Comparison of refractive and visual outcomes of 3 presbyopia-correcting intraocular lenses

Purpose: To evaluate and compare the clinical outcomes after cataract surgery with implantation of 3 types of trifocal diffractive intraocular lenses (IOLs). Setting: Hospital da Luz, Lisbon, Portugal. Design: Prospective comparative case series. Methods: Patients undergoing phacoemulsification cataract surgery with implantation of 1 of the 3 trifocal IOLs were enrolled: TECNIS Synergy (Synergy group, 30 patients), Acrysof PanOptix (PanOptix group, 30 patients), and POD F (Finevision group, 30 patients). The outcomes of distance, intermediate, and near visual acuity (VA), refraction, defocus curve, photic phenomena, and spectacle independence were evaluated at the 3-month follow-up. Results: 180 eyes of 90 patients were enrolled. No statistically significant differences were found between groups in monocular distance-corrected intermediate (Synergy group 0.04 ± 0.11, PanOptix group 0.05 ± 0.09, and Finevision group 0.08 ± 0.10; P = .107) and near VA (0.01 ± 0.08, 0.01 ± 0.06, and 0.04 ± 0.10, respectively; P = .186). Similarly, no statistically significant differences among groups were found in binocular uncorrected distance ( P = .572), near ( P = .929), and intermediate VA ( P = .327). By contrast, statistically significant differences between groups were found in the visual acuity for the vergence demands of −0.50, −1.00, −2.00, −3.50, and −4.00 diopters ( P ≤ .045). No statistically significant differences among groups were found in the frequency, severity, and bothersomeness of different disturbing visual symptoms, including glare and halos ( P ≥ .129). More than 87 (96%) of patients in all groups did not require the use of spectacles at any distance postoperatively. Conclusions: The 3 trifocal IOLs evaluated provided an effective visual rehabilitation with minimal incidence of photic phenomena. A trend to obtain a wider range of functional focus was observed with the TECNIS Synergy IOL.