Visual Performance of a Quadrifocal (Trifocal) Intraocular Lens Following Removal of the Crystalline Lens

Am J Ophthalmol. 2017 Dec;184:52-62. doi: 10.1016/j.ajo.2017.09.016. Epub 2017 Sep 18.


Purpose: To evaluate visual performance after implantation of a quadrifocal intraocular lens (IOL).

Methods: Setting: Department of Ophthalmology, Goethe University, Frankfurt, Germany.

Study population: Twenty-seven patients (54 eyes) received bilateral implantation of the PanOptix IOL (AcrySof IQ PanOptixTM; Alcon Research, Fort Worth, Texas, USA) pre-enrollment. Exclusion criteria were previous ocular surgeries, corneal astigmatism of >1.5 diopter (D), ocular pathologies, or corneal abnormalities. Intervention or Observational Procedure(s): Postoperative examination at 3 months including manifest refraction; uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) in 4 m, 80 cm, 60 cm, and 40 cm slit-lamp examination; defocus testing; contrast sensitivity (CS) under photopic and mesopic conditions; and a questionnaire on subjective quality of vision, optical phenomena, and spectacle independence was performed.

Main outcome measure(s): At 3 months postoperatively, UCVA and DCVA in 4 m, 80 cm, 60 cm, and 40 cm (logMAR), defocus curves, CS, and quality-of-vision questionnaire results.

Results: Mean spherical equivalent was -0.04 ± 0.321 D 3 months postoperatively. Binocular UCVA at distance, intermediate (80 cm, 60 cm), and near was 0.00 ± 0.094 logMAR, 0.09 ± 0.107 logMAR, 0.00 ± 0.111 logMAR, and 0.01 ± 0.087 logMAR, respectively. Binocular defocus curve showed peaks with best visual acuity (VA) at 0.00 D (-0.07 logMAR) and -2.00 D (-0.02 logMAR).

Conclusion: Visual performance of the PanOptix IOL showed good VA at all distances; particularly good intermediate VA (logMAR > 0.1), with best VA at 60 cm; and high patient satisfaction and spectacle independence 3 months postoperatively.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Lens, Crystalline / surgery*
  • Lenses, Intraocular*
  • Male
  • Middle Aged
  • Phacoemulsification*
  • Postoperative Period
  • Prospective Studies
  • Prosthesis Design
  • Pseudophakia / physiopathology*
  • Refraction, Ocular*
  • Surveys and Questionnaires
  • Time Factors
  • Vision, Binocular*