Visual performance of four types of diffractive multifocal intraocular lenses and a review of articles

Visual performance following implantation of presbyopia correcting intraocular lenses

OBJECTIVE

To compare the visual outcomes following bilateral implantation of 3 presbyopia correcting IOLs.

METHODS

Results are reported for patients who underwent phacoemulsification with bilateral implantation of one of the following IOLs: Panoptix IOL, AT LISA tri IOL and Symphony IOL. Six months postoperative examination included monocular UIVA at 80 and 60 cm and monocular UNVA and DCNVA at 40 cm, monocular UDVA and CDVA, Spherical equivalent (SE) refraction, binocular defocus curve, contrast sensitivity, photopic phenomena, and spectacle independence.

RESULTS

UIVA at 80 cm was significantly better in the AT LISA group and the Symfony groups than the Panoptix group, while UIVA at 60 cm was better in the Symfony group and the Panoptix group than the AT LISA group. A worse DCNVA was recorded in the Symfony group. At a defocus of -2.50 D, the near VA was similar in the PanOptix and AT LISA groups (0.05, 0.07 logMAR respectively), which were significantly better than the Symfony group (0.3 LogMAR). Binocular photopic and scotopic contrast sensitivity outcomes were similar among the three groups at all spatial frequencies. In Symphony group, the frequency and the degree of bother of photic phenomena was relatively higher than the other two groups. Higher percentage of patients in symphony group reported their need for reading glasses.

CONCLUSION

PanOptix IOL and AT LISA IOL would be a good choice for patients aiming for an optimum near vision, while Symfony IOL seems suitable for patients having the priority for good intermediate vision.

Evaluation of visual and optical quality following phacoemulsification cataract surgery with diffractive multifocal intraocular lens implantation: An observational study

The assessment of patient satisfaction following cataract surgery is heavily reliant on the evaluation of visual quality, specifically after the placement of diffractive multifocal intraocular lenses (MIOLs) under varying pupil conditions. The objective of this study was to examine the visual and optical clarity following cataract phacoemulsification and the use of Tecnis ZMB00 MIOL for implantation. The study involved 116 individuals (135 eyes) who received cataract phacoemulsification and underwent Tecnis ZMB00 MIOL implantation. Assessments were conducted 1 week and 3 months after the surgery. These assessments involved measuring uncorrected and corrected visual acuity for distant, intermediate, and near vision. Additionally, scatter light values and wavefront aberrations were measured under different aperture settings of 3 and 5 mm. There was no noticeable disparity in visual acuity between 1 week and 3 months after the surgery. After 3 months of surgery, there was a considerable decrease in scatter light values and spherical aberrations compared to the values observed 1 week after surgery, under the setting of a 5 mm aperture. Moreover, the modulation transfer function values showed a significant rise after 3 months following the surgery, particularly under the 5 mm aperture condition. The most substantial increase was observed at the intermediate spatial frequency of 20 cycles per degree (cpd), in comparison to the values obtained 1 week after the operation. The combination of cataract phacoemulsification and Tecnis ZMB00 MIOL implantation yielded favorable visual acuity at various distances for patients. Furthermore, enhancements in the measurements of scattered light, higher-order aberrations, and modulation transfer function values were noted 3 months after the surgical procedure, specifically under the condition of a 5 mm pupil. These findings suggest an increase in visual clarity and night vision to a certain degree.

Visual results and subjective satisfaction after implantation of two different trifocal diffractive intraocular lenses models (AcrySof IQ PanOptix and AT LISA tri 839 MP)

BACKGROUND

This study aimed to compare visual results following the implantation of two distinct diffractive trifocal IOLs utilizing various vision evaluation techniques and subjective satisfaction.

METHODS

The study included 32 eyes receiving AcrySof IQ PanOptix implantation and 32 receiving AT LISA tri 839 MP. Post-operative examination at one year included uncorrected visual acuity (UCVA), distance-corrected visual acuity (DCVA) at 4 m, 80 cm, 60 cm, and 40 cm, Contrast sensitivity under photopic and mesopic conditions, and a questionnaire on subjective quality of vision, optical phenomena, and spectacle independence.

RESULTS

The two groups were similar in baseline demographics, pre-operative visual, biometric data (except for axial length), and surgical paraments. The PanOptix outperformed the AT LISA tri in the intermediate range when using the standard visual acuity testing (UCVA: 0.23 ± 0.14 logMAR vs. 0.31 ± 0.17 logMAR, p = 0.04; BCVA: 0.21 ± 0.12 vs. 0.28 ± 0.14, p = 0.03) and in the intermediate and far range when using the interactive computer program (intermediate: UNVA "E" optotype test: 0.05 ± 0.12 vs. 0.12 ± 0.13, p = 0.03; Far: UNVA "E" optotype: 0.07 ± 0.12 vs. 0.13 ± 0.10, p = 0.05). In addition, the PanOptix group had higher contrast sensitivity under photopic and mesopic conditions with and without glare at all spatial frequencies. There was no difference in subjective outcomes between the groups.

CONCLUSIONS

Patients who received PanOptix IOL had better visual outcomes for intermediate and far with higher contrast sensitivity under various conditions. Based on patients ' needs and demands, these results could support discussion when tailoring the optimal multifocal IOl.

Association of Patient Satisfaction with Cataract Grading in Five Types of Multifocal IOLs

INTRODUCTION

This study investigated patient satisfaction levels in five premium intraocular lenses (IOLs). A secondary aim was to determine whether patient satisfaction was associated with the cataract grade before lens surgery.

METHODS

In this multicenter prospective comparative study, 164 patients from diverse backgrounds underwent cataract surgery and were assigned for identical bilateral implantation of multifocal IOLs. In addition to visual performance, quality of life was measured using the National Eye Institute Refractive Error Quality Of Life Instrument (NEI-RQL 42) scoring questionnaire. The Sirius Scheimpflug Analyzer was used to evaluate the posterior cornea and aberrations. Finally, the association of patient satisfaction reports with the Pentacam Cataract Grading Scale (PCGS) and Lens Opacities Classification System (LOCS III) was evaluated.

RESULTS

A considerable subjective improvement was observed in uncorrected far, near (40 cm), and intermediate (60 cm) visual acuity in the five groups (P values < 0.001). A significant difference was observed in mesopic and photopic contrast sensitivity between Symfony, Trinova, and AT LISA at the spatial frequency of 12 cycles per degree, favoring Symfony (P < 0.001). PanOptix users had considerably lower mean coma values (P < 0.001), while AT LISA users had lower mean spherical aberrations (P = 0.009) compared to the other groups. No additional safety concerns relating to IOLs were recorded. Mean satisfaction had a high correlation with LOCS and Pentacam Nuclear Staging (PNS) in each lens group, e.g., correlation coefficient and P value for AT LISA were respectively r = 0.99, P < 0.001 and r = 0.97, P = 0.004.

CONCLUSION

Despite discrepancies between groups of lenses, most patients who received multifocal IOLs reported satisfaction at more than 3 years after the initial operation. A growing number of patients with cataracts are seeking spectacle-free vision with presbyopia-correcting IOLs. Hence, the high satisfaction rate among patients with cataract could indicate the value of offering a wider range of available lenses.

Comparison of visual performance with iTrace analyzer following femtosecond laser-assisted cataract surgery with bilateral implantation of two different trifocal intraocular lenses

AIM

To compare the postoperative binocular visual performance with an iTrace analyzer following femtosecond laser-assisted cataract surgery (FLACS) combined with bilateral implantation of two different types of diffractive trifocal intraocular lenses (IOL).

METHODS

During this retrospective observational study, patients who received bilateral FLACS combined with implantation of two different types of diffractive trifocal IOLs were evaluated. According to the IOLs' different types and design, the patients were divided into AT LISA tri839MP group (tri839 group) and AcrySof PanOptix TFNT00 group (TFNT group). Study parameters included preoperative and postoperative uncorrected distance visual acuity (UDVA) at 5 m, uncorrected near visual acuity (UNVA) at 30 cm and 40 cm, uncorrected intermediate visual acuity (UIVA) at 60 cm and 80 cm, postoperative refractive status, objective visual qualities and total high order aberrations (HOAs) postoperatively. The postoperative complications were also recorded.

RESULTS

Totally 56 eyes of 28 patients (tri839 group, n=26; TFNT group, n=30) were included. Preoperative baseline characteristics between groups were not statistically significantly different. UDVA was not significantly different between groups except for 1wk follow-up due to the postoperative corneal edema. TFNT group showed statistically significant better UNIA at 60 cm than tri839 group at the 1wk (0.05±0.19 vs 0.15±0.10 logMAR, P=0.013), 1mo (0.05±0.12 vs 0.15±0.09 logMAR, P=0.001) and 3mo (0.04±0.12 vs 0.15±0.11 logMAR, P=0.001) follow-up, while tri839 group showed statistically significant better UNIA at 80 cm than TFNT group at the 1d (0.14±0.15 vs 0.20±0.14 logMAR, P=0.041) and 1mo (0.09±0.07 vs 0.14±0.10 logMAR, P=0.042) follow-up. Postoperative refractive status showed stable at every visit. Modulated transfer function (MTF) values and strehl ratio (SR) values were improved and HOAs were lower significantly after surgery.

CONCLUSION

FLACS with bilateral implantations of both tri839 and TFNT00 can achieve satisfactory natural whole-course vision, high postoperative refractive stability and good visual quality but without significantly difference. iTrace aberration instrument can accurately evaluate the visual quality under different status.

Assessing Visual Outcomes: A Comparative Study of US-FDA Premarket Approval Data for Multifocal and EDOF Lens Implants in Cataract Surgery

This study compares the efficacy, safety, and patient-reported outcomes of three intraocular implants (IOL): Tecnis Synergy IOL, AcrySof IQ PanOptix Trifocal, and Tecnis Symfony EDOF IOL. Participants achieving 20/20 or better uncorrected binocular visual acuity were as follows: Synergy-67% distance, 64% intermediate, and 47% near; PanOptix-73% distance, 73% intermediate, and 50% near; and Symfony-63% distance, 75% intermediate, and 22% near. Symfony demonstrated superior intermediate visual acuity compared to Synergy (p = 0.0182) for those achieving 20/25 or better. Both Synergy and PanOptix showed superiority over Symfony for near visual acuity (p < 0.0001). Halos were statistically more common in Synergy participants compared to PanOptix (p = 0.0013) and Symfony (p < 0.0001). Each trial lens outperformed its monofocal IOL in terms of independence from glasses or contacts, with Synergy and PanOptix showing statistical significance over Symfony. Comparing contrast sensitivities and defocus curves was challenging due to data variance and as such, standardization of United States Food and Drug Administration (US-FDA) data reporting is key for better comparison of outcomes among different IOL platforms.

Trifocal intraocular lenses versus bifocal intraocular lenses after cataract extraction among participants with presbyopia

BACKGROUND

Presbyopia occurs when the lens of the eyes loses its elasticity leading to loss of accommodation. The lens may also progress to develop cataract, affecting visual acuity and contrast sensitivity. One option of care for individuals with presbyopia and cataract is the use of multifocal or extended depth of focus intraocular lens (IOL) after cataract surgery. Although trifocal and bifocal IOLs are designed to restore three and two focal points respectively, trifocal lens may be preferable because it restores near, intermediate, and far vision, and may also provide a greater range of useful vision and allow for greater spectacle independence in individuals with presbyopia.

OBJECTIVES

To assess the effectiveness and safety of implantation with trifocal versus bifocal IOLs during cataract surgery among people with presbyopia.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2022, Issue 3); Ovid MEDLINE; Embase.com; PubMed; ClinicalTrials.gov; and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 31 March 2022.  SELECTION CRITERIA: We included randomized controlled trials that compared trifocal and bifocal IOLs among participants 30 years of age or older with presbyopia undergoing cataract surgery.

DATA COLLECTION AND ANALYSIS

We used standard Cochrane methodology and graded the certainty of the body of evidence according to the GRADE classification.

MAIN RESULTS

We identified seven studies conducted in Europe and Turkey with a total of 331 participants. All included studies assessed visual acuity using a logarithm of the minimum angle of resolution (LogMAR chart). Of them, six (86%) studies assessed uncorrected distance visual acuity (the primary outcome of this review). Some studies also examined our secondary outcomes including uncorrected near, intermediate, and best-corrected distance visual acuity, as well as contrast sensitivity. Study characteristics All participants had bilateral cataracts with no pre-existing ocular pathologies or ocular surgery. Participants' mean age ranged from 55 to 74 years. Three studies reported on gender of participants, and they were mostly women. We assessed all of the included studies as being at unclear risk of bias for most domains. Two studies received financial support from manufacturers of lenses evaluated in this review, and at least one author of another study reported receiving payments for delivering lectures with lens manufacturers. Findings All studies compared trifocal versus bifocal IOL implantation on visual acuity outcomes measured on a LogMAR scale. At one year, trifocal IOL showed no evidence of effect on uncorrected distance visual acuity (mean difference (MD) 0.00, 95% confidence interval (CI) -0.04 to 0.04; I2 = 0%; 2 studies, 107 participants; low-certainty evidence) and uncorrected near visual acuity (MD 0.01, 95% CI -0.04 to 0.06; I2 = 0%; 2 studies, 107 participants; low-certainty evidence). Trifocal IOL implantation may improve uncorrected intermediate visual acuity at one year (MD -0.16, 95% CI -0.22 to -0.10; I2 = 0%; 2 studies, 107 participants; low-certainty evidence), but showed no evidence of effect on best-corrected distance visual acuity at one year (MD 0.00, 95% CI -0.03 to 0.04; I2 = 0%; 2 studies, 107 participants; low-certainty evidence). No study reported on contrast sensitivity or quality of life at one-year follow-up. Data from one study at three months suggest that contrast sensitivity did not differ between groups under photopic conditions, but may be worse in the trifocal group in one of the four frequencies under mesopic conditions (MD -0.19, 95% CI -0.33 to -0.05; 1 study; I2 = 0%, 25 participants; low-certainty evidence). One study examined vision-related quality of life using the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) at six months, and suggested no evidence of a difference between trifocal and bifocal IOLs (MD 1.41, 95% CI -1.78 to 4.60; 1 study, 40 participants; low-certainty evidence). Adverse events Adverse events reporting varied among studies. Of five studies reporting information on adverse events, two studies observed no intraoperative and postoperative complications or no posterior capsular opacification at six months. One study reported that glare and halos were similar to the preoperative measurements. One study reported that 4 (20%) and 10 (50%) participants had glare complaints at 6 months in trifocal and bifocal group, respectively (risk ratio 0.40, 95% CI 0.15 to 1.07; 40 participants). One study reported that four eyes (11.4%) in the bifocal group and three eyes (7.5%) in the trifocal group developed significant posterior capsular opacification requiring YAG capsulotomy at one year. The certainty of the evidence for adverse events was low.

AUTHORS' CONCLUSIONS

We found low-certainty of evidence that compared with bifocal IOL, implantation of trifocal IOL may improve uncorrected intermediate visual acuity at one year. However, there was no evidence of a difference between trifocal and bifocal IOL for uncorrected distance visual acuity, uncorrected near visual acuity, and best-corrected visual acuity at one year. Future research should include the comparison of both trifocal IOL and specific bifocal IOLs that correct intermediate visual acuity to evaluate important outcomes such as contrast sensitivity, quality of life, and vision-related adverse effects.

Comparative Visual Outcome Analysis of a Diffractive Multifocal Intraocular Lens and a New Diffractive Multifocal Lens with Extended Depth of Focus

This study compares the visual and refractive performance of the TECNIS Synergy (DFR00V-DFW150-225-300-375) multifocal intraocular lens (IOL) and the AcrySof IQ PanOptix (TFAT00-30-40-50-60) multifocal IOL. Patients who underwent phacoemulsification and cataract extraction and received either a multifocal Synergy or PanOptix IOL were included. Monocular uncorrected distance (UDVA), intermediate (UIVA), near (UNVA), and corrected distance (CDVA) visual acuities were assessed at three and six months postoperatively. Secondary outcome measures of photic phenomena were also assessed. A total of 140 patients (224 eyes) were included in this study, with 69 patients (105 eyes) in the Synergy group and 71 patients (119 eyes) in the PanOptix group. There were no statistically significant differences in UIVA or CDVA measurements across all time points. When assessing UDVA, at three months postoperatively, there were more eyes in the PanOptix group with vision better than 20/40 (p = 0.04). At three and six months postoperatively, the average UNVA was superior in the Synergy group (p = 0.01, 0.002). While the Synergy group reported more night vision disturbances at one and three months (p = 0.01, 0.03), the PanOptix group had more night vision disturbances at six months (p = 0.02). Although not statistically significant, the AcrySof IQ PanOptix multifocal IOL demonstrated better UDVA and UIVA sooner postoperatively than the TECNIS Synergy multifocal IOL. The Synergy IOL provided statistically better UNVA compared to the PanOptix IOL at three and six months postoperatively. Synergy patients reported more early photic phenomena than PanOptix patients, which later diminished.

Comparison of 3-month visual outcomes of a new multifocal intraocular lens vs a trifocal intraocular lens

PURPOSE

To compare the clinical performance of the TECNIS Synergy multifocal (model ZFR00V) intraocular lens (IOL) with that of the AcrySof PanOptix Trifocal (model TFNT00) IOL in patients undergoing bilateral cataract surgery.

SETTING

Multicenter clinical setting.

DESIGN

Prospective randomized comparative study.

METHODS

Patients aged 22 years or older were randomly assigned (2:1) to bilateral implantation with ZFR00V or TFNT00 IOLs. End points included the mean binocular distance-corrected near visual acuity (DCNVA) at 40 cm, photopic and mesopic DCNVAs at 33 cm, photopic low-contrast corrected distance visual acuity (CDVA) and mesopic CDVA, nondirected patient responses to an ocular/visual symptoms questionnaire, and safety.

RESULTS

Of the 150 patients implanted with IOLs, 95 of the 97 patients with ZFR00V IOLs and 52 of the 53 patients with TFNT00 IOLs completed the 3-month follow-up. Most patients in the ZFR00V and TFNT00 groups achieved 20/25 or better binocular CDVA (100% vs 96.2%) and DCNVA measured at 40 cm (88.4% vs 75.0%) and 33 cm (78.9% vs 51.9%). The mean between-group difference in binocular DCNVA at 40 cm favored ZFR00V IOLs (0.5 lines Snellen; 95% CI, 0.012 to 0.089; P ≤ .05). Similarly, the mean binocular photopic and mesopic DCNVAs at 33 cm (0.8 lines Snellen each; both P ≤ .05 vs TFNT00) and photopic high-contrast and low-contrast CDVA (0.5 lines Snellen each; both P ≤ .05 vs TFNT00) favored ZFR00V IOLs. Patient-reported ocular/visual symptoms and safety were generally similar between the 2 IOLs.

CONCLUSIONS

The ZFR00V IOL showed an extensive range of vision, particularly through near distances, and better mesopic performance than the TFNT00 IOL in patients undergoing cataract surgery.

Longitudinal evaluation of trifocal and extended depth of focus lenses implantation using standard automated perimetry parameters

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 study to evaluate the effect of trifocal IOL AcrySof IQ PanOptix® and extended depth of focus intraocular lens (EDOF) Tecnis Symfony® IOL implantation on visual field parameters. 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/- 1.08 dB (p = 0.15); foveal sensitivity was 34.5/33.9 dB (p = 0.41); VFI 98.5/98.4% (p > 0.99); PSD 1.85/1.86 (p = 0.07); and for test duration 305.81/298.36 s (p = 0.35); all respectively. Analysis of pre- and postoperative parameters of trifocal IOL were the rates of change of FN 1.22/1.83% (p = 0.29); FP 1.65/1.48% (p = 0.95); MD - 1.55/- 1.37 dB (p = 0.19); foveal sensitivity 33.9/34.9 dB (p = 0.47); VFI 98.6/98.3% (p = 0.62); PSD 1.58/2.05 (p = 0.02); and test duration 297.17/298.57 s (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.

Patient Satisfaction and Visual Function Following Implantation of Trifocal or Extended Range of Vision Intraocular Lenses

Purpose

Materials and Methods

Results

Conclusion

Clinical Outcomes, Contrast Sensitivity, Reading Performance and Patient Satisfaction Following Bilateral Implantation of AT LARA 829MP EDoF IOLs

Purpose

To evaluate the visual outcomes, contrast sensitivity, reading performance and patient satisfaction after bilateral implantation of AT LARA extended depth of focus (EDoF) intraocular lenses (IOLs).

Methods

Patients undergoing phacoemulsification for age-related cataract and satisfying the eligibility criteria underwent bilateral implantation with AT LARA EDoF IOLs (Carl Zeiss Meditec, Jena, Germany). At follow-up visits of 1, 3, 6 and 12 months, binocular uncorrected and corrected distance, intermediate and near visual acuity, reading performance, defocus curve, contrast sensitivity and patient satisfaction for dysphotopsia and spectacle independence were evaluated.

Results

A total of 60 eyes from 30 patients with a mean age of 65.40±7.71 years were included in the study. At 12 months, 83% of patients (n=25) had binocular cumulative uncorrected distance visual acuity (UDVA) of 20/20 or better. Postoperative spherical equivalent refraction accuracy was within ±0.50 D for 95% of eyes (n=57) and refractive cylinder accuracy was within ≤0.50 D in 95% of eyes (n=57). The mean binocular uncorrected near visual acuity (UNVA) was 0.16±0.09 logMAR, and the mean uncorrected intermediate visual acuity (UIVA) at 60 and 80 cm was 0.01±0.09 and 0.03±0.08 logMAR, respectively, at 12 months. Reading speeds at 40, 60 and 80 cm showed improvement over time. No patient had complaints of severe dysphotopsia and none of the patients required glasses for any activity. No eye underwent YAG-laser capsulotomy for significant posterior capsule opacification at the end of mean follow-up.

Conclusion

In our limited experience of 30 patients at 12 months, AT LARA EDoF IOLs resulted in excellent visual outcomes for uncorrected distance, intermediate and near visual acuity. The incidence of dysphotopsia and spectacle dependence was low, resulting in good patient satisfaction.

Trial Registry

CTRI/2020/08/027105 (www.ctri.nic.in).

Clinical Outcomes and Patient Satisfaction with a New Diffractive-Refractive Trifocal Intraocular Lens - A 12 Month Prospective Study

Purpose

To evaluate the clinical outcomes and patient satisfaction after implantation of Optiflex Trio, a new trifocal intraocular lens (IOL) following cataract surgery.

Methods

Patients undergoing phacoemulsification for age-related cataracts and who satisfy the eligibility criteria underwent bilateral implantation with Optiflex Trio trifocal IOL. At follow -up visits of 1, 3, 6, and 12 months, binocular uncorrected and corrected distance, intermediate and near visual acuity, reading performance, contrast sensitivity (CS) and patient satisfaction for dysphotopsia and spectacle independence were evaluated using questionnaires.

Results

A total of 54 eyes from 27 patients with mean age of 66.30±7.48 years were included in the study. At 12 months, 78% (n = 21) patients had binocular cumulative UDVA of 20/20 or better. Post-op SE refraction accuracy was within ±0.50 D for 93% (n = 50) eyes, and refractive cylinder accuracy was within ≤0.50 D in 94% (n = 51) eyes. The mean binocular UNVA was 0.01±0.05 LogMAR, and the mean UIVA at 60 and 80 cm was 0.07±0.06 and 0.03±0.05 LogMAR, respectively, at 12 months. Reading speeds at 40, 60 and 80 cm showed improvement overtime. No patient had complained of severe dysphotopsia, and none of the patients required glasses for any activity. No eye underwent YAG-laser capsulotomy for significant PCO at the end of mean follow-up.

Conclusion

After 12 months, Optiflex Trio trifocal IOL provided a complete visual restoration with good visual quality outcomes in terms of uncorrected distance, intermediate and near visual acuity. The incidence of dysphotopsia was low, and spectacle independence was high, resulting in good patient satisfaction.

Trial Registry

CTRI/2019/10/021647 (www.ctri.nic.in).