Official ESCRS | European Society of Cataract & Refractive Surgeons


Effect of pupil size and intraocular lens decentration on visual outcomes in diffractive trifocal intraocular lens implantation

Search Title by author or title

Session Details

Session Title: Multifocal IOLs I

Session Date/Time: Sunday 15/09/2019 | 16:30-18:00

Paper Time: 17:30

Venue: Free Paper Forum: Podium 1

First Author: : Y.Yoo SOUTH KOREA

Co Author(s): :    D. Paik   Y. Kim   K. Shin   D. Lim   T. Chung                 

Abstract Details


To evaluate the effect of pupil size and the intraocular lens (IOL) decentration from the first Purkinje image on the long term visual outcomes at near, intermediate, and far distance, dysphotopsia, and satisfaction in diffractive trifocal IOL implantation


Twenty-six eyes of 26 cataract patients who underwent diffractive trifocal IOL (FineVision) implantation at Samsung Medical Center were enrolled to this retrospective study.


At 1 year after surgery, postoperative evaluations included corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), manifest refraction, and defocus curves. Wavefront aberrometer (OPD-Scan III, Nidek, JAPAN) was used to measure both the pupil size and the decentration of IOLs from the first Purkinje image. The effect of pupil size was evaluated by dividing the patients into two groups (Group I; pupil size less than 3.5mm, Group II; pupil size more than 3.5mm). Dysphotopsia, overall satisfaction, and spectacle independence were evaluated by questionnaire.


IOL decentration at 1 year postoperatively was 0.22±0.19mm and the most decentered direction was temporal side of the first Purkinje image (14 eyes). IOL decentration was not associated with visual acuity at all distances. In Group I, pupil size showed negative correlation with spherical power (R=-0.764, P=0.001), visual acuity at 50cm (R=-0.674, P=0.008), 60cm (R=-0.794, P=0.001) and 80cm (R=-0.715, P=0.004). In group II, UCVA (R=0.840, P=0.001), visual acuity at 43cm (R=0.821, P=0.001) and 33cm (R=0.759, P=0.004) showed positive correlation to pupil size. Group I showed more spectacle dependence than Group II at near and intermediate (P=0.019 and P=0.012, respectively).


Visual outcomes at near, intermediate, and far distance could be influenced by the distribution of light that focuses on each distance in a diffractive trifocal IOL.

Financial Disclosure:


Back to previous