Intraindividual Comparison Of A Trifocal And A Monofocal Edof Intraocular Lens In Intermediate And Near Vision

Innovative monofocal intraocular lenses (IOLs) attempt to improve intermediate visual acuity by modifying spherical aberrations for high-demanding patients in this field. Very heterogeneous terms for these IOLs have been introduced including EDOF monofocal, premium monofocal, monofocal plus, as well as mono EDOF. In this study a monofocal EDOF IOL was compared intraindividually with a trifocal IOL to evaluate their visual performance especially at intermediate and near distance.

Academic institutional prospective clinical trial

Fifty eyes of 25 patients presenting for bilateral cataract surgery were included in this prospective clinical study. An monofocal EDOF IOL (IsoPure EDOF IOL, PhysIOLs.a. - Liège Science Park) was implanted in the patient's dominant eye and a trifocal IOL (FineVision HP Trifocal IOL, PhysIOLs.a. - Liège Science Park) in the non-dominant eye. Six months after surgery a detailed follow-up examination was performed including best corrected distance (BCDVA), distance corrected intermediate (DCIVA) and distance corrected near visual acuity (DCNVA), contrast sensitivity as well as a defocus curve. Furthermore, lens decentration and tilt using anterior OCT imaging as well as wavefront aberrometry was assessed. 

6 months postoperatively, BCDVA (EDOF:-0.05±0.10 logMAR; trifocal: -0.03±0.09 logMAR; P= .519), DCIVA (EDOF: 0.21±0.11 logMAR; trifocal: 0.18±0.11 logMAR; P= .287) and contrast sensitivity (EDOF: 0.47±0.28 logMar; trifocal: 0.48±0.11 logMAR; P= .187) were comparable in both eyes. The trifocal IOL performed better at DCNVA (EDOF: 0.57±0.18 logMAR; trifocal: 0.20±0.15 logMAR; P< .001). Defocus curves revealed no significant differences from +1.0D to -1.0D (P> .05), whereas significantly better results from -1.5D to -4.0D (P< .001) were obtained with the trifocal lens. Equivalent results of lens tilt (EDOF: 5.4±1.9°; trifocal: 5.23±1.3°; P= .733) and decentration (EDOF: 0.22±0.13°; trifocal: 0.19±0.07°; P= .401) were observed.

In this intraindividual comparison between a monofocal EDOF IOL and a trifocal IOL, the EDOF IOL achieved comparable distant and intermediate visual acuity as well as contrast sensitivity 6 months postoperatively. As expected, the trifocal IOL achieved significantly better visual acuity at near distance. Decentration and tilt values were generally low. Wavefront analysis data will be presented.