This study aimed to compare the outcomes of two diffractive trifocal intraocular lenses and one extended depth of focus (EDOF) intraocular lens (IOLs). This was a six month, single centred, prospective, randomised, comparative study in which patients who underwent routine cataract surgery were randomised to receive one of two trifocal IOLs (AcrySof IQ PanOptix; Alcon Laboratories, Fort Worth, TX, or FineVision Micro F; PhysIOL SA, Liège, Belgium) or an EDOF IOL (TECNIS Symfony; Abbott Medical Optics, Inc., Abbott Park, IL). There were 20 patients in each group. The primary outcome was binocular and monocular uncorrected distance (UDVA), intermediate (UIVA) and near (UNVA) visual acuity. The secondary outcomes were quality of vision and aberrometry outcomes. There was no statistically significant differences found between groups in either monocular (P=.717) or binocular (P=.837) UDVA. Monocular and binocular UNVA were statistically and significantly better for both trifocal lenses than for the EDOF IOL (P=.002). The percentage of patients with J2 UNVA was 52.5% monocularly and 70% binocularly for the TECNIS Symfony IOL, 81.5% monocularly and 100% binocularly for the AcrySof IQ PanOptix IOL, and 82.5% monocularly and 95% binocularly for the FineVision Micro F IOL. There was no significant difference in binocular UIVA between groups; VA was better than 0.6 in 55%, 53% and 35% of patients with the TECNIS Symfony, AcrySof IQ Pan-Optix, and FineVision Micro F IOLs, respectively. Overall, 90% patients achieved spectacle independence. There were no differences in visual symptoms and aberrometry among groups. All three IOLs provided good visual acuity at all distances, a high percentage of spectacle independence, and little or no impact of visual symptoms on the patients’ daily functioning. Vision at distance and intermediate was comparable between lenses although near vision was statistically better for both trifocal IOLs compared to the EDOF IOL. The study limitations seem to include that intermediate vision was only measured at 60cm. Additionally the EDOF lens was targeted for micromonovision or emmetropia which may confound the near vision results. Further studies are required to assess the stability of outcomes and the rates of posterior capsule opacification.

A comparative evaluation of a new generation of diffractive trifocal and extended depth of focus intraocular lenses.
Cochener B, Boutillier G, Lamard M, Auberger-Zagnoli C.
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Inderpaul S Sian

FRCOphth, MCOptom, PG Cert (Clin Ed), MB ChB, BOptom (HONS), Musgrove Park Hospital, Taunton & Somerset Foundation Trust.

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