Visual outcomes and subjective experience after bilateral implantation of a new diffractive trifocal intraocular lens

J Cataract Refract Surg. 2013 Mar;39(3):343-9. doi: 10.1016/j.jcrs.2012.09.017. Epub 2013 Jan 16.


Purpose: To assess clinical outcomes and subjective experience after bilateral implantation of a diffractive trifocal intraocular lens (IOL).

Setting: Midland Eye Institute, Solihull, United Kingdom.

Design: Cohort study.

Methods: Patients had bilateral implantation of Finevision trifocal IOLs. Uncorrected distance visual acuity, corrected distance visual acuity (CDVA), and manifest refraction were measured 2 months postoperatively. Defocus curves were assessed under photopic and mesopic conditions over a range of +1.50 to -4.00 diopters (D) in 0.50 D steps. Contrast sensitivity function was assessed under photopic conditions. Halometry was used to measure the angular size of monocular and binocular photopic scotomas arising from a glare source. Patient satisfaction with uncorrected near vision was assessed using the Near Activity Visual Questionnaire (NAVQ).

Results: The mean monocular CDVA was 0.08 logMAR ± 0.08 (SD) and the mean binocular CDVA, 0.06 ± 0.08 logMAR. Defocus curve testing showed an extended range of clear vision from +1.00 to -2.50 D defocus, with a significant difference in acuity between photopic conditions and mesopic conditions at -1.50 D defocus only. Photopic contrast sensitivity was significantly better binocularly than monocularly at all spatial frequencies. Halometry showed a glare scotoma of a mean size similar to that in previous studies of multifocal and accommodating IOLs; there were no subjective complaints of dysphotopsia. The mean NAVQ Rasch score for satisfaction with near vision was 15.9 ± 10.7 logits.

Conclusions: The trifocal IOL implanted binocularly produced good distance visual acuity and near and intermediate visual function. Patients were very satisfied with their uncorrected near vision.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Contrast Sensitivity / physiology
  • Female
  • Glare
  • Humans
  • Lens Implantation, Intraocular / methods*
  • Lenses, Intraocular*
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Phacoemulsification*
  • Prospective Studies
  • Prosthesis Design
  • Quality of Life
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vision, Binocular / physiology
  • Visual Acuity / physiology*