PATIENT-REPORTED VISUAL FUNCTION, SPECTACLE INDEPENDENCE, SATISFACTION, AND VISUAL OUTCOMES OF A TRIFOCAL DIFFRACTIVE INTRAOCULAR LENS FOLLOWING REMOVAL OF THE CRYSTALLINE LENS IN HYPEROPIC, MIOPIC AND EMMETROPIC PATIENTS.

Assessment visual parameters to distance, intermediate and near vision, patient-reported visual function, spectacle independence and satisfaction after bilateral trifocal intraocular lens implantation, in hyperopic, miopic and emmetropic patients.

Clínica Baviera - AIER Eye Group

Retrospective study in three groups (G) of patients (GH hyperopia, GM myopia and GE emmetropia)  after phacoemulsification for removal the crystalline lens and bilateral implantation of a preloaded non toric diffractive trifocal intraocular lens (RayOne® Trifocal). Complete ophthalmologic examination was performed before and after the operation. Preoperative astigmatism required was < 1.5 D. Patients with a minimum of three-months follow-up data were included. Main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), manifest refraction. Spectacle independence, visual function and patient satisfaction were assessed using PRO, CatQuest-9F.

2035 patients (4070 eyes) of 1555 (3110 eyes) with hypermetropia, 202 (404 eyes) myopia and 278 (556 eyes) emmetropia, with a mean age (years) of 58 ± 7, 59 ± 8, 58 ± 7 respectively (p < 0.001). In GH (preoperative spherical equivalent, SE, mean 2.22 ± 0.7 D), mean postoperative SE 0.08 ± 0.29 D, UDVA 0.04 ± 0.05 logMAR, UIVA was 0.25 ± 0.10 logMAR, UNVA 0.14 ± 0.08 logMAR and CDVA 0.02 ± 0.04 logMAR. GM (preoperative SE mean was -3.26 ± 2.56 D), mean postoperative SE 0.16 ± 0.64 D, UDVA 0.07 ± 0.16 logMAR, UIVA 0.25 ± 0.10 logMAR, UNVA 0.15 ± 0.08 logMAR and CDVA 0.03 ± 0.04 logMAR. GE (preoperative SE mean was 0.38 ± 0.34 D), mean postoperative SE was 0.07 ± 0.28 D, UDVA was 0.04 ± 0.06 logMAR, UIVA was 0.26 ± 0.12 logMAR, UNVA 0.15 ± 0.10 logMAR and CDVA 0.02 ± 0.05 logMAR. Patients who declared not to use glasses to distance was in GH 99.8%, GM 98.6% and GE 99.6%. In GH 99.7%, GM 98.6% and GE 99.2% not use glasses for intermediate vision. In GH 99.7%, GM 95.9% and GE 98% not use glasses for near. In GH 96.8 % and 91.2%, GM 98.6% and 97.3%, GE 96.2% and 90.8%, respectively do not report discomfort in night vision or in night driving. GH 98.3%, GM 95.8%, GE 87.1%, said they were satisfied with the result; in GH 98%, GM 96.5%, GE 96.3% would repeat the procedure.

The trifocal diffractive IOL implant, after removal the cryslalline lens, provided good visual performance at all distances, excellent levels of patient-report independence of glasses, good visual function and satisfaction and very low levels of visual disturbance, with a high safety profile, in hyperopic, myopic and emmetropic patients.