Visual Outcomes After Paired Contralateral Implantation Of 2 Trifocal Iols With Complementary Optical Designs And Visual Performance Profiles

The purpose of this study is to evaluate the clinical and patient reported outcomes after bilateral paired implantation of the yellow Vivinex^TM Gemetric^TM (G) and Gemetric^TM Plus (GP) trifocal toric and non-toric preloaded multiStert^TM IOLs (HOYA Surgical Optics, Singapore). In this paired approach, either toric or non-toric versions of the Vivinex^TM Gemetric^TM was implanted in the first and Vivinex^TM Gemetric^TM Plus in the contralateral second eye in order to combine the benefits of both optical lens designs and resulting differences in light distribution and visual performance profiles.

Medipolis Eye Center, Antwerpen, Belgium

This prospective analysis of  6-month follow-up outcomes includes data of 29 subjects aged from 39 to 78 years (59 ± 7.8),of whom 8 patients were treated for cataract and 21 underwent refractive lens exchange.

Manifest refraction is reported as sphere, cylinder and manifest refraction spherical equivalent (MRSE). Visual outcomes are reported in logMAR and include means of monocular and binocular corrected and uncorrected distance visual acuity (CDVA and UDVA at 4m), and distance corrected and uncorrected intermediate and near visual acuity (DCIVA / UIVA at 66cm and DCNVA / UNVA at 35cm) Patient reported outcomes on patient satisfaction,  spectacle use, and photic phenomena  were obtained by questionnaires.

Mean MRSE ± SD is -0.11 ± 0.16 (G) and -0.13 ± 0.18 D (GP). Monocular CDVA is -0.05 ± 0.07 logMAR with G and -0.02 ± 0.07 with  GP . DCIVA is 0.14 ± 0.09 (G) and 0.14 ± 0.10 logMAR (GP). The only statistically significant difference is seen in monocular DCNVA, which is 0.20 ± 0.07 (G) and 0.11 ± 0.08 (GP) logMAR (p<0.01). Binocular UDVA, UIVA and UNVA of -0.06 ± 0.07, 0.07 ± 0.07 and 0.09 ± 0.10 logMAR, respectively, led to high patient satisfaction. Only 3.5% of subjects reported  needing glasses some of the time, and 100% were very (28/29) or mostly (1/29) satisfied with their vision at all three tested distances. Moderate to severe halo, glare and starburst were reported by 34.5, 6.9, and 10.3%, respectively.

The study demonstrates the benefits of the paired implantation of the two Vivinex^TM Gemetric^TM IOL variants with complementary light distribution and, therefore, visual performance profiles. The difference in uncorrected and distance corrected monocular near visual acuities highlights a design-specific advantage  of Vivinex^TM Gemetric^TM Plus for near vision without compromising distance vision Combination of both designs in the paired implantation approach leads to high patient satisfaction and acceptable rates of photic phenomena in daily life.