Mix-and-match vs bilateral trifocal and bilateral EDOF intraocular lens implantation: the spline curve battle

Abstract

Purpose: To compare the postoperative vision acuity curves following three pseudophakic presbyopic correction techniques. Setting: Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis, Greece Design: Prospective, randomized, comparative trial Methods: Stage 2 LOCS-III Cataract patients populated three study groups: a) Premium Monovision Group who received the Panoptix intraocular lens (IOL) in the recessive eye and the Vivity IOL in the dominant one, b) Bilateral Trifocal Group who received bilaterally the Panoptix IOL, and, c) Bilateral xEDOF Group who received bilaterally the Vivity IOL. Postoperative bilateral uncorrected vision acuity (UVA) was measured at 25.5, 28, 33, 40, 50, 66, 100, 200 and 300cm distances. Spline curve fitting was attempted and areas of the curves (AOC) and Curvatures k were calculated. All patients responded to the NEI-VFQ-25 questionnaire. Results: 90 patients populated equally the three groups. Premium monovision and bilateral trifocal implantation delivered similar visual acuity (all AOC p>0.05); however the trifocal patients suffered from vision acuity drops in certain distance ranges as expressed in negative curvature values. Bilateral xEDOF patients demonstrated worse near vision acuity (p<0.05). Premium monovision patients reported better scores in NEI-VFQ 25 (p=0.03) and in the near activities (p=0.02) and distant activities subscales (p=0.04). Conclusion: All surgical options provide impressive outcomes. Premium monovision seems to deliver the best results.