Assessing Functional Outcomes: A Comparative Study Of Two Diffractive Trifocal Intraocular Lenses

The ARTIS Symbiose intraocular lens (IOL) system (Cristalens Industrie, France) offers a unique approach to multifocality, with one lens providing extended depth of focus for intermediate vision (ARTIS Symbiose MID) and the other for near vision (ARTIS Symbiose PLUS), in addition to the distance focus. This single-center clinical study aims to comprehensively evaluate visual acuity across all distances achieved with the ARTIS Symbiose IOL system, comparing its performance to the conventional diffractive multifocal IOL, AcrySof IQ PanOptix (Alcon, TX, USA).

International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University Hospital Heidelberg, Germany. 

Bilateral implantation of AcrySof IQ PanOptix or ARTIS Symbiose IOLs was randomly assigned to 100 eyes of 50 patients. Visual acuity at far, intermediate, and near distances, as well as defocus curve, were compared between ARTIS MID, ARTIS PLUS IOLs, and AcrySof IQ PanOptix IOL. Postoperative follow-up at 1, 6, and 12 months included assessment of uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance-corrected intermediate (DCIVA) visual acuity at 80 cm. Additionally, defocus curve testing with distance correction and monocular and binocular contrast sensitivity testing were conducted as part of the one-month follow-up visit.

To date, 40 patients with a mean age of 71 years have been enrolled in the study. At 1 month postoperative, binocular visual acuity for ARTIS Symbiose IOL exhibited UDVA/CDVA of 0.03/-0.06 and UIVA/CIVA of 0.00/0.04 in logMAR units. The AcrySof IQ PanOptix lens showed comparable results with UDVA/CDVA of -0.04/-0.08 and UIVA/CIVA of 0.01/0.02. At 1 month postoperative, the binocular distance-corrected defocus curve for the ARTIS Symbiose lens system exhibited continuous visual acuity of 0.10 logMAR or better within the range of +0.50 to -3.0 diopters of defocus. AcrySof IQ PanOptix demonstrated continuous visual acuity of 0.10 logMAR or better within the range of +1.0 to -2.75 diopters of defocus. Further detailed evaluations are ongoing.

Both the complementary diffractive lens system and conventional diffractive multifocal IOL show promising results in providing functional outcomes across distance, near, and intermediate vision. Additionally, the continuous improvement in binocular visual acuity highlights the efficacy of ARTIS Symbiose lens system. Continued evaluation at 6 and 12 months postoperatively will provide further insights into visual acuity and defocus curve outcomes.