Quality of life related variables measured for three multifocal diffractive intraocular lenses: a prospective randomised clinical trial

Abstract

Importance: Quality of vision after multifocal intraocular lens (IOLs) implantation in relation to patient satisfaction. It is important to include the evaluation of visual quality and patient satisfaction in clinical practice.

Background: To evaluate and compare quality of life and patient satisfaction after implantation of three types of diffractive-refractive and apodized-diffractive bifocal and trifocal multifocal IOLs.

Design: Comparative, prospective, case series and randomized.

Participants: Hundred and four eyes of 52 patients.

Methods: Three multifocal IOLs: AT LISA 809 M (Carl Zeiss Meditec) (AT LISA group, 38 eyes), AT LISAtri 839MP (Carl Zeiss Meditec) (AT LISAtri group, 32 eyes), and ReSTOR SN6AD1 (Alcon) (ReSTOR group, 34 eyes) were implanted after cataract surgery.

Main outcome measures: Contrast sensitivity, photopic phenomena, patient satisfaction and quality of life criteria were evaluated.

Results: Patient of ≥ 88% were satisfied with near and intermediate visual outcomes. Better distance-corrected intermediate visual acuity at 90 cm was detected for AT LISA tri group (P < 0.04). No statistically significant differences were found among groups in postoperative contrast sensitivity (P ≥ 0.053). There were no significant differences in spectacle dependence scores among the groups (P ≥ 0.180). The addition of an intermediate focus did not statistically affect halo and glare size and intensity (P ≥ 0.256) or subjective impact (P ≥ 0.077). Patient satisfaction was consistently high for all groups (P ≥ 0.154).

Conclusions and relevance: Contrast sensitivity outcomes and patient satisfaction remained high in the trifocal group when compared to the bifocal IOL groups.

Keywords: cataract surgery; contrast sensitivity; diffractive-refractive IOL; refractive lensectomy; trifocal IOL.