Short-Term Clinical Outcomes Of Bilateral Mix-And-Match Implantation Of Extended Depth-Of-Focus And Diffractive Trifocal Intraocular Lens Versus Bilateral Implantation Of Trifocal Intraocular Lens
Published 2024 - 42nd Congress of the ESCRS
Reference: FP25.11 | Type: Free paper | DOI: 10.82333/bnpg-f628
Authors: Yong-Ha Jo* 1 , Ho Seok Chung 1 , Hun Lee 1 , Jae Yong Kim 1 , Hung Won Tchah 2
1Department of Ophthalmology,Asan Medical Center, University of Ulsan College of Medicine,Seoul,Korea, Republic Of, 2Kim's Eye Hospital,Seoul,Korea, Republic Of
Purpose
We aimed to evaluate the clinical outcomes after mix-and-match cataract surgery using non-diffractive Extended Depth-of-Focus (EDOF) intraocular lens (IOL) and diffractive trifocal IOL versus bilateral implantation of diffractive trifocal IOL.
Setting
Asan Medical Center, Seoul, Republic of Korea.
Methods
This study is a single-center, retrospective, comparative analysis of patients who underwent bilateral cataract surgery from 2021 to 2024. We operated patients with trifocal IOL (Panoptix, Alcon Inc.) implantation in both eyes (Group 1) and mix-and-match implantation of EDOF IOL (Vivity, Alcon Inc.) in the dominant eye and trifocal IOL in the non-dominant eye (Group 2). Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), defocus curve, contrast sensitivity, and questionnaires (satisfaction score, need for near glasses, incidence of glare and halo, and whether you recommend this surgery to other patients) were measured preoperatively and postoperatively.
Results
A total of 82 eyes of 41 patients in Group 1 and 76 eyes of 38 patients in Group 2 were included. At six months after surgery, mean binocular UDVA, UIVA, and UNVA in logMAR was 0.04±0.06, 0.00±0.20, and 0.09±0.09 in Group 1 and 0.04±0.05, 0.10±0.10, and 0.24±0.18 in Group 2, respectively. Although Group 1 had better monocular UIVA and UNVA of the dominant eye over Group 2, there were no statistically significant differences in binocular VA. Group 2 showed lower satisfaction with VA (50.0%) and a higher need for near glasses (25.0%) than Group 1. Group 1 reported a higher incidence of photic phenomena (glare 46.4%, halo 57.9%) than Group 2 (glare 28.2%, halo 37.5%). Overall recommendation rate was 68.4% in Group 1 and 87.5% in Group 2.
Conclusions
The new authentic mix-and-match implantation of EDOF IOL and trifocal IOL showed the potential to achieve comparable visual outcomes with bilateral trifocal IOL implantation in all distance, intermediate, and near vision with less photic phenomena. We found that a mix-and-match surgery approach could be a reasonable solution for patients concerned about post-operative photic phenomena.