Visual Performance of Two Diffractive Trifocal Intraocular Lenses: A Randomized Trial
Julius Hienert, Kristina Stjepanek, Nino Hirnschall, Manuel Ruiß, Hannah Zwickl, Oliver Findl
Abstract
PURPOSE: To compare two trifocal intraocular lenses (IOLs), the RayOne Trifocal RAO603F IOL (closed-loop haptic IOL; Rayner Intraocular Lenses Limited) and the AT Lisa tri 839 MP IOL (plate-haptic IOL; Carl Zeiss Meditec AG), concerning optical and capsular bag performance. METHODS: Patients scheduled for cataract surgery received either a closed-loop haptic IOL or a plate-haptic IOL in the first eye and the other IOL in the second eye. Three months postoperatively, autorefraction and subjective refraction, uncorrected and corrected distance visual acuity at 4 m, 80 cm, and 40 cm, an objective reading test (Salzburg Reading Desk; SRD Vision), a defocus curve, IOL tilt and decentration, a questionnaire about dysphotopsia, and grading of halos with a halometer were performed. RESULTS: Eighty-eight eyes of 44 patients were included. Visual acuity was comparable between both IOLs. The closed-loop haptic IOL performed better in the defocus curve at −1.50 diopters (D) (0.08 ± 0.10 vs 0.12 ± 0.09 logMAR; P < .01). The plate-haptic IOL had better contrast sensitivity without glare under mesopic and photopic conditions in miosis ( P = .0018 and .002, respectively) and mydriasis ( P = .017 and .003, respectively). Significant differences were found for less overall subjective disturbance ( P = .047) and starbursts ( P = .039) for the plate-haptic IOL, but not for the other positive dysphotopsia symptoms. CONCLUSIONS: Both trifocal IOLs delivered good and comparable visual function with low degrees of disturbing dysphotopsia. The closed-loop haptic IOL was slightly superior in the defocus curve, whereas the plate-haptic IOL was slightly superior concerning contrast sensitivity and positive dysphotopsia. [ J Refract Surg . 2021;37(7):460–465.]