Longitudinal Evaluation Of Photic Phenomena After Bilateral Panoptix Trifocal Intraocular Lens Implantation

To investigate whether the severity of dysphotopsia changes over time following bilateral implantation of trifocal intraocular lenses (IOLs).

University Eye Clinic of Heidelberg, Germany

This study evaluated 23 patients who underwent bilateral PanOptix (Alcon) trifocal IOL implantation at two postoperative time points: an early period (3–12 months), using data from routine clinical follow-up, and a long-term period (2–9 years), during which patients were recalled for repeat assessment. Clinical measurements included slit-lamp and visual acuity assessments. Photic phenomena were quantified using a dedicated halo and glare simulation software.

The mean follow-up times for visits 1 and 2 were 6.0±1.5 and 45.4±30.1 months, respectively. At visit 1, the mean uncorrected distance visual acuity (UDVA) was 0.03±0.13 and there was no statistically significant difference in UDVA between visits 1 and 2 (0.04±0.08; p=0.120). Compared to visit 1 (36.6±24.0), there was a statistically significant decrease in mean halo size values at visit 2 (22.5±20.1; p=0.016). Mean halo intensity also decreased significantly at visit 2 (24.7±22.6) compared to visit 1 (43.4±25.5; p=0,005). Both mean glare size (5.6±12.0) and intensity (8.4±15.4) at visit 1 showed no statistically significant difference at visit 2 (size 3.3±11.1, p=0.175; intensity 5.5±16.1, p=0,124).

Long-term follow-up showed a significant reduction in halo size and intensity after bilateral PanOptix IOL implantation, while glare parameters remained low at both visits. Our analysis suggests that this trifocal lens produces moderate and well-tolerated glare effects, with initial halo symptoms substantially decreasing over the long term postopertively, highlighting the role of extended adaptation time in mitigating the severity of photic phenomena.