Clinical outcomes following trifocal diffractive intraocular lens implantation for age-related cataract in China

Abstract

Purpose: The aim of this study was to evaluate visual, refractive and patient satisfaction outcomes following implantation of a trifocal diffractive intraocular lens (IOL).

Patients and methods: This prospective, consecutive study included patients undergoing lens phacoemulsification of cataract and implantation of a trifocal diffractive IOL (AT LISA tri 839MP). Visual outcomes, including near, intermediate and distance visual acuity (VA), refractive error, contrast sensitivity, defocus curve and patient satisfaction were assessed preoperatively and postoperatively.

Results: Thirty IOLs were implanted in 26 patients. Distance VA improved significantly from 0.70±0.45 to 0.08±0.11 logMAR (p<0.0001) 1 week postoperatively, and to 0.07±0.13 logMAR (p<0.0001) at 1 month and 0.05±0.10 logMAR (p<0.0001) at 3 months. Uncorrected near and intermediate VA, as well as corrected near, intermediate and distance VA, were stable and maintained during the follow-up period. Preoperative anterior chamber depth demonstrated an association with effective adjustment of postoperative spherical equivalent using a regression formula (p=0.007). No significant differences were observed for VA at defocus curves of 0 to -3 D. Contrast sensitivity at each spatial frequency improved significantly at 1 week, 1 month and 3 months under photopic and photopic with glare conditions. Under mesopic and mesopic with glare conditions, significant differences were observed postoperatively at low and medium spatial frequencies. Patients reported a high level of satisfaction and an absence of glare or halo 3 months postoperatively.

Conclusion: In this study, the trifocal diffractive IOL provided excellent visual performance at all distances and improved contrast sensitivity under different conditions, resulting in high levels of patient satisfaction and spectacle independence in Chinese patients.

Keywords: contrast sensitivity defocus curves; patient satisfaction; spherical equivalent; trifocal diffractive intraocular lens; visual acuity.

Figure 1

The adjusted quadratic curve for preoperative anterior chamber depth (ACD) and the spherical equivalent (SE). The x-axis represents SE and y-axis preoperative ACD. For ACD 2.8–4.12 mm, the postoperative SE was easy to shift to myopia, while for ACD <2.8 or >4.12 mm, the postoperative SE was prone to hyperopia.