Comparison of visual quality between the refractive-diffractive hybrid bifocal EDOF and the refractive-diffractive hybrid trifocal IOL
Purpose To comparatively analyze visual quality after cataract surgery with implantation of the extended depth of focus (EDOF) refractive-diffractive hybrid bifocal intraocular lens (IOL) AM3UH and the refractive-diffractive hybrid trifocal intraocular lens AT LISA tri 839MP. Methods This was a multicenter, retrospective and prospective bidirectional cohort study. Sixty-nine patients (69 eyes) with AM3UH IOL implantation were enrolled in the AM3UH group. Sixty-two patients (62 eyes) implanted with AT LISA tri 839MP IOL were enrolled in the 839MP group. Uncorrected distance visual acuity (UDVA, logMAR), uncorrected intermediate visual acuity (UIVA, logMAR), uncorrected near visual acuity (UNVA, logMAR) and best corrected distance visual acuity (BCDVA) were assessed before and 3 months after surgery. The visual function index 11R (VF-11R) was used to evaluate the quality of life after cataract surgery. Light interference, spectacle independence and postoperative satisfaction were evaluated by questionnaires. Results The preoperative UDVA of AM3UH group and 839MP group was (0.93 ± 0.38) logMAR and (0.90 ± 0.47) logMAR, respectively. At 3 months postoperatively, the UDVA, UIVA, UNVA and BCDVA of the AM3UH group were (0.14 ± 0.19) logMAR, (0.13 ± 0.12) logMAR, (0.15 ± 0.1) logMAR, and (0.09 ± 0.11) logMAR, respectively; and those of the 839MP group were (0.90 ± 0.47) logMAR, (0.12 ± 0.08) logMAR, (0.07 ± 0.08) logMAR, (0.12 ± 0.06) logMAR, and (0.05 ± 0.04) logMAR, respectively. Both IOLs (AM3UH and 839MP) significantly improved postoperative UDVA. No significant differences were observed between groups regarding distance, near, or best-corrected distance visual acuity (P > 0.05); however, the trifocal 839MP group demonstrated significantly superior UIVA. Patient satisfaction with intermediate and near vision was also higher in the 839MP group, though far vision satisfaction was similar. Both lenses showed low and comparable levels of glare and halos (the majority of patients were either asymptomatic or reported only mild symptoms), with a slight trend toward less glare and more halos in the 839MP group. Rates of spectacle independence at all distances did not differ significantly (P > 0.05). Conclusion Both lenses offer good visual quality and increased spectacle independence. The AT LISA tri 839MP provides superior intermediate vision and related patient satisfaction, with a similar overall side-effect profile.