Comparative analysis of visual quality between unilateral implantation of a trifocal intraocular lens and a rotationally asymmetric refractive multifocal intraocular lens

Abstract

Aim: To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens (IOL) and asymmetric refractive multifocal IOL.

Methods: The prospective nonrandom, comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs: AT LISA tri 839MP (30 eyes; Carl Zeiss Meditec, Germany) and LS-313 MF30 (30 eyes; Oculentis GmbH, Germany). Visual acuity, refractive outcome, contrast sensitivity, defocus curves, quality of vision, and optical phenomena were evaluated at 3mo postoperatively.

Results: There were no statistical differences between groups in uncorrected distance visual acuity (P=0.13) and uncorrected near visual acuity (P=0.54). In contrast, uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group (P=0.02). No significant statistical between-group difference was detected in cylinder (P=0.43). Compared to trifocal group, spherical refraction and spherical equivalent in refractive multi focal group were more myopic (P<0.01). Under photopic conditions, no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree (cpd). The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group (P=0.01, P=0.034, respectively). The questionnaires of quality of vision and optical phenomena showed no differences between groups.

Conclusion: Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity. Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.

Keywords: contrast sensitivity; rotationally asymmetric multifocal intraocular lens; trifocal intraocular lens; visual quality.

Figure 1. Distribution of monocular refractive outcomes for trifocal and refractive multifocal groups at 3mo postoperatively

A: Spherical dioptre; B: Refractive cylinder; C: Spherical equivalent refraction.

Figure 2. Monocular defocus curves at 3mo postoperatively.

Figure 3. The 3-month postoperative monocular contrast sensitivity under photopic conditions

A: Without glare; B: With glare. ^aStatistically significant (P<0.05).

Figure 4. Results for the Catquest-9SF questionnaire

A: Results for item A; B: Results for item B; C: Results for item C1-C7.