Virtual Implantation To Predict Outcomes Of A Trifocal Intraocular Lens In Presbyopic Subjects: Results Of A Prospective Multicenter Study

To evaluate the reliability of virtual implantation using VirtIOL device to predict the performance of AT LISA tri 839MP, a trifocal intraocular lens (IOL).

Prospective study conducted in 2 sites in Spain and Germany.

Adult presbyopic lens exchange candidates with no signs of cataracts were enrolled in this study. The following outcomes were measured for the trifocal IOL: defocus curve, contrast sensitivity (CS) in photopic/mesopic conditions, and visual phenomena in mesopic conditions. First, these outcomes were preoperatively assessed by the patients using the VirtIOL device, and then compared with the results obtained at 3M following bilateral IOL implantation. 

In total, 45 candidates completed this study. Defocus curve obtained with VirtIOL showed a similar shape compared to 3M postop, especially an extended intermediate vision plateau, which is expected for a trifocal IOL. However, VA values were found to be consistently and significantly underestimated between +1.0 D to -3.5 D compared to the M3 postop defocus curve. The shape of the CS curve was almost identical between VirtIOL and 3M postop, but VirtIOL underestimated the values by ≈0.3 logCS units for each spatial frequency. Burst pattern was similar between VirtIOL (2.65 ± 0.97 degrees) and 3M postop (2.74 ± 0.95 degrees, p=0.63) as well as annular pattern (0.88 ± 0.42 degrees vs 0.93 ± 0.49 degrees, p=0.59). 

This study demonstrated that VirtIOL can reasonably predict the performance of AT LISA tri 839MP. The difference observed between VirtIOL and 3M postop in the defocus and CS curves needs to be taken into account when the device is used in a clinical study.