Comparison of 3-month visual outcomes of a new multifocal intraocular lens vs a trifocal intraocular lens

H Burkhard Dick, Robert E Ang, Dean Corbett, Peter Hoffmann, Manfred Tetz, Alberto Villarrubia, Carlos Palomino, Alfredo Castillo-Gomez, Linda Tsai, Eugenia K Thomas, Priya Janakiraman, H Burkhard Dick, Robert E Ang, Dean Corbett, Peter Hoffmann, Manfred Tetz, Alberto Villarrubia, Carlos Palomino, Alfredo Castillo-Gomez, Linda Tsai, Eugenia K Thomas, Priya Janakiraman

Abstract

Purpose: To compare the clinical performance of the TECNIS Synergy multifocal (model ZFR00V) intraocular lens (IOL) with that of the AcrySof PanOptix Trifocal (model TFNT00) IOL in patients undergoing bilateral cataract surgery.

Setting: Multicenter clinical setting.

Design: Prospective randomized comparative study.

Methods: Patients aged 22 years or older were randomly assigned (2:1) to bilateral implantation with ZFR00V or TFNT00 IOLs. End points included the mean binocular distance-corrected near visual acuity (DCNVA) at 40 cm, photopic and mesopic DCNVAs at 33 cm, photopic low-contrast corrected distance visual acuity (CDVA) and mesopic CDVA, nondirected patient responses to an ocular/visual symptoms questionnaire, and safety.

Results: Of the 150 patients implanted with IOLs, 95 of the 97 patients with ZFR00V IOLs and 52 of the 53 patients with TFNT00 IOLs completed the 3-month follow-up. Most patients in the ZFR00V and TFNT00 groups achieved 20/25 or better binocular CDVA (100% vs 96.2%) and DCNVA measured at 40 cm (88.4% vs 75.0%) and 33 cm (78.9% vs 51.9%). The mean between-group difference in binocular DCNVA at 40 cm favored ZFR00V IOLs (0.5 lines Snellen; 95% CI, 0.012 to 0.089; P ≤ .05). Similarly, the mean binocular photopic and mesopic DCNVAs at 33 cm (0.8 lines Snellen each; both P ≤ .05 vs TFNT00) and photopic high-contrast and low-contrast CDVA (0.5 lines Snellen each; both P ≤ .05 vs TFNT00) favored ZFR00V IOLs. Patient-reported ocular/visual symptoms and safety were generally similar between the 2 IOLs.

Conclusions: The ZFR00V IOL showed an extensive range of vision, particularly through near distances, and better mesopic performance than the TFNT00 IOL in patients undergoing cataract surgery.

Conflict of interest statement

Disclosures: H.B. Dick reports a consulting contract (particular requested and consented work) with Johnson & Johnson Vision and has received contractual payments from Alcon Laboratories, Inc./Novartis Corp. for presentations and work on request. R. Ang has received research grants from Acevision, Inc., Acufocus, Inc., Bausch & Lomb, Inc.; Beaver-Visitec International, Glaukos Corp., Ivantis, Inc., Johnson & Johnson Vision, and STAAR Surgical Co. D. Corbett is a consultant for Johnson & Johnson Vision and reports providing investigation and professional services to and receiving travel and accommodations services from Johnson & Johnson Vision. P. Hoffmann has received compensation for clinical studies from Hoya Surgical Optics, Inc. and Johnson & Johnson Vision and lecture fees from Alcon Laboratories, Inc., Bausch & Lomb, Inc., Heidelberg Engineering, Inc., Hoya Surgical Optics, Inc., and Johnson & Johnson Vision. A. Castillo-Gomez, M. Tetz, C. Palomino, and A. Villarrubia report no conflicts of interest.

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of ASCRS and ESCRS.

Figures

Figure 1.
Figure 1.
Photographs of (A) TECNIS Synergy IOL, model ZFR00V, and (B) AcrySof IQ PanOptix Trifocal IOL, model TFNT00.
Figure 2.
Figure 2.
Binocular CDVA outcomes at 3 months postoperatively for the ZFR00V (n = 95) and (n = 52) TFNT00 IOLs. Values presented as mean ± SD; *P ≤ .05 vs TFNT00.
Figure 3.
Figure 3.
Proportion of patients who achieved 20/25 (0.8 decimal) or better binocular CDVA, DCIVA, and DCNVA at 3 months. *P ≤ .05 vs TFNT00 IOLs.
Figure 4.
Figure 4.
Binocular distance-corrected defocus curves for eyes implanted with the ZFR00V and TFNT00 IOLs at 3 months. *P ≤ .05 for ZFR00V vs TFNT00 IOLs.

References

    1. Sudhir RR, Dey A, Bhattacharrya S, Bahulayan A. AcrySof IQ PanOptix intraocular lens versus extended depth of focus intraocular lens and trifocal intraocular lens: a clinical overview. Asia Pac J Ophthalmol (Phila) 2019;8:335–349
    1. Johnson & Johnson Vision. TECNIS Synergy IOL with TECNIS Simplicity Delivery System. 05/2021. Santa Ana, CA: Johnson & Johnson Vision; 2021
    1. US Food and Drug Administration. Alcon Laboratories, Inc. AcrySof IQ PanOptix Trifocal Intraocular Lens (Model TFNT00) and AcrySof IQ PanOptix Toric Trifocal Intraocular Lens (Models TFNT30, TFNT40, TFNT50, TFNT60). 09/11/2019. Silver Spring, MD: US Food and Drug Administration; 2019
    1. Liu JL, McAnany JJ, Wilensky JT, Aref AA, Vajaranant TS. M&S smart system contrast sensitivity measurements compared with standard visual function measurements in primary open-angle glaucoma patients. J Glaucoma 2017;26:528–533
    1. Vargas V, Radner W, Allan BD, Reinstein DZ, Dick HB, Alió JL. Methods for the study of near, intermediate vision, and accommodation: an overview of subjective and objective approaches. Surv Ophthalmol 2019;64:90–100
    1. Canovas C, Weeber H, Trentacost D, Janakiraman P, Tarantino N, Raheja M, Piers P. Optical and visual performance of violet blocking intraocular lenses. ARVO, Vancouver, BC, 2019
    1. Zhao H, Mainster MA. The effect of chromatic dispersion on pseudophakic optical performance. Br J Ophthalmol 2007;91:1225–1229
    1. Yildirim TM, Fang H, Schickhardt SK, Wang Q, Merz PR, Auffarth GU. Glistening formation in a new hydrophobic acrylic intraocular lens. BMC Ophthalmol 2020;20:186.
    1. Wang Q, Yildirim TM, Schickhardt SK, Labuz G, Khoramnia R, Merz PR, Son H-S, Munro DJ, Friedmann E, Auffarth GU. Quantification of the in vitro predisposition to glistening formation in one manufacturer's acrylic intraocular lenses made in different decades. Ophthalmol Ther 2021;10:165–174
    1. Grzybowski A, KanclerzBeiko PGHH. IOLs glistenings and quality of vision. Graefes Arch Clin Exp Ophthalmol 2019;257:2795–2796
    1. Johansson B. Glistenings, anterior/posterior capsular opacification and incidence of Nd:YAG laser treatments with two aspheric hydrophobic acrylic intraocular lenses—a long-term intra-individual study. Acta Ophthalmol 2017;95:671–677
    1. Ribeiro FJ, Ferreira TB, Silva D, Matos AC, Gaspar S. Visual outcomes and patient satisfaction after implantation of a presbyopia-correcting intraocular lens that combines EDOF and multifocal profiles. J Cataract Refract Surg 2021;47:1448–1453
    1. Kim TI, Chung TY, Kim MJ, Lee K, Hyon JY. Visual outcomes and safety after bilateral implantation of a trifocal presbyopia correcting intraocular lens in a Korean population: a prospective single-arm study. BMC Ophthalmol 2020;20:288.
    1. Kohnen T, Herzog M, Hemkeppler E, Schönbrunn S, Lorenzo ND, Petermann K, Böhm M. Visual performance of a quadrifocal (trifocal) intraocular lens following removal of the crystalline lens. Am J Ophthalmol 2017;184:52–62
    1. Pedrotti E, Carones F, Talli P, Bonacci E, Selvi F, Galzignato A, Besutti A, Gregorio AD, Marchini G. Comparative analysis of objective and subjective outcomes of two different intraocular lenses: trifocal and extended range of vision. BMJ Open Ophthalmol 2020;5:e000497
    1. Doroodgar F, Niazi F, Sanginabadi A, Karimian F, Niazi S, Alinia C, Javadi MA. Visual performance of four types of diffractive multifocal intraocular lenses and a review of articles. Int J Ophthalmol 2021;14:356–365
    1. Pew Research Center. Mobile Fact Sheet. Washington, DC: Pew Research Center; 2021. Available at: . Accessed July 13, 2021
    1. American Association of Retired Persons. Tech and the 50+ Survey. Washington, DC: AARP; 2020. Available at: . Accessed December 24, 2020
    1. Sandoval HP, Lane S, Slade SG, Donnenfeld ED, Potvin R, Solomon KD. Defocus curve and patient satisfaction with a new extended depth of focus toric intraocular lens targeted for binocular emmetropia or slight myopia in the non-dominant eye. Clin Ophthalmol 2020;14:1791–1798
    1. Xu Z, Cao D, Chen X, Wu S, Wang X, Wu Q. Comparison of clinical performance between trifocal and bifocal intraocular lenses: a meta-analysis. PLoS One 2017;12:e0186522.
    1. Plaza-Puche AB, Alió JL, MacRae S, Zheleznyak L, Sala E, Yoon G. Correlating optical bench performance with clinical defocus curves in varifocal and trifocal intraocular lenses. J Refract Surg 2015;31:300–307
    1. de Silva SR, Evans JR, Kirthi V, Ziaei M, Leyland M. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database Syst Rev 2016;12:CD003169.
    1. Maxwell A, Holland E, Cibik L, Fakadej A, Foster G, Grosinger L, Moyes A, Nielsen S, Silverstein S, Toyos M, Weinstein A, Hartzell S. Clinical and patient-reported outcomes of bilateral implantation of a +2.5 diopter multifocal intraocular lens. J Cataract Refract Surg 2017;43:29–41
    1. Zhong Y, Wang K, Yu X, Liu X, Yao K. Comparison of trifocal or hybrid multifocal-extended depth of focus intraocular lenses: a systematic review and meta-analysis. Sci Rep 2021;11:6699.
    1. Asena BS. Visual and refractive outcomes, spectacle independence, and visual disturbances after cataract or refractive lens exchange surgery: comparison of 2 trifocal intraocular lenses. J Cataract Refract Surg 2019;45:1539–1546
    1. Modi S, Lehmann R, Maxwell A, Solomon K, Cionni R, Thompson V, Horn J, Caplan M, Fisher B, Hu JG, Yeu E. Visual and patient-reported outcomes of a diffractive trifocal intraocular lens compared with those of a monofocal intraocular lens. Ophthalmology 2021;128:197–207
    1. Chang DH. Visual acuity and patient satisfaction at varied distances and lighting conditions after implantation of an aspheric diffractive multifocal one-piece intraocular lens. Clin Ophthalmol 2016;10:1471–1477
    1. Schallhorn JM. Multifocal and extended depth of focus intraocular lenses: a comparison of data from the united states food and drug administration premarket approval trials. J Refract Surg 2021;37:98–104
    1. Rosa AM, Miranda  C, Patrício MM, McAlinden C, Silva FL, Castelo-Branco M, Murta JN. Functional magnetic resonance imaging to assess neuroadaptation to multifocal intraocular lenses. J Cataract Refract Surg 2017;43:1287–1296

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