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).

This prospective, interventional clinical study is conducted at the university eye clinic in Heidelberg, Germany.

A study randomized 51 patients for bilateral implantation of IQ PanOptix or ARTIS Symbiose IOLs (ARTIS MID, ARTIS PLUS). Visual acuity at far, intermediate, and near distances, along with defocus curves, were compared. Follow-ups at 1, 6, and 12 months assessed UDVA, CDVA, UIVA, and DCIVA at 80 cm. At one month, defocus curve testing with distance correction and monocular/binocular contrast sensitivity tests were conducted to evaluate vision quality.

To date, 51 patients (mean age: 70) have been enrolled. At 6 months, ARTIS Symbiose showed UDVA/CDVA of 0.00/-0.08, UIVA/CIVA of -0.01/0.00, and UNVA/DCNVA of 0.08/0.09, while PanOptix had UDVA/CDVA of -0.09/-0.11, UIVA/DCIVA of -0.02/-0.02, and UNVA/DCNVA of 0.01/0.0. At 12 months, ARTIS Symbiose maintained UDVA/CDVA of -0.01/-0.09, UIVA/CIVA of -0.01/0.01, and UNVA/DCNVA of 0.04/0.04, while PanOptix achieved UDVA/CDVA of -0.10/-0.12, UIVA/DCIVA of -0.05/-0.05, and UNVA/DCNVA of -0.02/-0.04. At 6 months, ARTIS Symbiose had a defocus range of +0.50 to -2.75 D, while PanOptix ranged from +0.50 to -3.00 D, which remained stable at 12 months. Further 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.