Korean J Ophthalmol.  2016 Jun;30(3):180-191. 10.3341/kjo.2016.30.3.180.

Visual Outcomes, Patient Satisfaction and Spectacle Independence with a Trifocal Diffractive Intraocular Lens

Affiliations
  • 1International Vision Correction and Research Centre (IVCRC) & David J Apple International Laboratory of Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. florian.kretz@med.uni-heidelberg.de
  • 2International Vision Correction Research Network (IVCRC.net), Heidelberg, Germany.
  • 3Augenklinik Ahaus-Raesfeld-Rheine, Gerl Group, Ahaus, Germany.
  • 4Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
To evaluate visual outcomes following implantation of a trifocal diffractive intraocular lens (IOL) and to analyze their correlation with patient satisfaction and ease of performing daily tasks.
METHODS
This was a prospective study enrolling 100 eyes of 50 patients undergoing cataract surgery with implantation of trifocal IOL AT LISA tri 839MP. Visual and refractive outcomes were evaluated during a 3-month follow-up. Postoperatively, a questionnaire was used to evaluate patient satisfaction with regard to surgical outcome, spectacle independence, perception of photic phenomena, and ease of performing some vision-related activities.
RESULTS
A total of 91%, 87%, and 79% of eyes achieved a monocular uncorrected distance, near, and intermediate visual acuity of 0.1 logarithm of the minimum angle of resolution or better, respectively. After the surgery, 96% of the patients could perform their daily activities without problems. The mean spectacle independence scores for reading, doing computer work, and for distance were 10.33 ± 12.47, 5.71 ± 11.90, and 3.92 ± 9.77, respectively (scale: 0 = no spectacles needed; 40 = spectacles always needed). No correlation was found between spectacle independence and visual outcome (-0.101 ≤ r ≤ 0.244, p ≥ 0.087). Mean scores (0 = no symptoms; 40 = strong symptoms) for glare at night, ghost images, and halos were 15.15 ± 12.02, 4.49 ± 7.92, and 13.34 ± 10.82, respectively. No correlation was found between photic phenomena and visual outcome (-0.199 ≤ r ≤ 0.209, p ≥ 0.150). A total of 80% of patients reported satisfaction with the surgery outcome, and 86% would recommend the surgery to friends and family.
CONCLUSIONS
Implantation of the AT LISA tri 839MP IOL after cataract surgery provides effective visual restoration associated with a minimal level of photic phenomena, a positive impact on the performance of vision-related daily activities, and a high level of postoperative patient satisfaction.

Keyword

Cataract; Presbyopia; Surveys and questionnaire

MeSH Terms

Cataract Extraction/*methods
Eyeglasses
Female
Follow-Up Studies
Humans
Lens Implantation, Intraocular/*methods
Male
Middle Aged
*Patient Satisfaction
*Phakic Intraocular Lenses
Prospective Studies
Prosthesis Design
Pseudophakia/*physiopathology
Refraction, Ocular/*physiology
Surveys and Questionnaires
*Visual Acuity

Figure

  • Fig. 1 Distribution of monocular and binocular postoperative uncorrected distant, intermediate, and near visual outcomes in the analyzed sample. UDVA = uncorrected distance visual acuity; UIVA = uncorrected intermediate visual acuity; UNVA = uncorrected near visual acuity.

  • Fig. 2 Scatterplot showing the relationship between postoperative binocular logarithm of the minimum angle of resolution (logMAR) uncorrected distance visual acuity (UDVA) and uncorrected intermediate visual acuity (UIVA).

  • Fig. 3 Distribution of patient responses regarding difficulty performing the following activities (scale: 1 = yes, 2 = partly, 3 = no, and 4 = no assessable): reading the newspaper, reading a book, watching TV, driving a car during the day, driving a car at night, shopping, doing computer work, working in the house or garden, and doing handicraft work.


Reference

1. Gatinel D, Pagnoulle C, Houbrechts Y, Gobin L. Design and qualification of a diffractive trifocal optical profile for intraocular lenses. J Cataract Refract Surg. 2011; 37:2060–2067.
2. Valle P, Oti J, Canales V, Cagigal M. Visual axial PSF of diffractive trifocal lenses. Opt Express. 2005; 13:2782–2792.
3. Mojzis P, Kukuckova L, Majerova K, et al. Comparative analysis of the visual performance after cataract surgery with implantation of a bifocal or trifocal diffractive IOL. J Refract Surg. 2014; 30:666–672.
4. Mojzis P, Pena-Garcia P, Liehneova I, et al. Outcomes of a new diffractive trifocal intraocular lens. J Cataract Refract Surg. 2014; 40:60–69.
5. Marques EF, Ferreira TB. Comparison of visual outcomes of 2 diffractive trifocal intraocular lenses. J Cataract Refract Surg. 2015; 41:354–363.
6. Law EM, Aggarwal RK, Kasaby H. Clinical outcomes with a new trifocal intraocular lens. Eur J Ophthalmol. 2014; 24:501–508.
7. Ramon ML, Pinero DP, Perez-Cambrodi RJ. Correlation of visual performance with quality of life and intraocular aberrometric profile in patients implanted with rotationally asymmetric multifocal IOLs. J Refract Surg. 2012; 28:93–99.
8. Alio JL, Plaza-Puche AB, Pinero DP, et al. Quality of life evaluation after implantation of 2 multifocal intraocular lens models and a monofocal model. J Cataract Refract Surg. 2011; 37:638–648.
9. Cochener B, Vryghem J, Rozot P, et al. Clinical outcomes with a trifocal intraocular lens: a multicenter study. J Refract Surg. 2014; 30:762–768.
10. Alio JL, Montalban R, Pena-Garcia P, et al. Visual outcomes of a trifocal aspheric diffractive intraocular lens with microincision cataract surgery. J Refract Surg. 2013; 29:756–761.
11. Sheppard AL, Shah S, Bhatt U, et al. Visual outcomes and subjective experience after bilateral implantation of a new diffractive trifocal intraocular lens. J Cataract Refract Surg. 2013; 39:343–349.
12. Vryghem JC, Heireman S. Visual performance after the implantation of a new trifocal intraocular lens. Clin Ophthalmol. 2013; 7:1957–1965.
13. Cochener B, Vryghem J, Rozot P, et al. Visual and refractive outcomes after implantation of a fully diffractive trifocal lens. Clin Ophthalmol. 2012; 6:1421–1427.
14. Lesieur G. Outcomes after implantation of a trifocal diffractive IOL. J Fr Ophtalmol. 2012; 35:338–342.
15. Voskresenskaya A, Pozdeyeva N, Pashtaev N, et al. Initial results of trifocal diffractive IOL implantation. Graefes Arch Clin Exp Ophthalmol. 2010; 248:1299–1306.
16. Schmickler S, Bautista CP, Goes F, et al. Clinical evaluation of a multifocal aspheric diffractive intraocular lens. Br J Ophthalmol. 2013; 97:1560–1564.
17. Friedrich R. Intraocular lens multifocality combined with the compensation for corneal spherical aberration: a new concept of presbyopia-correcting intraocular lens. Case Rep Ophthalmol. 2012; 3:375–383.
18. Alio JL, Grabner G, Plaza-Puche AB, et al. Postoperative bilateral reading performance with 4 intraocular lens models: six-month results. J Cataract Refract Surg. 2011; 37:842–852.
19. Alio JL, Plaza-Puche AB, Pinero DP, et al. Optical analysis, reading performance, and quality-of-life evaluation after implantation of a diffractive multifocal intraocular lens. J Cataract Refract Surg. 2011; 37:27–37.
20. Alfonso JF, Fernandez-Vega L, Puchades C, Montes-Mico R. Intermediate visual function with different multifocal intraocular lens models. J Cataract Refract Surg. 2010; 36:733–739.
21. Alfonso JF, Puchades C, Fernandez-Vega L, et al. Visual acuity comparison of 2 models of bifocal aspheric intraocular lenses. J Cataract Refract Surg. 2009; 35:672–676.
22. Alfonso JF, Fernandez-Vega L, Baamonde MB, Montes-Mico R. Prospective visual evaluation of apodized diffractive intraocular lenses. J Cataract Refract Surg. 2007; 33:1235–1243.
23. Alfonso JF, Fernandez-Vega L, Senaris A, Montes-Mico R. Prospective study of the Acri.LISA bifocal intraocular lens. J Cataract Refract Surg. 2007; 33:1930–1935.
24. Alio JL, Pinero DP, Plaza-Puche AB, Chan MJ. Visual outcomes and optical performance of a monofocal intraocular lens and a new-generation multifocal intraocular lens. J Cataract Refract Surg. 2011; 37:241–250.
25. Alba-Bueno F, Vega F, Millan MS. Halos and multifocal intraocular lenses: origin and interpretation. Arch Soc Esp Oftalmol. 2014; 89:397–404.
26. Lubinski W, Gronkowska-Serafin J, Podboraczynska-Jodko K. Clinical outcomes after cataract surgery with implantation of the Tecnis ZMB00 multifocal intraocular lens. Med Sci Monit. 2014; 20:1220–1226.
Full Text Links
  • KJO
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr