Visual Performance And Patient Satisfaction After Implantation Of A Hydrophobic Trifocal Intraocular Lens

The purpose of this multicentric prospective study is to determine the postoperative visual performance and patient-reported outcomes of patients undergoing bilateral implantation of the ZEISS AT ELANA 841P (Carl Zeiss Meditec AG, Jena, Germany), a  hydrophobic trifocal intraocular lens (IOL). 

Dept. of Ophthalmology, University of Heidelberg, Germany; Precise Vision Augenärzte, Rheine, Germany; Oftalvist Alicante, Spain

The prospective, multicentric clinical trial includes a total of 120 eyes of 60 patients, aged 64.6 ± 7.9 years and bilaterally implanted with the AT ELANA 841P IOL following cataract or refractive lens exchange surgery. Subjects were followed up to 12-months, and examinations included: monocular and binocular uncorrected and distance-corrected visual acuities (VA) for far (UDVA, CDVA @4m), intermediate (UIVA, DCIVA @66cm), and near (UNVA, DCNVA @40cm), subjective refraction reported as manifest refraction spherical equivalent (MRSE), monocular and binocular defocus curve, photopic and mesopic contrast sensitivity, patient satisfaction in terms of visual disturbance and spectacle independence.

At 12 months postoperatively, mean binocular uncorrected logMAR VAs were -0.05±0.08 (UDVA), 0.05±0.10 (UIVA), and 0.12±0.13 (UNVA). Mean MRSE was 0.23±0.47 D, with 82% of eyes within ±0.50 D, and 93% within ±1.0 D. Respective binocular distance-corrected logMAR VAs were -0.09±0.07 (CDVA), 0.04±0.09 (DCIVA), and 0.09±0.12 (DCNVA). For all patients, the binocular photopic defocus curve showed a wide range of functional vision (CDVA of 0.2 logMAR or better) from distance to 33 cm. No need for glasses for far, intermediate, and near vision was reported by 100%, 98% and 67% of patients. 89% of subjects rated their vision as good to excellent and 89% reported being satisfied. 82% reported not being bothered by halo and glare. 

The results of this study show that the AT ELANA 841P IOL, the next generation trifocal IOL from ZEISS, allows full restoration of uncorrected vision over a wide range of distances and is a safe, predictable, and effective treatment option in the course of cataract or refractive lens exchange surgery. These conclusions can be drawn based on visual acuity outcomes and supported by patient reported outcomes regarding rates of spectacle independence, photic phenomena and overall satisfaction 1 year after implantation.