Long-term objective and subjective outcomes following bilateral implantation of diffractive bifocal or trifocal intraocular lenses

To evaluate and compare the objective and subjective outcomes after the bilateral implantation of a diffractive bifocal and trifocal intraocular lens.

This is a case-control, single-center observational study which included 27 patients; 16 patients were implanted bilaterally with the bifocal AcrySof IQ ReSTOR+3.0D and 11 patients with the trifocal AT LISA tri 839MP. Uncorrected visual acuity at distance, intermediate, and near under mesopic and photopic conditions using ETDRS charts with 10% and 100% contrast, corrected distance visual acuity, and binocular defocus curve in photopic conditions; binocular contrast sensitivity under mesopic and photopic conditions for far and near distances were assessed. The Visual Function Questionnaire-25 questionnaire was used to assess patients' satisfaction. All the measurements were performed 6-24 months after cataract surgery.

The ReSTOR group had better binocular uncorrected near visual acuity in photopic conditions with low and high contrast charts (p = 0.040 and p = 0.033, respectively), as well as in far contrast sensitivity measurement under mesopic conditions with a spatial frequency of 3 cycles per degree (p = 0.034). There was not a significant difference between the two study groups in uncorrected near, intermediate or distance vision under mesopic conditions. The AT LISA tri study group had better subjective outcomes.

Both intraocular lenses restore visual acuity after cataract surgery. The ReSTOR intraocular lens provides better objective outcomes than the AT LISA tri, although the latter provides better subjective outcomes. The relevance of this study is the evaluation of both objective and subjective outcomes.