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Visual Acuity, Quality of Vision, and Patient-Reported Outcomes After Bilateral Implantation with a Trifocal or Extended Depth of Focus Intraocular Lens

Authors Tran DB, Owyang A, Hwang J, Potvin R

Received 3 December 2020

Accepted for publication 20 January 2021

Published 3 February 2021 Volume 2021:15 Pages 403—412


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Dan B Tran,1 Ashley Owyang,1 Jin Hwang,1 Richard Potvin2

1Coastal Vision Medical Group, Orange, CA, USA; 2Science in Vision, Bend, OR, USA

Correspondence: Dan B Tran
Coastal Vision Medical Group, 293 S. Main St., Suite 100, Orange, CA, 92868, USA

Purpose: To evaluate the visual acuity, quality of vision and patient reported outcomes for patients that were either bilaterally implanted with a trifocal intraocular lens (IOL) or an extended depth of focus (EDOF) IOL.
Design: Single site, prospective, non-interventional, masked, two-arm comparative study.
Methods: Subjects who had prior uncomplicated cataract surgery with bilateral implantation of one of the lenses above were evaluated. Subjects in each group were assessed during a single visit. The uncorrected and best distance-corrected binocular near (40 cm), intermediate (60 cm), and distance visual acuity (VA) were measured, along with a spectacle independence questionnaire, a quality of vision questionnaire and contrast sensitivity measured in both mesopic and photopic conditions.
Results: The study included 23 EDOF and 25 trifocal subjects. Binocular Uncorrected VAs were similar at distance and intermediate, but about 1.5 lines better at near with the trifocal (p < 0.001). Binocular best corrected distance – VA was significantly better with the EDOF lens (0.5 lines, p < 0.001), though the mean VA was better than 20/20 in both groups. Distance-corrected intermediate and near VA were significantly better with the trifocal IOL (1 line and 1.5 lines respectively, p < 0.001). Significantly more trifocal subjects had 20/25 or better VA at all three test distances (64% vs 4%, p< 0.001). Patient reported spectacle independence was significantly higher in the trifocal group, driven primarily by differences in near vision. Mesopic and photopic binocular contrast sensitivity, satisfaction and subjective quality of vision scores were similar between groups.
Conclusion: The trifocal IOL provided significantly better near vision (1.5 lines) with slightly worse distance vision (0.5 lines), while providing similar contrast sensitivity and visual quality. It may be the preferred choice for patients desiring more spectacle independence.

Keywords: trifocal IOL, EDOF IOL, presbyopia correction, cataract surgery, extended depth of focus

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