Hasan Basri ARİFOĞLU, Serdar ÖZATEŞ, Başak BOSTANCI CERAN, Emin Emrullah TAŞINDI

Refractive results, visual quality and patient satisfaction with a new trifocal intraocular lens design

Aim: To evaluate the outcomes after bilateral implantation of a new trifocal intraocular lens (IOL).Materials and Methods: The study included patients with visually significant cataract that underwent bilateral implantation of theAcriva Trinova Sinusoidal Trifocal IOL. The preoperative corrected distance visual acuity (CDVA) and postoperative uncorrecteddistance visual acuity (UDVA), CDVA, uncorrected intermediate (UIVA) and near visual acuities (UNVA) along with manifest refractionswere assessed at 1 month and 6 months after cataract surgery. The defocus curve and contrast sensitivity (CS) were evaluated atthe 6th month visit. Patient satisfaction and incidence of dysphotopic symptoms were assessed.Results: The study enrolled a total of 60 eyes of 30 patients, 10 males and 20 females aged 61.78± 8.73 years (range, 45 to 78 years).90% of the patients (n: 27) achieved a binocular UIVA of 0.1 LogMAR or better at the 6-month visit while, 96.7% (n:29) patients hada binocular UNVA of 0.1 LogMAR or better in the same postoperative visit. The CS results were within the the range of normalityat 6 months post-surgery. 6.7% of patients reported marked halo around light sources and 3.3% reported glare that interferes withnighttime driving. 96.6% of the patients reported spectacle independence for all distances and rated their visual function and qualitysatisfactory at all distances.Conclusion: Bilateral implantation of the Acriva Trinova Sinusoidal Trifocal IOL seems to provide effective restoration of visualfunction at all distances after cataract surgery in the majority of patients. Contrast sensitivity results and low incidence of dysphotopicphenomena might be associated with high patient satisfaction.

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1. Calladine D, Evans JR, Shah S et al. Multifocal versus monofocal intraocular lenses after cataract extraction. Sao Paulo Med J 2015;133:68.
2. Braga-Mele R, Chang D, Dewey S et al. Multifocal intraocular lenses: relative indications and contraindications for implantation. J Cataract Refract Surg 2014;40:313-22.
3. Cillino G, Casuccio A, Pasti M et al. Working-age cataract patients: visual results, reading performance, and quality of life with three diffractive multifocal intraocular lenses. Ophthalmol 2014;121:34-44.
4. Kohnen T. First implantation of a diffractive quadrafocal (trifocal) intraocular lens. J Cataract Refract Surg 2015;41:2330-2.
5. Gundersen KG, Potvin R. Comparison of visual outcomes and subjective visual quality after bilateral implantation of a diffractive trifocal intraocular lens and blended implantation of apodized diffractive bifocal intraocular lenses. Clin Ophthalmol 2016;10:805-11.
6. Madrid-Costa D, Ruiz-Alcocer J, Ferrer-Blasco T et al. Optical quality differences between three multifocal intraocular lenses: bifocal low add, bifocal moderate add, and trifocal. J Refract Surg 2013;29:749-54
7. Haigis W, Lege B, Miller N et al. Comparison of immersion ultrasound biometry and partial coherence interferometry for intraocular lens calculation according to Haigis. Graefes Arch Clin Exp Ophthalmol 2000;238:765-73.
8. Davison JA, Simpson MJ. History and development of the apodized diffractive intraocular lens. J Cataract Refract Surg 2006;32:849-58.
9. Alió JL, Elkady B, Ortiz D et al. Clinical outcomes and intraocular quality of a diffractive multifocal intraocular lens with asymmetrical Light distribution. J Cataract Refract Surg 2008;34:942-8.
10. Alfonso JF, Fernández-Vega L, Puchades C et al. Intermediate visual function with different multifocal intraocular lens models. J Cataract Refract Surg 2010;36:733-9.
11. Mojzis P, MAjerova K, Plaza –Puche AB et al. Visual outcomes of a new toric trifocal intraocular lens. J Cataract Refract Surg 2015;41:695-706
12. Alió JL, Plaza-Puche AB, Alió del Barrio JL et al. Clinical outcomes with a diffractive trifocal intraocular lens. European J Ophthalmol 2018;28:419-24.
13. Kohnen T, Herzog M, Hemkeppler E et al. Visual performance of a quadrifocal (trifocal) intraocular lens following removal of the crystalline lens. Am J Ophthalmol 2017;184:52-62.
14. Cochener B, Vryghem J, Rozot P et al. Clinical outcomes with a trifocal intraocular lens: a multicenter study. J Refract Surg 2014;30:762-8.
15. Lawless M, Hodge C, Reich J et al. Visual and refractive outcomes following implantation of a new trifocal intraocular lens. Eye Vis 2017;4:10.
16. Nagy ZZ, Popper-Sachetti A, Kiss HJ. Comparison of visual and refractive outcomes between hydrophilic and hydrophobic trifocal intraocular lenses sharing the same optical design. J Cataract Refract Surg 2019;45:553-61.
17. Jonker SM, Bauer NJ, Makhotkina NY et al. Comparison of a trifocal intraocular lens with a+ 3.0 D bifocal IOL: results of a prospective randomized clinical trial. J Cataract Refract Surg 2015;41:1631-40.
18. Sezgin BA. Visual and refractive outcomes, spectacle independence, and visual disturbances after cataract or refractive lens exchange surgery: Comparison of 2 trifocal intraocular lenses. J Cataract Refract Surg 2019;45:1539-46.
19. Piovella M, Colonval S, Kapp A et al. Patient outcomes following implantation with a trifocal toric IOL: twelve-month prospective multicentre study. Eye 2019;33:144-53.
20. Gyory JF, Madár E, Srinivasan S. Implantation of a diffractive–refractive trifocal intraocular lens with centralized diffractive rings: Two-year results. J Cataract Refract Surg 2019;45:639-46.
21. Mendicute J, Kapp A, Lévy P, Krommes G et al. Evaluation of visual outcomes and patient satisfaction after implantation of a diffractive trifocal intraocular lens. J Cataract Refract Surg 2016;42:203-10.
22. 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 Cataract Refract Surg 2014; 30:666- 72.
23. García-Pérez JL, Gros-Otero J, Sánchez-Ramos C et al. Short term visual outcomes of a new trifocal intraocular lens. BMC Ophthalmol 2017;17:72.
24. Akman A, Asena L, Ozturk C et al. Evaluation of quality of life after implantation of a new trifocal intraocular lens. J Cataract Refract Surg 2019;45:130-4.
25. Schwarz C, Canovas C, Manzanera S et al. Binocular visual acuity for the correction of spherical aberration in polychromatic and monochromatic light. J Vis 2014;14:8.
26. Vega F, Alba-Bueno F, Millan MS. Energy distribution between distance and near images in apodized diffractive multifocal intraocular lenses. Invest Ophthalmol Vis Sci 2011;52:5695-701.
27. Gatinel D, Houbrechts Y. Comparison of bifocal and trifocal diffractive and refractive intraocular lenses using an optical bench. J Cataract Refract Surg 2013;39:1093-9.
28. Vinas M, Gonzalez-Ramos A, Dorronsoro C et al. In vivo measurement of longitudinal chromatic aberration in patients implanted with trifocal diffractive intraocular lenses. J Refract Surg 2017;33:736-42.
29. Kretz FT, Breyer D, Diakonis VF et al. Clinical outcomes after binocular implantation of a new trifocal diffractive intraocular lens. J Ophthalmol 2015;2015:962891
30. Mojzis P, Majerova K, Hrckova L et al. Implantation of a diffractive trifocal intraocular lens: one-year followup. J Cataract Refract Surg 2015;41:1623-30.