Comparison of visual quality and subjective outcomes among 3 trifocal intraocular lenses and 1 bifocal intraocular lens

PURPOSE: To compare visual quality and subjective outcomes between 3 trifocal intraocular lenses (IOLs) and 1 bifocal IOL. SETTING: Clínica Oftalmológica Martínez de Carneros, Madrid, Spain. DESIGN: Prospective case series. METHODS: This study comprised patients having bilateral phacoemulsification and implantation of an AcrySof IQ PanOptix, AT LISA tri 839MP, FineVision, or Tecnis ZLB00 IOL. Postoperative evaluation included logarithm of the minimum angle of resolution (logMAR) uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and distance-corrected near visual acuity (DCNVA); reading speed; through-focus logMAR visual acuity at 100%, 50%, and 12% contrast; and contrast sensitivity function (CSF) under photopic and mesopic conditions. Subjective outcomes were assessed using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). RESULTS: The study enrolled 160 patients, 40 in each group. Six months postoperatively, there were no statistically significant between-group differences in the spherical equivalent, UDVA, CDVA, DCNVA, reading performance, or CSF under photopic and mesopic conditions. The defocus curves at 100%, 50%, and 15% of contrast showed that trifocal IOLs, especially the AcrySof PanOptix, had better intermediate performance than the bifocal IOL and comparable outcomes at far and near distances. There were no statistically significant differences in the postoperative NEI VFQ-25 questionnaire scores between the 4 IOL groups. CONCLUSION: The trifocal IOLs provided better intermediate distance vision than the bifocal IOL without compromising distance or near vision.