Visual, Refractive And Aberrometric Outcomes Of A New Trifocal Intraocular Lens Pairing Two Complementary Light Distributions

Vivinex Gemetric (Hoya, Japan) is an new family of trifocal diffractive IOLs with same addition power (3,5D and 1,75D) and two distinct light energy distributions (Gemetric and Gemetric Plus) that differ only in the amount of light distribution to each distance foci: Gemetric IOL offers 50.8% for far, 17.3% for intermediate and 21.8% for near, while Gemetric Plus offers 39.2% for far, 16.9% for intermediate and 32.8% for near (with 3mm pupil). The aim of this study is to analyze the visual, refractive and aberrometric outcomes in patients implanted with this new IOL pairing two trifocal lenses with complementary light distribution (Gemetric on the dominant eye & Gemetric Plus on the non-dominant eye).

Vissum (Miranza Group), Alicante, Spain

Prospective study. Complete preop and postop optometric and ophthalmological examination at 1, 3 and 6 months, including: far, near and intermediate visual acuity (VA), subjective refraction, contrast sensitivity (CSV-1000, VectorVision), defocus curve and ocular aberrometry (Osiris, CSO). In addition, we analyzed the subjective visual function using the Quality of Vision (QoV) questionnaire and the satisfaction survey (NAVQ-10). A descriptive statistical analysis and the Wilcoxon test were performed to compare pre- and postoperative values (significance level: p<0.05; SPSS v.22.0 software). Furthermore, we performed a comparison between groups (Gemetric and Gemetric plus) using U de Mann-Whitney test (significance level: p<0.05).

50 eyes (25 patients). Mean age was 57.6y. Mean uncorrected VA (LogMAR) was 0.03±0.1 for far, 0.07±0.1 for intermediate and 0.02±0.1 for near vision. The corrected VA was -0.03±0.1 for far, 0.07±0.1 for intermediate distance and 0.00±0.1 for near. CDNVA was 0.01±0.1. The mean spherical equivalent -0.09±0.2D. Mean HOA was 0.29±0.2 mm, and mean PSF of 0.25±0.08. Contrast sensitivity measurement showed mean values within the normal range for patients of similar age range. The defocus curve shows sharp vision (above AV 0.2) between -3.5 and +1D. Significant differences for near vision (UNVA, CNVA and CDNVA) in favor of Gemetric Plus compared to Gemetric (p<0.05). Not statistical differences for far and intermediate vision among IOLs. 

This new trifocal intraocular lens provides an advanced visual outcome at all distance ranges, fulfilling the expectations of a modern trifocal IOL, and being specially relevant the outstanding performance at the near focus. Gemetric and Gemetric plus showed differences on near visual acuity outcomes. Pairing two trifocal lenses with complementary light distribution achieved good full range of vision from far to close near vision and high quality of vision based on patient's satisfaction: 88% of patients reported spectacle independence for far, and 94% for near and intermediate vision.