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First Author: J.Alió SPAIN
Co Author(s): E. Sala P. Peña-Garcia
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To evaluate the visual acuity at different distances in trifocal, bifocal and accommodative lenses using the defocus curve.
Vissum-Instituto Oftalmológico de Alicante. Alicante, Spain.
This retrospective, consecutive, comparative series of cases comprised 369 eyes were analized (196 patients). Age range between 42 to 83 years. We analyzed 60 eyes (30 patients) AT Lisatri 839 MP, 40 eyes (20 patients) Fine Vision, 55 eyes (33 patients) Restor SN6AD1, 20 eyes (10 patients) Seelens MF, 26 eyes (13 patients) Synchrony and 27 eyes (14 patients) Crystalens . For statistical analisis created 3 groups: Trifocal, Bifocals and accommodatives. The defocus curve was evaluated binocullary at 6 months after the surgery and was performed using the phoropter and a 100% contrast ETDRS chart at 4 m under photopic conditions (approximately 160cd/m2). Manifest refraction was used to designate the zero baseline. A minimun range of -5,00D of defocus was used for all lenses with increments of 0.50; All visual informations recorded were in logMAR and represented in a 2-dimensional graph using cartesian coordinates (x-axis, spherical blur, y-axis, logmar visual acuity). Distance, near and intermediate visual acuity outcomes were evaluated preoperatively and postoperatively during a 6 months follow-up. Postoperative constrast sensitivity, pupilometry and ocular aberrations were also analized.
The trifocal models (FineVision and Lisatri 839MP) were compared. The Lisatri achieved significant better visual values at far and intermediate vision (p<0.001). In the bifocal group, RestorSN6AD1 achieved the best values for intermediate and near visual acuity and the Seelens had the best values in far distance (p<0.05). Two accommodative models were also compared (Synchrony and Crystalens). No significant differences between them were found. Trifocal and accommodative groups were also compared. The Lisatri showed the best values of both groups in intermediate and near distance (p<0.001). The FineVision showed significant better results in near distance compared to Synchrony (p<0.001), and clinically relevant better values (altought no significant) in intermediate distance (p=0.082) compared to Syncrony. Regarding the comparison of the trifocal and bifocal models, no significant differences were detected between Lisatri and RestorSN6AD1 at far and near distance (p>0.05), but better values for intermediate distance were found for the trifocal model (p=0.005). However, the RestorSN6AD1 showed similar values for intermediate distance compared to the FineVision (p=0.102). In addition, a comparison between the accommodative and the bifocal models was also performed. Statistically better values were found for RestorSN6AD1 and Seelens for all distances.
Trifocal, bifocal and accommodative lenses demostrate to improve distance vision. In near vision, the worst results were obtained with accommodative lenses, but in general, these kind of lenses provide a better contrast sensitivity. The best results in near vision were achieved with trifocal lenses. In intermediate vision LISAtri, FineVision and RestorSN6AD1 provide the best results. We conclude that trifocal and bifocal lenses are the best option to obtain the best visual outcomes for different distances. The best overall result in the total group of lenses evaluated in the present study was obtained with the LISAtri 839 MP.