Large Real-World Comparison Of Two Trifocal Iols: Visual, Refractive And Patient-Reported Outcomes With 12-Month Pco/Nd:Yag—Vsy Trinova Pro C Versus Omni Trioptix Trifocal

To compare distance/intermediate/near vision, refractive predictability, defocus performance, contrast sensitivity, dysphotopsia and posterior capsule opacification (PCO) after implantation of two trifocal intraocular lenses (IOLs): VSY Trinova Pro C (Trinova) and Omni Trioptix Trifocal (Omni).

Single tertiary referral eye centre.

Retrospective comparative study; one eye per patient (n=340; 170 Trinova, 170 Omni). Outcomes at 3 and 12 months included uncorrected distance (UDVA), intermediate (UIVA, 65 cm) and near (UNVA, 40 cm) visual acuity in logMAR, manifest refraction spherical equivalent (MRSE), defocus curve, photopic contrast sensitivity (CS, no glare), halo (0–10), PCO grade (0–3), Nd:YAG laser capsulotomy rate and NEI Visual Function Questionnaire-25 (NEI-VFQ-25). PCO grading underwent QC; PCO could not decrease over time unless Nd:YAG was performed. Welch t or Mann–Whitney U for continuous; χ²/Fisher for categorical data. Sensitivity analysis of covariance (ANCOVA) adjusting for preoperative corrected distance visual acuity (CDVA) was performed.

Preop CDVA was worse in Trinova (0.33±0.11 vs 0.27±0.09; p<0.001). At 3 months, UDVA was similar (0.03±0.04 vs 0.04±0.03; p=0.58), while Trinova had better UIVA (0.09±0.04 vs 0.12±0.04) and UNVA (0.10±0.05 vs 0.16±0.04; both p<0.001), persisting after ANCOVA. MRSE predictability was similar (±0.50 D: 82% vs 83%; p=0.89). Trinova showed higher CS at 6 cpd (1.60±0.08 vs 1.53±0.10) and lower halo (median 3 vs 4; both p<0.001). NEI-VFQ-25 was higher (90±5 vs 88±5; p<0.001) and full near spectacle independence greater (29% vs 18%; p=0.02). At 12 months, 85% vs 78% would choose the same IOL (p=0.13). PCO was lower (median 0 [0–1] vs 1 [0–2]; p<0.001), with similar Nd:YAG laser capsulotomy rates (6.5% vs 10.0%; p=0.32).

Both trifocal IOLs provided excellent distance vision and refractive predictability. Despite worse baseline CDVA, Trinova delivered superior intermediate/near performance, better contrast sensitivity, fewer halos and higher patient-reported quality of vision. Near spectacle independence was significantly greater with Trinova. PCO burden was lower through 12 months. These findings should be interpreted considering baseline imbalances inherent to the retrospective design.