Comparison Of Vision Functions, Visual Disturbances, And Patient Satisfaction Following The Implantation Of Three Different Presbyopia-Correcting Intraocular Lens Models

Presbyopia-correcting, multifocal intraocular lenses (IOLs) have gained increasing popularity during the last decade. Although most available IOL models provide good trifocal vision, large differences in the quality of postoperative vision have been reported. Visual disturbances like blurry or distorted vision and positive dysphotopsia, such as halo, glare, and starburst might have a negative impact on the performance of daily activities and can reduce patient satisfaction. The present study examined and compared the patient-reported visual outcomes (visual functions, visual disturbances, and satisfaction) after the implantation of three different presbyopia-correcting IOL models – all based on diffractive principles.

Anterior Segment Surgery Department, Asociación para Evitar la Ceguera en México I.A.P., Mexico City, Mexico.

Three different IOL models were implanted mono - or binocularly (Liberty 677MY: 11 patients/20 eyes; PanOptix: 17 patients/33 eyes; AT LISA tri: 10 patients/20 eyes). Refractive outcomes and visual acuities (uncorrected and corrected distance, UDVA, CDVA; distance-corrected intermediate, DCIVA, and near, DCNVA) were measured 6 months postoperatively. Patients were asked to complete a vision function questionnaire and evaluate the comfort or difficulty of performing simple daily activities and report their level of satisfaction. Positive dysphotopsia (halo, glare, starburst, ghosting) and other visual disturbances were rated separately by their frequency, intensity, and discomfort caused.

All examined IOL models resulted in favorable and comparable refractive and visual outcomes. 90% of AT LISA tri, 85% of Liberty, and 79% of PanOptix patients rated their postoperative vision as very or rather satisfied. The majority of patients could perform daily activities without severe difficulties in all three groups, however, PanOptix patients were the most likely to report severe difficulties while walking, reading subtitles on TV, seeing prices on price tags, and doing handwork. The frequency, intensity, and level of discomfort of halos, glare, starburst, and ghosting were the lowest among Liberty patients. The double and distorted vision was only observed in the PanOptix group.

All examined presbyopia-correcting IOLs are suitable for restoring vision at multiple distances, however, the quality of vision might differ based on their optical surface characteristics. Our results suggest that the Liberty 677MY IOL is the most likely to result in comfortable visual functions, and the least likely to cause severe dysphotposia. Nevertheless, we do suggest consulting with the patient about their visual behavior and needs, before choosing the right multifocal IOL for implantation.