Early Clinical Outcomes After the Mix-and-Match Approach of Trifocal and Non-Diffractive EDOF IOL

To evaluate early postoperative visual performance following cataract surgery using the mix-and-match approach with Clareon PanOptix diffractive trifocal and Clareon Vivity non-diffractive extended depth of focus (EDOF) intraocular lenses (IOLs).

This single-center, retrospective study was conducted between April 2024 and April 2025 and included 27 patients (54 eyes). Each patient underwent bilateral cataract surgery with implantation of a PanOptix IOL in one eye and a Vivity IOL in the fellow eye. Postoperative outcomes were evaluated for up to 1 month after surgery of the second eye. Monocular (PanOptix and Vivity) and binocular (mix-and-match, M-M) uncorrected visual acuity (UCVA) from 5 m to 30 cm, defocus curves (+2.0 D to -4.0 D), mesopic contrast sensitivity with and without glare, and subjective evaluation of photic phenomena (halo) using the ViSU-L Halo & Glare Simulator were assessed.

In the M-M group, 73% of patients achieved UCVA of ≤ 0.1 logarithm of the minimum angle of resolution (logMAR) across all distances (5 m to 30 cm). Binocular defocus curves showed visual acuity of ≤ 0.1 logMAR from 0 D to -3.0 D. Area under the log contrast sensitivity functions with or without glare was significantly higher in the M-M group compared to both monocular groups (all P < 0.05). The percentage of patients reporting no halo was highest in the Vivity group (77.8%), followed by the M-M (55.6%) and PanOptix groups (40.7%), and the M-M group showed a significantly higher rate than the PanOptix group (P = 0.0455).

Although limited by a short follow-up duration, the combination of PanOptix and Vivity IOL provided a favorable balance between visual acuity, contrast sensitivity, and photic phenomena. Our findings suggest that this mix-and-match approach may serve as a viable option for enhancing visual quality beginning in the early postoperative period.