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Contralateral Bifocal Intraocular Lenses overall satisfaction significantly greater than Trifocal Intraocular Lenses
![Contralateral Bifocal Intraocular Lenses overall satisfaction significantly greater than Trifocal Intraocular Lenses Contralateral Bifocal Intraocular Lenses overall satisfaction significantly greater than Trifocal Intraocular Lenses](https://medicaldialogues.in/h-upload/2020/09/28/750x450_135171-intraocular-lenses2.webp)
The percentage of cataract patients seeking spectacle independence with presbyopia-correcting IOLs is increasing. Multifocal IOLs have provided functional distance and near vision in patients undergoing cataract surgery and refractive clear lens exchange. The main limitations with bifocal presbyopia-correcting implants have included dysphotopsias such as halos and glare and poor intermediate vision. Trifocal IOLs were developed to add a third foci and improve intermediate function. There have been numerous studies comparing visual outcomes and patient satisfaction with bifocal and trifocal IOLs.
Assessing patient satisfaction can be challenging, because the subjective perception of each patient to an identical objective stimulus, like an IOL, can be highly variable. The aim of this study by Bucci Jnr was to directly compare patient preference and visual quality of the bifocal +3.25 Tecnis IOL to the trifocal PanOptix IOL when one of each is implanted in the same patient. The purpose was not only to quantitate levels of satisfaction and preference, but also to determine "why" they preferred one IOL over another.
Patients received a +3.25 Tecnis bifocal IOL in one eye and a PanOptix trifocal IOL in the opposite eye. Eyes were unilaterally evaluated and included UDVA, UIVA, UNVA, mesopic contrast sensitivity testing, and subjective questionnaires about overall satisfaction, and IOL preference.
Sixty eyes of thirty patients were evaluated. Patients preferred (p=0.028) +3.25 to PanOptix. Overall satisfaction was significantly greater (p=0.05) for +3.25 (4.70 vs 4.43/5.00). UDVA (p=0.032) and "freq. of glasses use distance" (p=0.05) were significantly better for +3.25 eyes. Objective intermediate (Jaeger) vision was significantly better (p=0.034) for PanOptix eyes. "Freq. of glasses use intermediate" favored +3.25. Regression revealed variables related to intermediate vision and "ability to read fine print without glasses" were significant predictors of overall satisfaction for both IOLs. Variables related to contrast sensitivity both with and without glare were significant predictors exclusively for PanOptix eyes.
- Despite achieving better objective uncorrected intermediate vision with a trifocal IOL, patients still prefer and can achieve greater levels of overall satisfaction with a bifocal IOL.
- Regression analysis strongly suggested that issues related to contrast sensitivity may be responsible for the patient's subjective preference for the bifocal IOL.
Source: Bucci Jnr; Clinical Ophthalmology 2022:16
https://doi.org/10.2147/OPTH.S388462
Dr Ishan Kataria has done his MBBS from Medical College Bijapur and MS in Ophthalmology from Dr Vasant Rao Pawar Medical College, Nasik. Post completing MD, he pursuid Anterior Segment Fellowship from Sankara Eye Hospital and worked as a competent phaco and anterior segment consultant surgeon in a trust hospital in Bathinda for 2 years.He is currently pursuing Fellowship in Vitreo-Retina at Dr Sohan Singh Eye hospital Amritsar and is actively involved in various research activities under the guidance of the faculty.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751