Visual Outcomes With Mix-And-Match Multifocal Iols: Comparing Clareon Panoptix And Clareon Vivity Combinations

To report real-world visual outcomes comparing mix-and-match implantation of two multifocal IOLs: the Clareon PanOptix trifocal IOL and the Clareon Vivity extended depth of focus IOL. This study evaluates whether combining different IOL technologies in a bilateral approach can optimise visual outcomes across all distances while maintaining patient satisfaction and minimising dysphotopsias.

OCL Vision, London (UK)

This prospective case series includes 46 eyes of 23 patients who underwent bilateral cataract surgery with mix-and-match IOL implantation. Eyes received either Clareon PanOptix trifocal or Clareon Vivity EDOF IOLs, with 19 eyes receiving toric versions. Postoperative data were collected at 2 weeks to 3 months. Outcomes include manifest refraction spherical equivalent (MRSE), monocular and binocular corrected and uncorrected visual acuity at distance (CDVA/UDVA), intermediate (UIVA at 65cm), and near (UNVA at 35cm). Patient-reported outcomes regarding satisfaction, spectacle independence, and dysphotopsias were assessed via questionnaires.

In patients with binocular surgery (n=23),UDVA was -0.009±0.082 logMAR. UIVA (n=5) was N6.0±1.095 (65cm) with 100% achieving at least N8 and UNVA was N5.435±0.97 (40cm) with 91.3% achieving at least N6. For the PanOptix eyes (n=23), mean IOL power was 19.5D, mean manifest SE was -0.071D±0.273 with 91.3% within ±0.5D of target. Monocular UDVA was 0.037±0.093 logMAR, UIVA (n=5) was N78.2±3.124 and UNVA was N5.783±1.284. For the Vivity eyes (n=23), mean IOL power was 19.5D, mean manifest SE was -0.174D±0.319 with 91.3% within ±0.5D of target. Monocular UDVA was 0.055±0.102 logMAR, UIVA (n=5) was N7±1.265 and UNVA was N7.174±1.903. Dysphotopsias were reported by 26% of patients. Surgeon ease of implantation and patient satisfaction were high.

Mix-and-match implantation of Clareon PanOptix trifocal and Clareon Vivity EDOF IOLs demonstrates excellent real-world outcomes with high refractive predictability and functional vision at all distances. The combination approach achieved outstanding binocular distance vision, good intermediate vision, and functional near vision with relatively low dysphotopsia rates. These results suggest that strategic pairing of different multifocal IOL technologies can provide patients with spectacle independence while optimising the balance between visual performance and optical side effects. Further studies with larger cohorts and standardised bilateral configurations are warranted.