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Early Clinical Outcomes After the Mix-and-Match Approach of Trifocal and Non-Diffractive EDOF IOL
Ayako Eno1,2, Akiko Takai1, Kyoko Fujita2
1Eno Eye Clinic Nishiashiya, Ashiya, Japan.
Clinical Ophthalmology (Auckland, N.Z.)
|July 15, 2026
Summary
This study combined PanOptix trifocal and Vivity extended depth of focus intraocular lenses (IOLs) in cataract surgery patients. The mix-and-match approach demonstrated favorable visual performance and contrast sensitivity, with reduced photic phenomena.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Vision Science
Background:
- Cataract surgery is a common procedure to restore vision.
- Intraocular lenses (IOLs) are implanted to correct refractive errors after cataract removal.
- Advanced IOLs, such as trifocal and extended depth of focus (EDOF) lenses, aim to provide spectacle independence.
Purpose of the Study:
- To evaluate early postoperative visual performance using a mix-and-match approach with Clareon PanOptix diffractive trifocal and Clareon Vivity non-diffractive EDOF IOLs.
- To compare the visual outcomes of combining these two distinct IOL technologies in a bilateral implantation strategy.
- To assess visual acuity, contrast sensitivity, and subjective photic phenomena in patients receiving the mix-and-match IOL combination.
Main Methods:
- A single-center, retrospective study included 27 patients (54 eyes) undergoing bilateral cataract surgery.
- Each patient received a PanOptix IOL in one eye and a Vivity IOL in the fellow eye (mix-and-match approach).
- Postoperative assessments included uncorrected visual acuity (UCVA) at various distances, defocus curves, mesopic contrast sensitivity (with/without glare), and halo/glare evaluation.
Main Results:
- 73% of patients in the mix-and-match group achieved UCVA of ≤ 0.1 logMAR across all tested distances.
- Binocular defocus curves showed visual acuity of ≤ 0.1 logMAR from 0 D to -3.0 D.
- The mix-and-match group exhibited significantly higher contrast sensitivity (with/without glare) and a better subjective halo experience compared to monocular PanOptix implantation.
Conclusions:
- The mix-and-match combination of PanOptix and Vivity IOLs offers a favorable balance of visual acuity, contrast sensitivity, and photic phenomena.
- This approach may enhance early postoperative visual quality for cataract surgery patients.
- Further investigation with longer follow-up is warranted to confirm these findings.
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