Dataset Information

Comparison of visual performance between diffractive bifocal and diffractive trifocal intraocular lenses.

ABSTRACT: To evaluate the visual performance of a diffractive bifocal intraocular lens (IOL) with + 4.0 D near addition (ZMB00) and a diffractive trifocal IOL with + 2.17 D and + 3.25 D near addition (AcrySof IQ PanOptix TFNT00), we investigated the 10-week postoperative parameters after cataract surgery in which ZMB00 or TFNT00 lenses were implanted bilaterally from 2011 to 2020 (with a 3-month interval between implantation of the right and left lenses). The study included 1448 eyes of 724 patients. The diffractive bifocal group comprised 1326 eyes of 663 patients (aged 67.0 ± 7.8 years; females/males, 518/145), and the diffractive trifocal group comprised 122 eyes of 61 patients (aged 66.6 ± 7.3 years; females/males, 35/26). A linear mixed-effects model using data for both eyes, with strict adjustments for sex, age, subjective refraction spherical equivalent, subjective refraction cylinder, corneal astigmatism, axial length, corneal higher-order aberrations, and pupil diameter, ensured statistical validity. Uncorrected near visual acuity and higher-order aberrations (ocular/internal, scaled to a pupil size of 4 mm) (Wavefront_4mm_postoperative_Ocular/Internal_Spherical) were significantly better in the bifocal group (p < 0.00068, Wald test). Uncorrected intermediate visual acuity, contrast sensitivity (6.3/4.0/2.5/1.6/1.0/0.7 degrees), and contrast sensitivity with glare (4.0/1.6/1.0/0.7 degrees) were significantly better in the trifocal group (p < 0.00068, Wald test).

SUBMITTER: Kawamura J

PROVIDER: S-EPMC10912743 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature

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Comparison of visual performance between diffractive bifocal and diffractive trifocal intraocular lenses.

Kawamura Junya J Tanabe Hirotaka H Shojo Tomohiro T Yamauchi Tomofusa T Takase Kosuke K Tabuchi Hitoshi H

Scientific reports 20240304 1

To evaluate the visual performance of a diffractive bifocal intraocular lens (IOL) with + 4.0 D near addition (ZMB00) and a diffractive trifocal IOL with + 2.17 D and + 3.25 D near addition (AcrySof IQ PanOptix TFNT00), we investigated the 10-week postoperative parameters after cataract surgery in which ZMB00 or TFNT00 lenses were implanted bilaterally from 2011 to 2020 (with a 3-month interval between implantation of the right and left lenses). The study included 1448 eyes of 724 patients. The ...[more]

PMID: 38438495

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Project description:PurposeTo compare the clinical performance between trifocal and bifocal intraocular lenses in bilateral cataract and/or refractive lens exchange (RLE) surgery.MethodsA comprehensive literature search of PubMed, EMBASE, Cochrane Controlled Trials Register and Web of Science was performed through October 2016 to identify randomized, controlled trials (RCTs) and comparative cohort studies. The primary outcomes were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), defocus curve, spectacle independence, patient satisfaction and contrast sensitivity. The secondary outcomes were residual sphere, spherical equivalent (SE), cylinder and complications.ResultsSix RCTs and 2 cohort studies including 568 eyes (278 in the trifocal group and 290 in the bifocal group) were identified. There was a statically significant difference between the two groups in UDVA (WMD: -0.03, 95% CI: -0.05 to -0.01, P = 0.005), but the difference (0.03 log MAR) is not clinically significant. Intermediate visual acuity was better in the trifocal IOL group judging from UIVA and defocus curves. There was a statically significant difference between the two groups in residual cylinder (WMD: 0.11, 95% CI: 0.02 to 0.20, P = 0.02), and subgroup AT Lisa tri 839MP trifocal also showed significant better UNVA than bifocal IOLs (WMD: -0.13, 95% CI: -0.17 to -0.08, P<0.00001). However, no significant differences were observed in UNVA (WMD: -0.04, 95% CI: -0.11 to 0.02, P = 0.19), spectacle independence (WMD: 1.27, 95% CI: 0.89 to 18.15, P = 0.07), patient satisfaction (WMD: 4.01, 95% CI: 0.07 to 22.72, P = 0.87), residual sphere (WMD: -0.03, 95% CI: -0.18 to 0.13, P = 0.74), SE (WMD: 0.04, 95% CI: -0.09 to 0.16, P = 0.55) or complications (WMD: 2.08, 95% CI: 0.35 to 12.43, P = 0.42).ConclusionsTrifocal IOL technology (especially AT Lisa trifocal 839M trifocal) had a clear advantage over bifocal IOLs in intermediate visual acuity, while both trifocal IOLs and bifocal IOLs showed excellent performance in distance visual acuity. AT Lisa trifocal 839M trifocal could provide better uncorrected near visual acuity than bifocal IOLs. However, more evidence is needed to compare their spectacle independence, higher satisfaction rate, and photic phenomena.

Project description:BackgroundTo compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted.MethodsA comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction.ResultsThere were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no significance [MD = 0.02, 95%CI: (- 0.03,0.06)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95%CI (- 0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD = 0.09,95%CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA (DCIVA) [MD = 0.09, 95%CI: (- 0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839 M) [MD = 0.18, 95%CI: (0.12, 0.24) for UIVA and MD = 0.19, 95%CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA (UDVA) and corrected distance visual acuity (CDVA) [MD = 0.01, 95%CI: (- 0.01,0.04) for UDVA; MD = 0.00, 95%CI: (- 0.01,0.01) for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD = -0.08, 95% CI: (- 0.19, 0.03) for spherical equivalent; MD = -0.09, 95%CI: (- 0.21, 0.03) for cylinder; MD = -0.09, 95% CI: (- 0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR = 0.89, 95% CI: (0.71, 1.12) for spectacle independence; RR = 1.81, 95% CI: (0.50, 6.54) for PCO incidence; RR = 0.98, 5% CI: (0.86, 1.12) for patient satisfaction].ConclusionPatients receiving trifocal IOLs, especially AT LISA tri 839 M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.

Project description:IntroductionAstigmatism reduces the postoperative visual performance after non-toric intraocular lenses (IOLs) implantation, and limits the use of refractive IOLs in cataract surgery. The purpose of this study was to compare the efficacy in astigmatism correction and the postoperative visual outcomes between the implantation of a trifocal IOL with femtosecond laser-assisted arcuate keratotomy (FSAK) in one eye and a bifocal toric IOL (TIOL) in the other, in patients with cataract and moderate astigmatism.MethodsThis prospective observational paired-eye study enrolled patients with cataract and corneal astigmatism (CA) between 0.75 and 2.25 D in both eyes. The patients underwent a mix-and-match treatment comprising trifocal IOL implantation with FSAK and bifocal TIOL implantation. We compared the visual acuity (VA) at all distances, defocus curve, postoperative refractive astigmatism (RfA), CA, high-order aberrations, modulation transfer function (MTF) curve, and Strehl ratio between the two eye groups.ResultsIn total, 41 patients (82 eyes) were enrolled and completed a 6-month follow-up. The 1- and 3-month uncorrected distance VA and 3-month uncorrected near VA were greater in eyes with bifocal TIOLs than with trifocal IOLs and FSAK (p = 0.036, 0.010, and 0.030, respectively), whereas the latter had greater uncorrected intermediate VA at every visit and greater VA in the intermediate range of defocus curve (at -1.50 and - 2.00 D) than the eyes with bifocal TIOLs. The postoperative RA of the eyes with trifocal IOL and FSAK was significantly higher than that of the bifocal TIOL-implanted eyes at the 3- and 6-month follow-ups.DiscussionBoth FSAK and TIOL implantation effectively reduce pre-existing moderate astigmatism in patients with cataract. The eyes with bifocal TIOLs had more stable long-term astigmatism correction, whereas those with trifocal IOLs and FSAK had better intermediate VA. Therefore, a mix-and-match implantation of trifocal IOL with FSAK and contralateral bifocal TIOL could achieve effective astigmatism correction and provide an overall optimal VA.

Dataset Information

Comparison of visual performance between diffractive bifocal and diffractive trifocal intraocular lenses.

Publications

Comparison of visual performance between diffractive bifocal and diffractive trifocal intraocular lenses.

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