDVA) and best-corrected (CDVA) distance visual acuities, uncorrected intermediate (UIVA) and near (UNVA) visual acuities, and subjective questionnaires were evaluated 1 month and 12 months postoperatively. Results The study enrolled 58 consecutive patients. Binocular UDVA, UIVA and UNVA were − 0.08 ± 0.07 logMAR, 0.15 ± 0.14 logMAR and 0.17 ± 0.11 logMAR at 1 month, compared to − 0.09 ± 0.06 logMAR (P = .323), 0.11 ± 0.10 logMAR (P = .030) and 0.13 ± 0.10 logMAR (P = 0.008) at 12 months. Satisfaction was high with 93.1% of patients fulfilled or more than fulfilled postoperatively, and 84.5% and 86.3% reported spectacle independence for near at the respective postoperative assessments. The mean daytime and nighttime quality of vision (QoV) scores were 9.12 ± 0.94 and 7.88 ± 1.74 at 1 month, compared to 9.24 ± 0.78 (P = .183) and 8.26 ± 1.38 (P = .043) at 12 months. Conclusions This IOL combination provides good unaided visual acuity at 1 and 12 months postoperatively, with high functional vision and postoperative satisfaction reported at 1 and 12 months. However, a significant improvement in overall nighttime QoV at the 12 months assessment was found.

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Clinical Outcomes of Combined Implantation of an Extended Depth of Focus IOL and a Trifocal IOL in a Korean Population

Journal of Ophthalmology ◽

10.1155/2021/9034258 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Ji Eun Song ◽

So Young Han ◽

Ramin Khoramnia ◽

Tamer Tandogan ◽

Gerd U. Auffarth ◽

...

Keyword(s):

Patient Reported Outcomes ◽

Reading Speed ◽

Depth Of Focus ◽

Extended Depth Of Focus ◽

Patient Reported ◽

Trifocal Iol ◽

Uncorrected Visual Acuity ◽

Visual Function Questionnaire ◽

Defocus Curve ◽

Optical Phenomena

Purpose. To evaluate monocular and binocular visual performance and patient-reported outcomes following combined implantation of a diffractive extended depth of focus (EDoF) IOL (Carl Zeiss AT LARA 829MP) and a diffractive trifocal IOL (Carl Zeiss AT LISA tri 839MP). Methods. This prospective study enrolled consecutive patients undergoing lens phacoemulsification of cataract and combined implantation of an EDoF IOL in the dominant eye and a trifocal IOL in the nondominant eye. Assessment included uncorrected visual acuity at near distances (UNVA), intermediate distances (UIVA), and far distances (UDVA), uncorrected defocus curve, contrast sensitivity (CS), reading speed, and patient satisfaction, evaluated six months after the surgery with the Visual Function Questionnaire (VFQ-25). Results. A total of 25 patients were enrolled. At six months postoperatively, outcomes of binocular UNVA, UIVA, and UDVA were superior to those of monocular outcomes. The binocular defocus curve showed significantly better results in comparison with the AT LISA tri IOL eyes at defocus levels of −1.0 D and −1.5 D ( P = 0.008 and P = 0.002 , respectively) and compared to the AT LARA IOL eyes at defocus levels of −3.0, −3.5 D, and −4.0 D ( P = 0.019 , P = 0.019 , and P = 0.035 , respectively). All of the patients were spectacle-free at far and intermediate distances, while 4% of patients needed spectacles at the near distance. Reading speed showed a rather high and gentle slope curve between 0.1 logMAR and 0.4 logMAR, and optical phenomena were improved after combined implantation of IOLs except halos. There were no significant differences in CS between the binocular and monocular results of each IOL. Conclusions. The combined implantation of an EDoF IOL and a trifocal IOL seems to be a good option for patients with demands for spectacle independence in their daily life, with minimal photic phenomena.

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Longitudinal Evaluation of Trifocal and Extended Depth of Focus Lenses Implantation using Standard Automated Perimetry Parameters

10.21203/rs.3.rs-1204190/v1 ◽

2022 ◽

Author(s):

Ricardo Y Abe ◽

Maíra Gomes Barbosa da Silva ◽

Thiago Nogueira Alves ◽

Wilson Takashi Hida

Keyword(s):

Intraocular Lens ◽

Test Duration ◽

Automated Perimetry ◽

Depth Of Focus ◽

Standard Automated Perimetry ◽

Longitudinal Evaluation ◽

Extended Depth Of Focus ◽

Global Indices ◽

Trifocal Iol ◽

Foveal Sensitivity

Abstract Purpose: To evaluate reliability and global indices parameters from standard automated perimetry (SAP) in normal eyes undergoing phacoemulsification cataract surgery with implantation of trifocal or extended depth of focus intraocular lens (IOL).Methods: Prospective comparative study. Comparison of trifocal IOL AcrySof IQ PanOptix® and extended depth of focus intraocular lens (EDOF) Tecnis Symfony® IOL. Patients underwent SAP pre- and postoperatively. Reliability indices (false negative rate - FN, false positive rate – FP), global indices (foveal sensitivity threshold, visual field index - VFI, standard pattern deviation – PSD, mean deviation MD) and test duration were analyzed.Results: A total of 23 eyes from 13 patients were in the trifocal IOL group and a total of 22 eyes from 14 patients were in the EDOF group The following results were obtained by analyzing pre- and postoperative SAP of EDOF IOL: the rate of change of FN was 1.95/1.41% (p=0.61); FP 1.64/1.27 (p=0.60); MD -1.60/-1.08dB (p=0.15); foveal sensitivity was 34.5/33.9dB (p=0.41); VFI 98.5/98.4% (p>0.99); PSD 1.85/1.86 (p=0.07); and for test duration 305.81/298.36s (p=0.35); all respectively. Analysis of pre- and postoperative parameters of trifocal IOL was: the rates of change of FN 1.22/1.83% (p=0.29); FP 1.65/1.48% (p=0.95); MD -1.55/-1.37dB (p=0.19) ; foveal sensitivity 33.9/34.9dB (p=0.47) ; VFI 98.6/98.3% (p=0.62); PSD 1.58/2.05 (p=0.02); and test duration 297.17/298.57s (p=0.87); all respectively. Conclusion: We identified a change in the PSD parameters in the trifocal IOL group. No other significant changes were identified in SAP parameters after implantation of trifocal AcrySof IQ PanOptix® and EDOF Tecnis Symfony® IOL. Longitudinal evaluation showed no changes in SAP after Trifocal and EDOF IOL implantation in normal subjects.

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Optical Performance of a Trifocal IOL and a Novel Extended Depth of Focus IOL Combined With Different Corneal Profiles

Journal of Refractive Surgery ◽

10.3928/1081597x-20200519-02 ◽

2020 ◽

Vol 36 (7) ◽

pp. 435-441 ◽

Cited By ~ 2

Author(s):

Javier Ruiz-Alcocer ◽

Amalia Lorente-Velázquez ◽

José Luis Hernández-Verdejo ◽

Pablo De Gracia ◽

David Madrid-Costa

Keyword(s):

Optical Performance ◽

Depth Of Focus ◽

Extended Depth Of Focus ◽

Trifocal Iol

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Faculty Opinions recommendation of Defocus curves of 4 presbyopia-correcting IOL designs: Diffractive panfocal, diffractive trifocal, segmental refractive, and extended-depth-of-focus.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.736885072.793567258 ◽

2019 ◽

Author(s):

Mark Packer

Keyword(s):

Depth Of Focus ◽

Extended Depth Of Focus

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Comparison of trifocal or hybrid multifocal-extended depth of focus intraocular lenses: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-86222-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yueyang Zhong ◽

Kai Wang ◽

Xiaoning Yu ◽

Xin Liu ◽

Ke Yao

Keyword(s):

Systematic Review ◽

Visual Acuity ◽

Meta Analysis ◽

Visual Quality ◽

Intraocular Lenses ◽

Depth Of Focus ◽

Refractive Lens Exchange ◽

Extended Depth Of Focus ◽

Refractive Lens ◽

Near Visual Acuity

AbstractThis meta-analysis aimed to evaluate the clinical outcomes following implantation of trifocal intraocular lenses (IOLs) or a hybrid multifocal-extended depth of focus (EDOF) IOL in cataract or refractive lens exchange surgeries. We examined 13 comparative studies with bilateral implantation of trifocal (898 eyes) or hybrid multifocal-EDOF (624 eyes) IOLs published through 1 March 2020. Better uncorrected and corrected near visual acuity (VA) were observed in the trifocal group (MD: − 0.143, 95% CI: − 0.192 to − 0.010, P < 0.001 and MD: − 0.149, 95% CI: − 0.217 to − 0.082, P < 0.001, respectively), while the hybrid multifocal-EDOF group presented better uncorrected intermediate VA (MD: 0.055, 95% CI: 0.016 to 0.093, P = 0.005). Trifocal IOLs were more likely to achieve spectacle independence at near distance (RR: 1.103, 95% CI: 1.036 to 1.152, P = 0.002). The halo photic effect was generated more frequently by the trifocal IOLs (RR: 1.318, 95% CI: 1.025 to 1.696, P = 0.031). Contrast sensitivity and subjective visual quality yielded comparable results between groups. Trifocal IOLs demonstrated better performance at near distance but apparently led to more photic disturbances. Our findings provided the most up-to-date and comprehensive evidence by comparing the benefits of advanced IOLs in clinical practice.

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