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Meta-Analysis
. 2021 Mar 23;11(1):6699.
doi: 10.1038/s41598-021-86222-1.

Comparison of trifocal or hybrid multifocal-extended depth of focus intraocular lenses: a systematic review and meta-analysis

Yueyang Zhong #  1 , Kai Wang #  1 , Xiaoning Yu  1 , Xin Liu  1 , Ke Yao  2
Affiliations
Meta-Analysis

Comparison of trifocal or hybrid multifocal-extended depth of focus intraocular lenses: a systematic review and meta-analysis

Yueyang Zhong et al. Sci Rep. .

Abstract

This meta-analysis aimed to evaluate the clinical outcomes following implantation of trifocal intraocular lenses (IOLs) or a hybrid multifocal-extended depth of focus (EDOF) IOL in cataract or refractive lens exchange surgeries. We examined 13 comparative studies with bilateral implantation of trifocal (898 eyes) or hybrid multifocal-EDOF (624 eyes) IOLs published through 1 March 2020. Better uncorrected and corrected near visual acuity (VA) were observed in the trifocal group (MD: - 0.143, 95% CI: - 0.192 to - 0.010, P < 0.001 and MD: - 0.149, 95% CI: - 0.217 to - 0.082, P < 0.001, respectively), while the hybrid multifocal-EDOF group presented better uncorrected intermediate VA (MD: 0.055, 95% CI: 0.016 to 0.093, P = 0.005). Trifocal IOLs were more likely to achieve spectacle independence at near distance (RR: 1.103, 95% CI: 1.036 to 1.152, P = 0.002). The halo photic effect was generated more frequently by the trifocal IOLs (RR: 1.318, 95% CI: 1.025 to 1.696, P = 0.031). Contrast sensitivity and subjective visual quality yielded comparable results between groups. Trifocal IOLs demonstrated better performance at near distance but apparently led to more photic disturbances. Our findings provided the most up-to-date and comprehensive evidence by comparing the benefits of advanced IOLs in clinical practice.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart depicting selection of studies. RCTs, randomized controlled trials.
Figure 2
Figure 2
Visual acuities (VAs) in logMAR comparing trifocal and the hybrid multifocal-extended depth of focus (EDOF)intraocular lens (IOL). (a) Forest plot displaying mean difference (MD) of uncorrected VA of far, intermediate and near distance. (b) Forest plot displaying MD of corrected VA of far, intermediate and near distance. (c) Forest plot displaying MD of uncorrected intermediate VA comparing three types of trifocal IOLs and the hybrid multifocal-EDOF IOL.
Figure 3
Figure 3
Spherical equivalent comparing trifocal and the hybrid multifocal-extended depth of focus (EDOF) intraocular lens (IOL).
Figure 4
Figure 4
Spectacle independence of far, intermediate and near distance comparing trifocal and the hybrid multifocal-extended depth of focus (EDOF) intraocular lens (IOL).
Figure 5
Figure 5
Photic disturbance of halo and glare comparing trifocal and the hybrid multifocal-extended depth of focus (EDOF) intraocular lens (IOL).
See this image and copyright information in PMC

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