Visual performance and patient-reported outcomes of a non-apodized diffractive trifocal intraocular lens in Chinese cataract patients: a prospective multicenter real-world study
Bilateral implantation of the PanOptix trifocal IOL provides excellent and early stable visual performance at distance, intermediate, and near in Chinese cataract patients and high refractive predictability and a high rate of spectacle independence are associated with substantial patient satisfaction in real-world clinical practice.
Abstract
Purpose To assess clinical visual performance and patient-reported satisfaction following bilateral implantation of a non-apodized diffractive trifocal intraocular lens (IOL), the AcrySof® IQ PanOptix® Trifocal IOL, in a real-world clinical setting in China. Methods This was a prospective, multicenter registry study including patients aged ≥ 18 years with bilateral age-related or complicated cataracts who underwent bilateral implantation of the PanOptix IOL. The primary endpoint was the proportion of patients achieving binocular uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuity of ≤0.200 logMAR at 3 months postoperatively. Secondary endpoints included best-corrected distance visual acuity (BCDVA), binocular defocus curves ranging from +2.00 D to −4.00 D, refractive predictability, and patient-reported outcomes assessed using the Catquest-9SF and IOLSAT questionnaires. The study was registered at Chinese Clinical Trial Registry (ChiCTR2100052791; 2021-11-05). Results A total of 137 patients completed the 3-months postoperative follow-up. At 3 months, the mean binocular UDVA, UIVA, and UNVA were 0.017 ± 0.086, 0.061 ± 0.110, and 0.061 ± 0.103 logMAR, respectively. Overall, 91.24% of patients achieved the composite endpoint of ≤0.200 logMAR binocularly at all three distances. The binocular defocus curve demonstrated a broad plateau of visual acuity, maintaining ≤0.200 logMAR between +0.50 D and −2.50 D. Refractive predictability was high, with 84.62% of eyes within ±0.50 D of emmetropia. Complete spectacle independence was reported by 96.90% of patients. Conclusion Bilateral implantation of the PanOptix trifocal IOL provides excellent and early stable visual performance at distance, intermediate, and near in Chinese cataract patients. High refractive predictability and a high rate of spectacle independence are associated with substantial patient satisfaction in real-world clinical practice.
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.
Yanfeng Zeng, Qiyao Ma, Yuancheng Qu et al.· Frontiers in Medicine· 0 citations
To evaluate visual performance, contrast sensitivity (CS), optical quality, and subjective satisfaction of Vivity extended depth-of-focus (EDOF) premium intraocular lens (pIOL) in early keratoconus (KC). In this prospective, interventional, single-center clinical study, ten patients with mild bilateral KC and cataract received AcrySof IQ Vivity pIOL. Pre- and postoperative assessments included monocular and binocular uncorrected and distance-corrected visual acuities at 4 m (UDVA, DCVA), uncorrected and distance-corrected intermediate and near visual acuities at 66 cm (UI66VA, DCI66VA) and 40 cm (UNVA, DCNVA), defocus curve, CS, wavefront aberrometry (RMS, PSF, Strehl ratio), halometry, and subjective outcomes. At 3 months, mean ± SD monocular DCVA in the dominant eyes (primary endpoint) was 0.06 ± 0.13 logMAR. A statistically significant improvement was observed between preoperative and postoperative monocular and binocular UDVA, UNVA, DCNVA (p < 0.001), and DCVA (p = 0.03). Binocular DCI66VA and UI66VA were 0.10 ± 0.15 and 0.14 ± 0.16 logMAR, respectively. The defocus curve was ≤ 0.20 logMAR from + 0.50 D to – 2.00 D. CS peaked under scotopic conditions at 6 cpd, total ocular RMS improved from 2.15 ± 1.98 to 1.09 ± 0.77 (p = 0.09). NEI-RQL-42 scores indicated favourable patient-reported outcomes, particularly for glare, clarity of vision, and satisfaction with correction. In this small prospective pilot study, bilateral implantation of a non-diffractive EDOF IOL was associated with favourable short-term visual outcomes in highly selected patients with stable early keratoconus. These preliminary findings suggest that early stable KC may not represent an absolute contraindication to non-diffractive EDOF IOL implantation, but larger comparative studies with longer follow-up are required.
E. Bonacci, Camilla Pagnacco, A. Fasolo et al.· International ophtalmology· 0 citations
A clearer understanding of the Liberty 677MTY trifocal toric IOL’s performance is offered, supporting its use as a safe and effective solution for achieving spectacle independence and enhancing postoperative quality of life.
Péter Dormán, Zoltán Z Nagy· BMC Ophthalmology· 0 citations
The CNWTTx lens results in excellent visual acuities at distance, intermediate, and near, leading to high rates of spectacle independence and patients are subjectively satisfied with their visual outcomes.
Zachary Zavodni· Journal of Ophthalmology· 0 citations
The subjective and objective visual outcomes after implantation of monofocal, bifocal, and extended depth-of-focus (EDOF) intraocular lenses (IOLs) were compared to compare the subjective and objective visual outcomes after implantation of monofocal, bifocal, and extended depth-of-focus (EDOF) intraocular lenses (IOLs).
T. Chen, E. Li, Z. Wang et al.· [Zhonghua yan ke za zhi] Chi...· 0 citations