Comparison Between Bilateral Implantation of a Trifocal IOL and Mix-and-Match Implantation of a Bifocal IOL and an Extended Depth of Focus IOL

Abstract

PURPOSE: To compare the clinical outcomes of mix-and-match implantation of a diffractive extended depth of focus intraocular lens (IOL) (TECNIS Symfony ZXR00; Johnson & Johnson Vision) and a diffractive bifocal IOL (TECNIS ZLB00 +3.25 diopters [D]; Johnson & Johnson Vision) and bilateral implantation of a diffractive trifocal IOL (AcrySof IQ PanOptix; Alcon Laboratories, Inc). METHODS: This prospective comparative study compares the clinical outcomes of patients with age-related cataract undergoing cataract surgery using the IOLs described. Patients were divided into the mix-and-match group and the trifocal group. Assessment included monocular and binocular uncorrected distance visual acuity (UDVA), intermediate visual acuity (UIVA at 60 cm), and near visual acuity (UNVA at 40 cm), uncorrected defocus curves, contrast sensitivity, and reading speed. Quality of vision was measured with the Visual Function Questionnaire (VFQ-25). RESULTS: A total of 50 patients (25 in each group) were enrolled. At 6 months postoperatively, outcomes of binocular UDVA, UIVA, and UNVA were similar in both groups. The binocular defocus curve only differed at vergences of −0.50 to −1.00 D (better for the mix-and-match group; P = .032 and .004, respectively) and at −4.00 D (better for the trifocal group; P = .001). Significantly higher reading speeds in the mix-and-match group were measured at 0.7 and 0.5 logMAR ( P = .038 and .034, respectively). There were no significant differences between groups for contrast sensitivity and the results of the questionnaire. CONCLUSIONS: The mix-and-match implantation seemed to be a good option for patients with high demands for distance and intermediate visual acuity, whereas the trifocal IOL appeared to be more suitable for patients with enhanced near vision demands. [ J Refract Surg . 2020;36(8):528–535.]

Clinical Outcomes of Combined Implantation of an Extended Depth of Focus IOL and a Trifocal IOL in a Korean Population

“…Recently, the blended implantation strategy has been attempted to take advantage of the merits of both IOL types, and good results have been reported [ 13 , 23 , 24 ]. In a previous study, we compared the visual performance of patients with mix-and-match implantation of an EDoF IOL in the dominant eye and a bifocal IOL in the nondominant eye with trifocal IOL implantation in both the eyes [ 17 ]. According to this study, patients with the mix-and-match implantation showed better visual acuity results from the far to intermediate distance, while patients with the trifocal IOL achieved better visual acuity results at the near distance.…”

“…All patients were 21 years or older at the time of enrollment and underwent surgery of the second eye within seven days after surgery of the first eye. e exclusion criteria were the same as previous studies [17].…”

“…All patients were 21 years or older at the time of enrollment and underwent surgery of the second eye within seven days after surgery of the first eye. The exclusion criteria were the same as previous studies [ 17 ]. This study was approved by the Institutional Review Board of Kangbuk Samsung Hospital (IRB File No.…”

“…Reading speed (words per minute) was automatically calculated by the system. All preoperative and postoperative evaluations were conducted similarly to previous studies [ 17 ].…”

Unilateral implantation of a new non-diffractive extended range-of-vision IOL in a young patient with Curschmann-Steinert myotonic dystrophy

“…Trifocal IOLs can provide good functional results for far, near and intermediate distances. 6 , 7 , 54 They are superior to monofocal IOLs at near and intermediate distance and provide better optical quality than bifocal IOLs at intermediate distance. 8 , 9 It has also been demonstrated that trifocal IOLs improve the near and intermediate reading acuity.…”