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

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).

Vivinex Gemetric (Hoya, Japan) is a 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). Fifty-four eyes (27 patients) were included.

This is a prospective study. Patients underwent a complete preoperative and postoperative 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©), monocular and binocular 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. Furthermore, we performed a comparison between groups (Gemetric and Gemetric plus) using U de Mann-Whitney test. 

Mean monocular uncorrected VA obtained (LogMAR) at 6 months was 0.01±0.06 for far vision, 0.08±0.09 for intermediate vision and 0.02±0.10 for near vision. The corrected VA was -0.02±0.04 for far, 0.07±0.09 for intermediate distance and 0.00±0.08 for near. The near VA with distance correction was 0.01±0.09. The mean spherical equivalent –0.06±0.21D and a mean addition of +0.12±0.26D. It was found a statistically significant difference for CNVA in favor of Gemetric Plus compared to Gemetric. No statistical differences were observed in distance and intermediate vision, although Gemetric Plus showed better DCNVA results, while Gemetric demonstrated superior UDVA performance. 

This new trifocal intraocular lens provides an advanced visual outcome at all distance ranges, fulfilling the expectations of a modern trifocal IOL, and being especially 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.