Comparison of visual performance between diffractive bifocal and diffractive trifocal intraocular lenses

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Optics

Background:

• Cataract surgery often involves intraocular lens (IOL) implantation to restore vision.
• Advanced IOLs, including diffractive bifocal and trifocal designs, aim to provide a wider range of visual clarity.
• Evaluating the comparative visual performance of these IOLs is crucial for patient outcomes.

Purpose of the Study:

• To compare the visual performance of a diffractive bifocal intraocular lens (IOL) with +4.0 D near addition (ZMB00) against a diffractive trifocal IOL (AcrySof IQ PanOptix TFNT00) with +2.17 D and +3.25 D near addition.
• To assess key postoperative visual parameters 10 weeks after bilateral IOL implantation.

Main Methods:

• A comparative study involving 1448 eyes from 724 patients who underwent bilateral implantation of either ZMB00 or TFNT00 IOLs.
• Data collected included uncorrected visual acuities, contrast sensitivity (with and without glare), and higher-order aberrations.
• Statistical analysis utilized a linear mixed-effects model, adjusting for multiple confounding factors like age, sex, and ocular characteristics.

Main Results:

• The diffractive bifocal (ZMB00) group demonstrated significantly better uncorrected near visual acuity and lower ocular/internal higher-order aberrations.
• The diffractive trifocal (TFNT00) group showed significantly better uncorrected intermediate visual acuity and superior contrast sensitivity, both with and without glare.
• These findings were statistically significant (p < 0.00068) after rigorous adjustments.

Conclusions:

• Both diffractive bifocal and trifocal IOLs offer distinct visual advantages.
• The choice between bifocal and trifocal IOLs may depend on individual patient needs and visual priorities, particularly concerning near versus intermediate vision.
• Further research could explore long-term outcomes and patient-reported satisfaction with each IOL type.