Clinical Outcomes Of Bilateral Mix-And-Match Implantation Of Extended Depth Of Focus And Trifocal Intraocular Lenses

To evaluate the clinical outcomes until three months after bilateral mix-and-match implantation of Extended Depth of Focus (EDOF) and trifocal intraocular lenses (IOLs).

Tertiary traing hospital, Asan Medical Center. 

All patients who had met inclusion and exclusion criteria underwent bilateral cataract surgery. The EDOF or toric EDOF IOL (Symfony, J&J Inc., New Brunswick, NJ, USA) was implanted in the dominant eye, and the trifocal or toric trifocal IOL (Synergy, J&J Inc.) in the non-dominant eye. Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), contrast sensitivity, satisfaction questionnaire, osmolarity, and matrix metalloproteinase-9 (MMP-9) were obtained before and one and three months postoperatively.

Fifty-four eyes of twenty seven patients were enrolled. One month after surgery, mean UDVA (logMAR) in the EDOF IOL-implanted eyes (0.04±0.05) was significantly better than in the trifocal IOL-implanted eyes (0.11±0.10). The mean UNVA in the trifocal IOL-implanted eyes (0.14±0.08) was significantly better than in the EDOF IOL-implanted eyes (0.56±0.25). The average tear osmolarity and MMP-9 levels significantly decreased one month after surgery compared with those before surgery. Although 55% of patients were satisfied at one month, 73% said they would recommend the mix-and-match implantation.

The bilateral Mix-and-match implantation using the EDOF and trifocal IOLs showed good visual outcomes at distance, intermediate, and near distances with wider range of vision without increased photic phenomena over three months.