Retrospective Analysis Of The Satisfaction Level Of A Group Of Patients After Trifocal Lens Implantation And Comparison Of Their Subjective Response With Pre- And Post-Surgery Objective Data.

Comparison of the satisfaction level of patients who underwent cataract surgery with a trifocal lens with pre-surgery and post-surgery data, in order to analyze the errors in those patients who were dissatisfied after surgery and to rule out future patients with similar characteristics. 

Private ophthalmology clinic, PRESBIT, Barcelona, Spain.

A total sample of 152 eyes operated by different ophthalmologists belonging to the same team during three years were taken. Pre-surgery topographies and corneal aberrometry obtained thanks to the Placido disc technology were used to assess whether the subject's sensation corresponds to objective data. Previous visual acuity, refraction and visual acuity after surgery were also taken into account in this study. As a retrospective study, patients whose RMS_HOA>0.33µm and those whose SAI>0.5D were considered as failures in the reclusion of patients for the implantation of trifocal lenses (physIOL). Likewise, previous visual acuities, the presence of amblyopia and low against-the-rule astigmatism were used as relevant data for the study.

92% of patients were satisfied with their visual acuity and quality of vision after trifocal lens implantation. There was a mean increase in VA; VAlog_MAR=1.6 (±0.05). Against-the-rule astigmatism resulted in lower final VA compared to patients with with-the-rule astigmatism. Cases of dissatisfaction: Patients with amblyopia despite achieving better final visual acuity, patients with initial log_MAR=0 whose contrast sensitivity was considered subjectively worse and patients whose aberrometric values were completly outside the rule. In addition, those patients with mild myopia showed discomfort from new reading distance. Finally, those patients older than 75 years are included because of their difficulty of neuroadaptation. 

It is important to consider all the parameters provided by the topographies and to exclude those patients whose values are out of the norm, values already described in the literature. Thus, we will discard those patients with RMS_HOA > 0.33 µm, SAI>0.5D and z_4,0 >0.100 µm to implant such lens. On the other hand, we will consider the patient's age, as well as the patient's requirements and initial visual characteristics in order to offer a better visual quality, ruling out patients who are too young, patients whose myopia compensates their presbyopia and patients affected by any of the three degrees of binocularity.