Visual outcomes and patient satisfaction in refractive lens exchange with trifocal intraocular lens in presbyopic hyperopia, emmetropia, and myopia

PURPOSE: To compare visual and refractive outcomes and visual function after bilateral refractive lens exchange (RLE) with a trifocal intraocular lens (IOL) in myopic, hyperopic, and emmetropic eyes with presbyopia. STUDY DESIGN: Retrospective comparative case series. METHODS: Charts of presbyopic patients who underwent RLE with implantation of RayOne Trifocal IOL were retrospectively reviewed. Visual and refractive outcomes were evaluated at 3 months. Patient satisfaction, spectacle independence, and visual disturbance were assessed by patient reported outcomes measures (PROMs) questionnaires. RESULTS: A total of 6788 eyes were classified into refractive groups. Mean (± standard deviation) visual acuity (logMAR) at 3 months: Group A (emmetropic), binocular uncorrected distance visual acuity (UDVA), 0.01 ± 0.11; monocular corrected distance visual acuity (CDVA), 0.01 ± 0.03; binocular uncorrected near visual acuity (UNVA) at 40 cm, 0.08 ± 0.07; binocular uncorrected intermediate visual acuity (UIVA) at 66 cm, 0.12 ± 0.11; postoperative spherical equivalent (SE) (diopters (D)), -0.05 ± 0.29. Group B (myopic), binocular UDVA, 0.03 ± 0.23; monocular CDVA, 0.01 ± 0.02; binocular UNVA, 0.07 ± 0.07; binocular UIVA, 0.12 ± 0.08; SE, -0.05 ± 0.52. Group C (hyperopic), binocular UDVA, 0.00 ± 0.03; monocular CDVA, 0.01 ± 0.02; binocular UNVA, 0.08 ± 0.07; binocular UIVA, 0.21 ± 0.09; SE, -0.08 ± 0.30. PROMs showed high levels of satisfaction and spectacle independence at all distances with worse results in myopes. Night vision was worse in hyperopes. CONCLUSIONS: In this retrospective analysis, RayOne Trifocal provided good visual performance at all distances, resulting in excellent levels of spectacle independence and satisfaction despite the preoperative refraction.