Abstract
Purpose To evaluate monocular and binocular visual performance and patient-reported outcomes following combined implantation of a diffractive extended depth of focus (EDoF) IOL (Carl Zeiss AT LARA 829MP) and a diffractive trifocal IOL (Carl Zeiss AT LISA tri 839MP). Methods This prospective study enrolled consecutive patients undergoing lens phacoemulsification of cataract and combined implantation of an EDoF IOL in the dominant eye and a trifocal IOL in the nondominant eye. Assessment included uncorrected visual acuity at near distances (UNVA), intermediate distances (UIVA), and far distances (UDVA), uncorrected defocus curve, contrast sensitivity (CS), reading speed, and patient satisfaction, evaluated six months after the surgery with the Visual Function Questionnaire (VFQ-25). Results A total of 25 patients were enrolled. At six months postoperatively, outcomes of binocular UNVA, UIVA, and UDVA were superior to those of monocular outcomes. The binocular defocus curve showed significantly better results in comparison with the AT LISA tri IOL eyes at defocus levels of −1.0 D and −1.5 D (P=0.008 and P=0.002, respectively) and compared to the AT LARA IOL eyes at defocus levels of −3.0, −3.5 D, and −4.0 D (P=0.019, P=0.019, and P=0.035, respectively). All of the patients were spectacle-free at far and intermediate distances, while 4% of patients needed spectacles at the near distance. Reading speed showed a rather high and gentle slope curve between 0.1 logMAR and 0.4 logMAR, and optical phenomena were improved after combined implantation of IOLs except halos. There were no significant differences in CS between the binocular and monocular results of each IOL. Conclusions The combined implantation of an EDoF IOL and a trifocal IOL seems to be a good option for patients with demands for spectacle independence in their daily life, with minimal photic phenomena.
Highlights
With the advancements in intraocular lenses (IOL) and cataract surgery techniques, it has become increasingly important to minimize visual side effects while improving visual acuity
Results e mean postoperative UDVA, UIVA, uncorrected visual acuity at near distances (UNVA), CDVA, and refraction are given in Table 2. ere were no statistically significant differences between lenses in postoperative uncorrected visual acuity at all distances or in CDVA (P > 0.05). e eyes with the AT LARA 829MP achieved a better monocular UIVA compared to the eyes with the AT LISA tri 839MP (P 0.09), while the eyes with the AT LISA tri showed a better monocular UNVA compared to the eyes with the AT LARA (P 0.59)
The spherical equivalent was significantly skewed toward myopic values in the eyes with AT LARA 829MP IOLs compared to the eyes with AT LISA tri 839MP IOLs (P < 0.05), the eyes with the AT LISA tri 839MP IOLs showed better visual acuity results in the defocus curve from −3 D to −4 D
Summary
With the advancements in intraocular lenses (IOL) and cataract surgery techniques, it has become increasingly important to minimize visual side effects while improving visual acuity. Ere are many studies which compare the clinical performance of these presbyopia-correcting IOLs. Trifocal IOLs have almost completely substituted bifocal IOLs because the addition of a third focus can provide better uncorrected visual acuity results at intermediate distances [1, 3, 5, 6]. A combination of presbyopia-correcting IOLs with different designs is one of the ways to compensate for these limitations and to further enhance results at intermediate and near distances [13,14,15]. Such a combination in a blended approach has become a topic of interest. V., Netherlands), optical biometry and keratometry (IOLMaster 700, Carl Zeiss Meditec, Oberkochen, Germany), slit lamp examination, and fundoscopy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
