Comparison of Two-Year Clinical and Patient-Reported Outcome Measures Between Acrysof IQ and Clareon PanOptix Multifocal Intraocular Lenses

PURPOSE: To compare the 2-year clinical and patient-reported outcome measures of PanOptix multifocal intraocular lenses (MIOLs) based on the lens material. DESIGN: Retrospective matched cohort study. METHODS: A comparison between patients who had undergone bilateral operation with Acrysof IQ versus Clareon PanOptix MIOLs was done by 1-to-1 matching of age, axial length, mean keratometry, and corneal astigmatism. A total of 122 eyes of 122 patients in each group were studied. Main outcome measures analyzed included uncorrected near visual acuity (UNVA) and uncorrected distance visual acuity (UDVA), prediction error in spherical equivalent and postoperative refraction stability, glistening, subsurface nano-glistening (SSNG), Nd:YAG laser posterior capsulotomy rates, the area under the log contrast sensitivity function (AULCSF) under photopic and mesopic conditions, Strehl ratio, and area ratio. Patient-reported outcome measures such as dysphotopsia and modified spectacle-independent Visual Function Index (VF)-14 questionnaire scores were collected at 2 years. RESULTS: Throughout the study period, comparable UNVA, UDVA, and refractive stability were observed between the groups, except for better UNVA among eyes with Clareon than among eyes with Acrysof IQ at 2 years (0.00 ± 0.02 vs 0.02 ± 0.04, P < .001). Clareon implantation resulted in better photopic (1.47 ± 0.19 vs 1.38 ± 0.21 logCWeber units; P < .001), and mesopic (1.16 ± 0.22 vs 1.06 ± 0.19 logCWeber units; P < .001) AULCSF, lower prevalence of glistening (0% vs 88%, P < .001) and SSNG (0% vs 26%, P < .001) and cumulative Nd:YAG laser capsulotomy rates (hazard ratio = 0.632; 95% CI = 0.482-0.830, P < .001) when compared to those with Acrysof IQ. No differences were observed in the incidence of clinically significant glare or halos, but the incidence of starburst (5% vs 16%, P = .002) tended to favor Clareon over Acrysof IQ. Modified VF-14 questionnaire scores were greater for Clareon than Acrysof IQ (93.4 ± 10.3 vs 90.4 ± 13.6 points, P < 0.001). A multivariable regression analysis showed that patient age (beta = -0.394, P < .001; beta = -0.352, P < .001) and glistening grade (beta = -0.163, P = .010; beta = -0.232, P < .001) remained significantly associated with the photopic and mesopic AULCSF, respectively. Furthermore, higher glistening grade (r = -0.144, P = .003; beta = -1.771, P = .001 when age and sex adjusted) were associated with worse modified VF-14 questionnaire scores. CONCLUSIONS: Clareon PanOptix outperformed Acrysof IQ PanOptix in visual quality and spectacle-independent visual function, potentially resulting from a lower prevalence of glistening.