Trifocal Intraocular Lens Implantation to Treat Visual Demands in Various Distances Following Lens Removal

PURPOSE: To evaluate visual and refractive outcomes after implantation of a trifocal intraocular lens (IOL). DESIGN: Prospective, nonrandomized noncomparative case series. METHODS: SETTING: Department of Ophthalmology, Goethe University, Frankfurt/Germany. PATIENT OR STUDY POPULATION: Twenty-seven patients (54 eyes) who had bilateral implantation of the AT LISA trifocal IOL (AT LISA tri839MP; Carl Zeiss Meditec, Jena, Germany) pre-enrollment. Exclusion criteria were previous ocular surgeries excluding cataract surgery and refractive lens exchange, irregular corneal astigmatism of >1.5 diopter, and ocular pathologies or corneal abnormalities. INTERVENTION OR OBSERVATION PROCEDURE(S): Postoperative examination at 1 and 3 months included manifest refraction; monocular and binocular uncorrected (UCVA) and distance-corrected (DCVA) visual acuity in 4 m, 80 cm, and 40 cm; slit-lamp examination; and tomography. At 3 months defocus testing, binocular contrast sensitivity (CS) under photopic and mesopic conditions and a questionnaire on subjective quality of vision, optical phenomena, and spectacle independence were performed. Main OUTCOME MEASURE(S): Three-months-postoperative monocular and binocular UCVA and DCVA in 4 m, 80 cm, and 40 cm (logMAR); defocus curve; CS; and quality-of-vision questionnaire results. RESULTS: Mean spherical equivalent was 0.05 +/- 0.32 D 3 months postoperatively. Binocular UCVA at distance, intermediate, and near was 0.1 +/- 0.1 logMAR, 0.0 +/- 0.1 logMAR, and 0.0 +/- 0.1 logMAR, respectively. Despite some optical phenomena, 92% of patients would choose the same IOL again. CONCLUSION: Evaluation of a trifocal IOL showed good VA (0.1 logMAR or better) at far, intermediate, and near distance; high patient satisfaction despite some optical phenomena; and high spectacle independence 3 months postoperatively. (C) 2016 by Elsevier Inc. All rights reserved.