Visual And Refractive Outcomes, Patient Satisfaction And Spectacle Independence After Phacoemulsification And Trifocal Intraocular Lens Implantation In Guatemala.

To asses visual and refractive outcomes, patient satisfaction and spectacle independence after bilateral trifocal intraocular lens (IOL) implantation in Guatemala. To compare visual and refractive outcomes after trifocal toric/non toric IOL implantation

National Ophthalmology Unit, Guatemala City, Central America

Prospective, non-randomized trial of patients who underwent successful bilateral phacoemulsification and Trifocal toric/non toric IOL implantation (Rayner Trifocal ®, UK), surgery performed by 5 surgeons. Pre/postoperative Uncorrected (UCVA), best-corrected (BCVA) distance, intermediate and near vision was assessed at day 1, week 1, month 1 and final consult. To asses patient satisfaction, the Quality of vision questionnaire (QoV), the Nine item National Eye Institute visual function questionnaire (NEI-VFQ-9/8) and degree of spectacle Independence was measured via survey responses. Influence of variables such as sex, age and astigmatism were correlated with visual results. Chi square and t test with significance defined as p<0.01 was used

92 eyes/46 patients analyzed from Jan 2020 to Dec 2022, average follow up was 10.8 mo, 83% females, mean age was 49.5 (+/-16.1 SD). Improvement refraction (p<0.01) and in BCVA at distance, intermediate and near was achieved at each time set (p<0.05). Significant difference between distance BCVA for non-toric vs. toric (p<0.01) however there was no significant difference at near and intermediate BCVA. High percentage of spectacle independence for distance and near (90%) and intermediate (100%) was reported. Mild haloes followed by glare were occasionally reported by patients. 92% of patient reported good to excellent vision after the procedure. No surgical complications/adverse events were recorded during the study period.

Data suggest significant postoperative visual success of bilateral cataract surgery with trifocal toric/non toric IOL implantation across multiple surgeons. High percentage of patient satisfaction and excellent visual acuity gained at distance, intermediate and near. These results suggest that Trifocal toric/non toric implantation in a cohort of Guatemalan patients seems to be an effective and safe procedure but more patient data and prospective clinical trials are needed, along with long term follow-up