Hydrophobic Acrylic Trifocal Iol In Post-Laser Refractive Surgery Eyes: Visual Performance, Predictability, And Patient-Reported Outcomes

To evaluate the clinical and patient-reported outcomes of the Clareon PanOptix (CP) hydrophobic acrylic trifocal IOL in eyes with a history of myopic laser refractive surgery (LRS).

Single-center

This study included 96 eyes (48 patients) with prior myopic LRS who received the CP. At postop 6 mo, monocular visual acuity (VA), manifest refraction, and prediction error were assessed. Prediction error was evaluated with total (TK) and conventional keratometry (CK). Patient-reported outcomes on satisfaction, and visual disturbances were collected. The correlation between preoperative corneal higher-order aberrations (HOAs) and postoperative outcomes was analyzed.

At postop 6 mo, the uncorrected VAs were 0.028±0.087 logMAR for distance, 0.175±0.129 for intermediate, and 0.093±0.136 for near. The mean postoperative SE was −0.142±0.375 D, with 81% of eyes within ±0.50 D. The IOLMaster 700 using the Barrett True-K formula with TK yielded the lowest mean absolute error (0.338±0.282 D) and the highest percentage of eyes within ±0.50 D (79.2%). Preoperative corneal primary spherical aberration was significantly and negatively correlated with overall patient satisfaction (p=0.022), whereas HOAs including peripheral cornea were associated with photic phenomena. Patients reported high satisfaction (mean score, 3.06±0.63 out of 4) and complete spectacle independence for distance and intermediate vision.

The CP is an effective option for presbyopia correction in post-LRS eyes. Optimal outcomes appear to be related to using modern IOL power calculation formulas that incorporate directly measured TK and performing a comprehensive, zone-specific analysis of corneal HOAs to guide patient selection and manage expectations.