Feasibility and Postoperative Outcome After Duet Procedure for Reversible Multifocality in Eyes with Co-Pathologies

Objectives: To evaluate the safety and efficacy of the simultaneous implantation of a monofocal capsular bag-fixated and a trifocal supplementary sulcus-fixated intraocular lens (duet procedure) in eyes with co-existing pathologies undergoing cataract or refractive lens surgery. Methods: In total, 80 eyes of 40 consecutive patients, who underwent refractive lens exchange or cataract surgery and received the duet procedure due to minor co-pathologies, were included in this retrospective case series. Preoperative assessment comprised slit-lamp biomicroscopy, optical biometry, posterior-segment optical coherence tomography, corneal endothelial specular microscopy, corneal tomography, manifest refraction and distance and near visual acuity testing. Three months postoperatively, uncorrected distance (UDVA) and uncorrected near visual acuity (UNVA) were recorded. Results: The preoperative manifest refractive spherical equivalent (MRSE) was -0.31 ± 4.29 diopters (D), with a mean refractive astigmatism of -0.80 ± 0.60 D. At three months postoperatively, monocular UDVA and binocular UNVA significantly improved from 0.52 ± 0.42 logMAR and 0.32 ± 0.27 logMAR to 0.05 ± 0.09 logMAR and -0.03 ± 0.10 logMAR, respectively (both p < 0.0001). Conclusions: Reversible multifocality provided by the duet procedure appears to be a feasible option in eyes with mild co-existing pathologies, as it yields satisfactory visual and refractive outcomes with high safety.