SPS-207 Trifocal IOLs II | ASCRS
2020 ASCRS Virtual Annual Meeting

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Papers in this Session
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Objective and Subjective Visual Quality after Implantation of a Trifocal Intraocular Lens in High Myopes with Different Axial Lengths
Author
Hui Liu, PhD, MD

Methods
This non-randomized retrospective study included 61 eyes of 44 patients implanted with the trifocal diffractive IOL (AT LISA tri 839MP): 21 eyes (15 patients) in the AL <26mm group, 19 eyes (13 patients) in the 26mm≤ AL <28mm group, and 21 eyes (16 patients) in the AL ≥28mm group. Postoperative outcomes at 3 months including corrected and uncorrected distance, intermediate and near visual acuity at 167 cd/m2 luminance, depth of focus at 85 cd/m2 luminance, objective optical quality parameters using Optical Quality Analysis System (OQAS) were compared between three groups.

Results
The mean UDVA, UIVA, UNVA, CDVA, DCIVA and DCNVA showed no significant differences between three groups (P >0.05). Statistically significant difference at all vergences was found between three groups except for -0.5D and 0D (P >0.05). AL <26 mm group curve showed better near and intermediate visual acuity through -3.0 D to -1.5 D (P <0.01 vs AL ≥28mm). Significantly lower values of OSI and higher values of MTF-cut off, SR and OVs were also found in the AL < 26 group (P <0.01 vs AL ≥28mm). All objective optical quality parameters (OSI, MTF cut-off, SR, OVs) had statistically significant correlation with subjective DCNVA or visual acuity at the vergence of -2.5D (P <0.05 to P <0.01).

Conclusion
Implantation of the trifocal IOL in highly myopic eyes with long axial length provided satisfactory short-term visual and refractive outcomes. However, when AL ≥28mm, the increase of intraocular scatter may influence the near visual acuity under photopic condition with lower illumination.
Comparison of Multicentric Clinical Outcomes Obtained on Three Different Trifocal Intraocular Lenses Differing in Optic Design and Material
Authors
Florian T. Kretz, MD
Detlev R. Breyer, MD
Ramin Khoramnia, MD
Gerd U. Auffarth, MD, PhD

Methods
Manifest refraction, monocular and binocular visual acuity (far, intermediate, near), defocus curves, contrast sensitivity and subjective Halo and Glare outcomes were compared with follow-up at 3 and 6 months postoperative.

Results
The preliminary results on 58 patients (116 eyes) show that POD F and POD F GF achieve refractive outcomes close to emmetropia, whereas PanOptix shows significantly hyperopic outcomes of 0.38±0.35D. Postoperative mean CDVA, DCIVA, DCNVA in logMAR are -0.02±0.10, 0.08±0.09, 0.06±0.11 for POD F; 0.00±0.09, 0.13±0.12, 0.15±0.17 for POD F GF and 0.00±0.10, 0.10±0.13, 0.15±0.12 respectively for PanOptix. All defocus curves show a wide defocus range with visual acuities ≤0.2 logMAR from -3.6D to 1.0D (POD F), -3.3D to 1.0D (POD F GF), and -3.25D to 0.8D (PanOptix). The Halo and Glare simulator tests show outcomes on a very acceptable level with no significant differences between the lenses.

Conclusion
In conclusion, the implantation of the investigated trifocal lenses allows for a safe and efficient restoration of near, intermediate, and far visual acuity. Preliminary contrast sensitivity outcomes show superior results with POD F.
Evaluation of Quality of Vision and Spectacle Independence with Bilateral Implantation of a Trifocal Intraocular Lens
Author
Andrew C. Shatz, MD, ABO

Methods
This is a prospective, single-arm clinical evaluation study of outcomes following successful, uncomplicated bilateral cataract surgery. Subjects will be assessed pre-operatively, operatively and at 1 day, 1 month and 3 months post-operatively. The 3-month evaluation will include measurement of the manifest refraction and uncorrected and best distance-corrected binocular visual acuity at distance, intermediate (60 cm) and near (40 cm). A questionnaire related to spectacle independence will be completed, along with a quality of vision questionnaire.

Results
Nine bilaterally implanted subjects have completed their 3-month visit. The mean spherical equivalent refraction was 0.13D. All subjects reported binocular intermediate and near VA of 20/25 or better. All but one subject reported not needing glasses for distance, near or intermediate work – one subject needed them for near work. Seven of nine subjects (77%) reported never wearing glasses; two subjects reported wearing glasses for near work. Eight of nine subjects (88%) reported functioning comfortably at all distances without spectacles and were mostly or completely satisfied with their vision at all distances. Haloes were the most commonly reported visual disturbances.

Conclusion
Early results indicate that the trifocal IOL provides excellent near, intermediate and distance vision for patients, with a high degree of spectacle independence.
Evaluation of Spectacle Independence after Bilateral Implantation of a Trifocal Intraocular Lens
Authors
Clayton G. Blehm, MD, ABO
Richard Potvin, OD

Methods
This is a prospective, single-arm, unmasked study of outcomes following successful, uncomplicated bilateral cataract surgery. Subjects will be assessed pre-operatively, operatively and at 1 day, 1 month and 3 months post-operatively. The 3-month evaluation will include measurement of the manifest refraction and uncorrected and best distance-corrected binocular visual acuity at distance, intermediate (60cm) and near (40cm). A questionnaire related to spectacle independence will be administered at the 3-month visit.

Results
Responses from 26 bilaterally implanted subjects were available for analysis. No subject reported needing spectacles for distance vision, only 1 (4%) needed spectacles for intermediate work and 3 (11%) needed spectacles for near vision. Twenty-two subjects (85%) reported never wearing glasses, with the remaining subjects wearing glasses only “some of the time” or less, usually for near work. All subjects reported functioning without glasses all or most of the time for distance, 25/26 (96%) for intermediate and 23/26 (88%) for near. Overall, 22/26 (85%) reported being completely satisfied. The remainder were mostly (2/26, 8%) or moderately (2/26, 8%) satisfied, with no subject dissatisfied.

Conclusion
A high percentage of patients can expect to function comfortably without spectacles for distance, intermediate and near vision with this trifocal IOL, with only a small percentage of patients likely to require spectacles occasionally for near work. Overall satisfaction was high, with no dissatisfied subjects.
Cumulative Binocular Vision Outcomes with a New Trifocal IOL
Authors
Elizabeth Yeu, MD
Satish S. Modi, FRCS, MD

Methods
This was a prospective, non-randomized, vision assessor-masked, multicenter (twelve sites in the USA), parallel-group study. Bilateral implantation after FLACS and IOL power calculation using Barret Universal II and Holladay II formula were used in the TFNT00 (T) and SN60AT (S) groups, respectively. Cumulative uncorrected (UC) and distance corrected (DC) visual acuities (VA) at distance (4 m), intermediate (66cm) and near (40cm) were analyzed.

Results
243 subjects (127 in the T group and 114 in the S group) completed the study. Mean age was 67.3 years and 67.5% were females. The mean (±SD) photopic binocular DCVA (logMAR) at 4m was -0.062 (0.066) [T] and -0.086 (0.063) [S]. There were clinically relevant differences in mean photopic binocular DCVA at 40 cm and 66 cm. The % of subjects who reached 20/25-2 or better at 40cm were 92.1% (UC, T) VS 9% (UC, S), 96.1% (DC, T) VS 0% (DC, S). The percentage of subjects who reached 20/25-2 or better at 66cm were 93.7% (UC, T) VS 50.5% (UC, S), 97.6% (DC, T) VS 26.1% (DC, S). The proportion of subjects achieving a threshold of binocular UCVA 20/25-2 at the 3 distances was 83.5% (T) and 8.1% (S).

Conclusion
The AcrySof IQ PanOptix Trifocal IOL provided superior binocular visual performance of 20/25-2 at near & intermediate and comparable at distance to the monofocal SN60AT IOL.

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