The First Clinical Experience With New Trifocal Intraocular Lens

Here we present our initial clinical experience with a new trifocal IOL with a hybrid optic consisting of a diffractive aspheric anterior surface and a refractive optic periphery (Triva-aAY, HumanOptics). The IOL is made of hydrophilic material with a 6.0 mm optic diameter and additions of +1.75 D for intermediate and +3.5 D for near vision. The continued advancement of IOL optic aims to address the demands of the patients for excellent visual acuity at different distances with minimum undesirable dysphotopsia effects. Here we present our initial clinical experience with the new trifocal IOL.  

Gemini Eye Clinic, Zlin, Czech Republic

32 eyes of 16 patients with a median age of 58 years (IQR, 54 – 64) were implanted with Triva aAY IOLs as part of routine cataract surgery. Follow-up was set at 6 months and included spherical equivalent refraction (SE), monocular and binocular visual acuities (VAs) Uncorrected and Corrected Distance Visual Acuity (UDVA, CDVA), Uncorrected and Distance Corrected Intermediate Visual Acuity (UIVA, DCIVA) at 66 cm, Uncorrected and Distance Corrected Near Visual Acuity (UNVA, DCNVA) at 40 cm. Defocus curves were recorded between -5.0 D and +1.5 D and perceived halo/glare was evaluated using a questionnaire. Values are expressed as median with 25-75% IQR.

At 6 months mean(SD) SE was 0.24 ± 0.48 D. Monocular CDVA, DCIVA and DCNVA were 0.0 logMAR (0.0; -0.01), 0.02 logMAR (0.0; -0.1) and 0.12 logMAR (0.03; -0.16), respectively. Binocular DCIVA was -0.02 logMAR (-0.06; -0.04) and DCNVA of 0.05 logMAR (-0.04; -0.10). All and 88% of patients read at least 0.2 logMAR or better at binocular DCIVA and DCNVA, respectively. Defocus curve showed that monocular and binocular visual acuities of 0.2 logMAR or better were maintained between -3.0 D and +1.0 D. Halos and starburst were perceived often by 46% and 36% of patients, respectively. Only 9% experience quite often glare.

The first clinical outcomes showed high-quality far, intermediate and near visual functions in terms of visual acuity and defocus curve.  Some patients observe halo and glare which for the majority is not bothersome and is likely similar to what is reported in the literature for other trifocal IOLs. In conclusion, the Triva-aAY may thus provide good quality of vision for highly demanding patients desiring spectacle independence.