Comparative Outcomes Of Trifocal, Extended‑Depth‑Of‑Focus, And Monofocal Intraocular Lenses: A Prospective Single‑Center Study

To compare visual performance, safety, and patient satisfaction over a 12‑month period following bilateral implantation of three different intraocular lens (IOL) models manufactured by Medicontur: Liberty (trifocal), ELON (extended depth of focus), and Bi‑Flex (monofocal). The present report summarizes the findings from the 3‑month follow‑up.

Magrabi Eye Center, Jeddah, Saudi Arabia.

This single‑center, prospective, comparative study is enrolling 90 patients (180 eyes) at Magrabi Eye Center, Jeddah, Saudi Arabia. After standard phacoemulsification, patients underwent bilateral implantation of either the Liberty, ELON, or Bi‑Flex IOLs (Medicontur, Hungary) (n = 30 per group). Binocular uncorrected and distance‑corrected visual acuity (VA) at distance, intermediate, and near were assessed at 1, 3, and 12 months postoperatively. Visual performance was further examined using binocular distance‑corrected VA defocus curves (VADC) and contrast sensitivity defocus curves (CSDC). Patient satisfaction and spectacle independence were evaluated using the PRSIQ, Catquest‑9SF, and dysphotopsia questionnaires.

At 1 month postoperatively, all three IOL groups achieved UDVA of 20/25 Snellen (0.1 logMAR) or better. At intermediate and near distances, the Liberty and ELON groups demonstrated comparable visual performance (≥20/32 Snellen, 0.2 logMAR), with the trifocal Liberty providing the best near acuity.

At 3 months, no significant differences were observed between Liberty and ELON in distance or intermediate vision. VADC analysis supported these results: Liberty maintained VA ≥0.2 logMAR (20/32 Snellen) from +1.0 to −4.0 D, whereas ELON sustained this level up to −3.5 D. Patient satisfaction and spectacle independence were high across all groups; Liberty performed best for near tasks, while ELON was associated with fewer dysphotopsia symptoms.

To the best of our knowledge, this is the first single‑center comparative investigation assessing the visual performance, safety profile, and patient‑reported satisfaction associated with the Liberty (trifocal), ELON (extended depth of focus), and Bi‑Flex (monofocal) intraocular lenses. As all three lenses demonstrated outcomes consistent with their respective optical designs, the findings of this study may assist clinicians in selecting the most appropriate IOL based on individual patient lifestyle requirements and personal preferences.