3-Year Outcomes Following Combined Implantation Of Enhanced Monofocal And Multifocal Intraocular Lenses

This prospective study evaluated the long-term visual outcomes and subjective patient satisfaction including photic phenomena three years after the combined implantation of multifocal and enhanced monofocal IOLs.

This single-center, prospective clinical trial was conducted at the Department of Ophthalmology and Optometry, Medical University of Vienna, Austria.

This study included 50 patients who underwent cataract surgery and combined implantation of an enhanced monofocal Isopure 123 IOL and either a multifocal Finevision HP POD F GF IOL or Finevision Triumf POD L GF IOL (all from BVI- PhysIOL, Belgium). After three years, the long-term assessment included subjective photic phenomena, spectacle independence, patient satisfaction (Catquest-9SF), uncorrected binocular distance, intermediate, and near visual acuity, and a defocus curve.

In total, 34 patients (68%) were available for follow-up. Results of binocular UDVA, UIVA80cm, UIVA66cm and UNVA demonstrated excellent outcomes in both groups: -0.04±0.10, 0.06±0.07, 0.10±0.08, and 0.17±0.08logMAR (Isopure-HP) and 0.03±0.11 (p=0.077), 0.09±0.10 (p=0.396), 0.11±0.11 (p=0.693), and 0.27±0.06logMAR (p<0.001) (Isopure-Triumf), respectively. Binocular defocus curves showed a mean visual acuity of ≤0.2logMAR up to defocus levels of -2.0D (Isopure-Triumf) and -3.0D (Isopure-HP). High spectacle independence (distance: 94%, intermediate: 94%, near: 35%) and patient satisfaction (82% very high, 18% high) and low values of halo (size: 13.0±13.5, intensity: 16.4±17.2) and glare (size: 9.6±9.0, intensity: 15.3±12.6) were observed.

The combined implantation of an enhanced monofocal IOL and a multifocal IOL proves to be a promising approach for achieving high visual performance across various distances. The low incidence of photic phenomena and high patient satisfaction emphasize the potential of this combined approach.