The Postoperative Visual and Refractive Outcomes of Trifocal and Extended Depth-of-Focus Intraocular Lenses in Patients with Different Biometric Characteristics

Abstract

We aimed to survey the potential correlation between biometric parameters and postoperative outcomes after implanting extended depth-of-focus (EDOF) intraocular lenses (IOLs) and trifocal IOLs. A retrospective cohort study was conducted, and patients receiving EDOF or trifocal IOL implantations were included. In total, 36 and 26 eyes were enrolled in the EDOF and trifocal groups, respectively. The primary outcomes of this study were the postoperative uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), and spherical equivalent (SE). The generalized linear model was applied to evaluate the adjusted odds ratio (aOR) and 95% confidence intervals (CIs) of primary outcomes in patients with different biometric characters. The final UDVA of the EDOF group was significantly better than that of the trifocal group (p = 0.020), and the UNVA and SE did not show significant differences between the two groups throughout the postoperative period (all p > 0.05). In a multivariable analysis, the UDVA was significantly better in the EDOF group than in the trifocal group (p = 0.038). For the subgroup analysis, the high axial length (AXL) value correlated to a lower postoperative UDVA in the EDOF group (both p < 0.05). Additionally, a large white-to-white (WTW) diameter was related to worse postoperative UNVA in the trifocal group (p = 0.042), and a high AXL was associated with higher SE in both the EDOF and trifocal groups (both p < 0.05). In conclusion, a high AXL correlates to worse postoperative outcomes in both the EDOF and trifocal IOLs, and trifocal IOL outcomes could be affected by large WTW diameters.

Keywords: axial length; extend depth-of-focus; spherical equivalent; trifocal; uncorrected distance visual acuity.

Figure 1

The final postoperative outcomes between the two groups. (A) The final uncorrected visual acuity between groups; (B) the final uncorrected near visual acuity between groups; and (C) the final spherical equivalent between groups. D: diopter; EDOF: extended depth-of-focus; UDVA: uncorrected distance visual acuity; UNVA: uncorrected near visual acuity; SE: spherical equivalent. * denotes significant differences between groups.