Comparison Of Visual Outcomes And Patient Satisfaction Following The Implantation Of Autofocus Pro Ringless Polyfocal Progressive Trifocal Iol And Diffractive Trifocal Iol.

To compare visual outcomes and patient satisfaction following the Implantation of Autofocus Pro ringless polyfocal Progressive trifocal IOL and diffractive trifocal IOL.

The Prospective non-randomised comparative study in which sequential bilateral cataract surgery by phacoemulsification technique was performed by a Single Surgeon at Aastha Hospital, Anand, Gujarat, India between June 22 to Sept 23. All patients wanted spectacle freedom and, advantages and disadvantages of both the IOLs were informed. The study adhered to the Declaration of Helsinki and was approved by the local ethics committee(1132/ac/07/CPCSEA). 

The study included 14 eyes of 7 patients receiving bilateral Autofocus Pro ringless polyfocal Progressive trifocal IOL(Autofocus) and 14 receiving AT LISA tri 839 MP trifocal IOL(AT LISA). Post-operative examination at one month included uncorrected visual acuity(UCVA) at 3 m, uncorrected intermediate visual acuity(UIVA) at 80 cm, UIVA at 60 cm, and uncorrected near visual acuity(UNVA) at 40 cm, Contrast sensitivity under photopic conditions, defocus curve and a questionnaire on subjective quality of vision, optical phenomena and spectacle independence. 

The inclusion criteria were age of patients between 45 to 77 years, axial length ranging from 22.00 to 26.00mm, corneal astigmatism <1.0 D and scotopic pupil size ranging from 3 to 6 mm. 

The two groups were similar in baseline demographics, pre-operative visual, biometric data and surgical parameters. The standard visual acuity testing of Autofocus IOL and AT LISA trifocal IOL is UCVA at 3M: 0.05 ± 0.08 logMAR vs. 0.01 ± 0.04 logMAR, p = 0.10; UIVA at 60 cms: 0.01 ± 0.10 logMAR vs. -0.01 ± 0.06 logMAR, p = 0.30, UIVA 80 cms: 0.01 ± 0.09 logMAR vs. -0.01 ± 0.06 logMAR, p = 0.46 and UNVA 40 cms: 0.14 ± 0.13 logMAR vs. 0.14 ± 0.09 logMAR, p = 0.33 respectively. In addition,Contrast sensitivity results were better in the Autofocus group than in the AT LISA trifocal group. The defocus curve, night vision and spectacle freedom shows better results of the Autofocus IOL than the AT LISA trifocal IOL. 

Patients who received Autofocus Pro ringless polyfocal Progressive trifocal IOL had comparable visual outcomes for distance, intermediate and near with higher contrast sensitivity under various conditions. It also allowed spectacle-independence, glare and halo-free vision with good patient satisfaction.