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Clinical outcomes of blending a trifocal intraocular lens with a bifocal lens in the fellow eye

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Session Details

Session Title: EDOF vs Multifocal IOLs

Session Date/Time: Sunday 23/09/2018 | 14:15-16:00

Paper Time: 15:25

Venue: Room A4

First Author: : F.Cheong MALAYSIA

Co Author(s): :                        

Abstract Details


Bilateral implantations of trifocal intraocular lenses (IOLs) are conventional practices to achieve optimum binocular summation for good overall vision and presbyopia correction. However, this is not always possible in certain circumstances. This study aims to evaluate the clinical and patient-reported outcomes of blending a diffractive trifocal intraocular lens with a diffractive bifocal lens in the fellow eye.


Multi-disciplinary private hospital, Gleneagles Kuala Lumpur.


Consecutive case series study of 12 patients who had unilateral implantations of a trifocal IOL combined with a bifocal IOL in the fellow eye. A single surgeon performed all operations in a standard manner, with no intraoperative complications. Outcome measures were (i) distance, intermediate and near visual acuities (ii) defocus curves (iii) patients’ perceived symptoms of haloes at night (iv) patients’ spectacle independence and (v) overall satisfaction.


Reasons for this blending strategy were (i) to extend the multifocality range of patients with a pre-existing bifocal IOL in the contralateral eye and (ii) complement the use of a higher powered toric bifocal IOL in the fellow eye. All patients achieved 20/25 or better vision for near, intermediate and distance. However, binocular defocus curves were slightly inferior to that seen in bilateral trifocal implantations. Haloes were seen by 75% of patients but none were affected significantly in their daily activities. 100% spectacle independence was achieved. Overall satisfaction was high (4.5/5.0).


Blending a trifocal IOL with a bifocal IOL appears to provide the patients with good overall vision for all distances. Total spectacle independence was achieved in all patients. The disparity in the lenses seems to be well tolerated by the patients. However, this study also demonstrated slightly lower defocus curves compared to previously observed results in patients with bilateral trifocal IOL implants, indicating the benefit of binocular summation in bilateral trifocal implantations for a more functional presbyopic correction.

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