A comparison of the visual performance of refractive rotationally asymmetric multifocal intraocular lenses and trifocal intraocular lenses

Abstract

Objective: The aim of this study is to compare the short term visual outcomes and subjective visual quality of the monocular implantation of a refractive rotationally asymmetric multifocal intraocular lens (IOL) (SBL-3, Lenstec, Inc., USA) with those of a trifocal IOL (AT LISA tri 839 MP, Carl Zeiss Meditec, Jena, Germany). Methods: This study involved a total of 46 patients (46 eyes) with age-related cataracts, who underwent uncomplicated cataract surgery. Twenty-two patients (22 eyes) had SBL-3 multifocal IOLs implanted (group A) and 24 patients (24 eyes) had AT LISA tri 839 MPs implanted (group B). The patients were all evaluated three months after surgery. Results: Group B had a significantly better performance (0.127±0.070) logMAR (20/40 Snellen equivalent) than group A (0.25±0.093) LogMAR for monocular UIVA at 80 cm (p < 0.05). There was no statistically significant difference at other distances. The monocular defocus curves showed that group B had a better performance than group A at a vergence of −1.5 D (p<0.05). Higher-order aberrations (HOAs) were significantly higher in group A (p <0.05). The SBL-3 IOLs resulted in much lower MTF cut-off (23.68±9.892) cpd and Strehl ratio (0.13±0.052) than trifocal IOLs (MTF cut-off 26.25±8.751 cpd, Strehl ratio 0.15±0.063). But there was no significant difference between the two IOLs (p >0.05). Complaints of halos at night were made by 37.5% (9/24) of group A and 9.1% (2/22) of group B, but they did not interfere with their vision. All the patients reported a high level of satisfaction and said they no longer needed to use spectacle correction at either far, intermediate or near distances. Conclusions: Both SBL-3 IOLs and AT LISA tri 839 MP trifocal IOLs provided good short-term visual outcomes at all distances postoperatively with a high level of spectacle independence and patient satisfaction. The AT LISA tri 839 MP lens provided better intermediate vision at 80 cm, while similar visual acuity (VA) was reported at other distances.