Objective Optical Quality Comparison Of A Sinusoidal Trifocal Iol And Two Aspheric Monofocal Iols: A 1-Year Ray-Tracing Wavefront Analysis With I-Trace
Published 2026 - 44th Congress of the ESCRS
Reference: FP32.03 | Type: Free paper | DOI: 10.82333/9sm0-1492
Authors: Dr Zelal Beşaltı Ekinci* 1 , A/Prof. Sibel Ahmet 1 , A/Prof. Burcu Kemer Atik 1 , A/Prof. Nilay Kandemir Beşek 1 , Prof. Dr Ahmet Kırgız 1 , Dr Gülay Yalçınkaya Çakır 1 , Dr Seda Liman Uzun 1 , Dr Dilan Çolak Arıcı 1
1Ophthalmology,Beyoglu Eye Training and Research Hospital,İstanbul,Türkiye
Purpose
To objectively compare internal optical quality, higher-order aberrations (HOAs), and contrast sensitivity between a sinusoidal-optic trifocal intraocular lens (IOL) and two different aspheric monofocal IOLs, and to assess whether the sinusoidal optic design maintains optical performance comparable to monofocal IOLs at 1-year follow-up.
Setting
Beyoglu Eye Training and Research Hospital, Istanbul, Turkiye.
Methods
This comparative study included 66 eyes of 66 patients implanted with a sinusoidal-optic trifocal IOL (Enova; n = 25) or one of two aspheric monofocal IOLs (Alcon AcrySof IQ, n = 27; Acriva, n = 14). All patients achieved a 1-year postoperative best-corrected visual acuity (BCVA) between 0.8 and 1.0 (Snellen). Demographic characteristics and postoperative refractive outcomes were also evaluated. Objective optical quality was assessed 1 year postoperatively using i-Trace ray-tracing wavefront aberrometry at a standardized 3.0 mm scan diameter, with analysis of the Dysfunctional Lens Index (DLI), higher-order aberrations (HOAs), Strehl ratio (SR), and modulation transfer function (MTF).
Results
At 1-year, Enova showed higher median DLI (9.90) vs Alcon (8.30; P=.014) and Acriva (6.60; P=.019). Internal HOAs were lower in Enova (0.071) vs Alcon (0.103; P=.004) and Acriva (0.114; P=.002). Internal Coma was lower in Enova (0.041) vs Alcon (0.063; P=.016). Spherical aberrations were similar (P>.05). MTF values at spatial frequencies of 5, 10, 15, 20, 25, and 30 cpd were significantly higher in the Enova group compared with both monofocal IOL groups (all P < 0.05), whereas no significant differences were observed between the Alcon and Acriva groups (P > 0.05). Internal SR was higher in the Enova group (median: 0.147) than in the Acriva group (median: 0.063; P = 0.006) and was comparable to the Alcon group (median: 0.113; P = 0.145).
Conclusions
At 1-year follow-up, the sinusoidal-optic trifocal IOL demonstrated optical quality parameters and contrast sensitivity outcomes that were comparable to aspheric monofocal IOLs, with lower internal higher-order aberrations and coma as assessed by ray-tracing wavefront analysis. These findings suggest that a sinusoidal optic design can preserve high internal optical quality while providing multifocality, challenging the traditional assumption of an inevitable trade-off between multifocality and optical image quality.