Age-related difference in the presbyopia-correcting effect of trifocal and enhanced monofocal intraocular lenses

To compare visual outcomes among three age groups in eyes with a trifocal (Alcon PanOptix^®) or enhanced monofocal intraocular lens (IOLs; Johnson & Johnson Eyhance^®).

Nonrandomized comparative study.

Seventy-eight eyes of 78 patients who received a trifocal IOL (trifocal category) and 78 eyes of 78 patients who received an enhanced monofocal IOL (enhanced monofocal category) were enrolled. Patients were stratified by age decade (n=26/group): 40-59 years of age (40s & 50s), 60-69 years of age (60s), and 70-79 years of age (70s). Uncorrected and distance-corrected visual acuity (VA) at various distances and photopic and mesopic contrast VA were examined at 3 months postoperatively and compared among age groups.

No significant differences in the mean uncorrected and distance-corrected VAs were detected at nearly all distances among the three age groups for either the trifocal or enhanced monofocal category. Mean photopic contrast VA was significantly different among the three age groups at 100% contrast for the trifocal category (P=0.018) and at 25%, 10%, 5%, and 2.5% contrasts in the enhanced monofocal category (P≤0.005); it was significantly better in the 40s & 50s age group than in the 60s or 70s age group (P≤0.002).

All-distance VA in eyes with a trifocal IOL and an enhanced monofocal IOL was essentially comparable among patients 40-79 years of age although contrast sensitivity was significantly worse in older patients, suggesting that these IOLs can be implanted irrespective of patient age with careful consideration of the age-dependent decline in contrast sensitivity.