Comparison of visual outcomes between bilateral trifocal intraocular lenses and combined bifocal intraocular lenses with different near addition

Abstract

Purpose: To compare outcomes in patients implanted bilaterally with a trifocal intraocular lens (IOL) with patients implanted with bifocal IOLs having different near addition in each eye.

Study design: Nonrandomized comparative study.

Methods: Seventy-eight patients scheduled for multifocal IOL implantation were divided into a trifocal group (n=32) implanted bilaterally with trifocal IOLs (Alcon TFNT00), and a combined bifocal group (n=46) implanted with a bifocal IOL with +3.0 diopter (D) addition in the dominant eye and +4.0D addition in the nondominant eye. At 3 months postoperatively, binocular all-distance visual acuity (VA), binocular contrast VA alone and with glare (glare VA), near stereoacuity, and incidence of patients reporting halo symptoms were assessed.

Results: Both mean binocular uncorrected and corrected VAs at far to intermediate distances were significantly better in the trifocal group than in the combined bifocal group (P≤0.0325), while binocular near VA did not differ significantly between groups. Mean photopic and mesopic contrast VA and glare VA at most contrasts, and stereoacuity were significantly better in the trifocal group than in the combined bifocal group (P≤0.0426). The incidence of patients reporting moderate halo symptoms was significantly greater in the trifocal group (P=0.0482).

Conclusions: Bilateral implantation of a trifocal IOL provided significantly better binocular VA at far to intermediate distances and comparable near VA compared with combined implantation of bifocal IOLs with +3.0D and +4.0D addition. Contrast VA and stereoacuity were significantly better, but the incidence of halo symptoms tended to be worse in patients with trifocal IOLs.

Keywords: Binocular visual function; Cataract surgery; Combined implantation of bifocal intraocular lenses; Near addition power; Trifocal intraocular lens.