Visual Performance, Satisfaction, and Spectacle Independence after Implantation of a New Hydrophobic Trifocal Intraocular Lens

Antonio Cano-Ortiz, Álvaro Sánchez-Ventosa, Timoteo González-Cruces, David Cerdán-Palacios, Vanesa Díaz-Mesa, Rubén Gallego-Ordóñez, Teresa Gálvez-Gómez, Jose A García Parrizas, Javier Zurera Baena, Alberto Villarrubia-Cuadrado, Antonio Cano-Ortiz, Álvaro Sánchez-Ventosa, Timoteo González-Cruces, David Cerdán-Palacios, Vanesa Díaz-Mesa, Rubén Gallego-Ordóñez, Teresa Gálvez-Gómez, Jose A García Parrizas, Javier Zurera Baena, Alberto Villarrubia-Cuadrado

Abstract

The main objective was to evaluate distance, intermediate, and near vision in patients who have undergone cataract extraction with bilateral implantation of a new trifocal diffractive intraocular lens (IOL), along with patient-reported outcomes (PRO). A total of 50 eyes from 25 patients after AsqelioTM Trifocal IOL (AST Products, Inc., Billerica MA, USA) implantation were assessed in this study. At 3 months after surgery, the photopic visual acuity (VA) at distance, intermediate, and near distances was measured. Binocular photopic defocus curves were also obtained. Three questionnaires to assess patients' visual satisfaction and spectacle dependence, among other items, were completed: the Catquest-9SF, the patient-reported spectacle independence questionnaire (PRSIQ), and the patient-reported visual symptoms questionnaire (PRVSQ). The average spherical equivalent was 0.21 ± 0.37 D at 3 months post-operation, and the average absolute tolerance to defocus was 3.64 ± 0.70 D. The mean binocular uncorrected VAs for distance, intermediate, and near vision were -0.02 ± 0.09, 0.06 ± 0.08, and 0.11 ± 0.07 logMAR, respectively. The best-corrected VA was better than 0.1 logMAR for the whole range from distance to near. PROs revealed spectacle independence and general satisfaction with vision, and the incidence of photic phenomena were low. This study shows that the new bi-aspheric diffractive trifocal IOL provides a good visual performance at different distances under photopic conditions, accompanied by patient satisfaction and spectacle independence.

Keywords: spectacle independence; trifocal intraocular lens; visual questionnaire.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
AsqelioTM Trifocal TFLIO130C.
Figure 2
Figure 2
Refractive and visual postoperative outcomes. (A) Cumulative Snellen uncorrected distance visual acuity; (B) Difference between uncorrected distance visual acuity versus corrected distance visual acuity; (C) Postoperative spherical equivalent refraction; (D) Postoperative residual refractive cylinder.
Figure 3
Figure 3
Distribution of residual astigmatism (D) scatterplot (J0 vs. J45). Empty bins represent preoperative data, and full black bins 3 months postoperation.
Figure 4
Figure 4
Average defocus curve 3 months after intraocular lens implantation (n = 50 eyes, 25 patients). Dotted curves represent the ± standard deviation curves. For reference purposes, dashed vertical grey lines highlight the location of far, intermediate (67 cm), and near vision (40 cm) on the vergence axis, and the grey shadowed area highlights that area on the chart corresponding to visual acuity values above 0.1 logMAR (equivalent to 1.0 Snellen decimal or 20/20).
Figure 5
Figure 5
Pie charts showing the distribution of reported visual experience within the last 7 days (upper row) and level of impairment (lower row) of halos (A1,A2), starbursts (B1,B2), and glare (C1,C2), as per the PRVSQ. (A1) percentage of halos symptoms; (A2) subjective level of halos; (B1) percentage of starbursts symptoms; (B2) subjective level of starbursts; (C1) percentage of glare symptoms; (C2) subjective level of glare. The legends in the middle apply to all the pie charts within each row, respectively.

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