Clinical outcomes of a trifocal compared with an EDOF IOL following bilateral cataract surgery



      To compare the visual and patient reported outcomes of 2 presbyopia-correcting intraocular lenses (IOLs).


      A total of 134 eyes (67 patients) that underwent cataract surgery with either a trifocal IOL or an extended depth of focus (EDOF) IOL bilaterally and were assessed 3 months after surgery. Outcome measures were binocular distance-corrected visual acuity at near (40 cm), intermediate (60 cm), and distance (6 m); Akman modified Quality of Life (QOL) Questionnaire-14; and 10% contrast visual acuity at distance and near, with and without glare.


      Mean binocular logMAR visual acuity (VA) for the PanOptix compared with the Symfony lenses: distance-corrected near VA, 0.054 versus 0.228; distance-corrected intermediate VA, 0.019 versus 0.063; and distance-corrected distance VA, –0.016 versus –0.021. The QOL questionnaire showed that 62% of the PanOptix group and 48% of the Symfony group had little or no difficulty with all QOL-related tasks. In a multivariable model controlling for pupil size and angle kappa (chord mu distance, right eyes), the differences were –0.005 (range, –0.03–0.02) and 0.165 (range, 0.12–0.21), respectively. Also, 10% contrast acuity was comparable in the 2 different lenses and was unaffected by glare.


      Binocular distance-corrected near VA was significantly better in the PanOptix group (p < 0.0001). This result remained statistically significant after controlling for pupil size and chord mu distance (p < 0.001). Intermediate and distance VAs were similar between the 2 groups. QOL scores were higher in the PanOptix group.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Canadian Journal of Ophthalmology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Keates RH
        • Pearce JL
        • Schneider RT.
        Clinical results of the multifocal lens.
        J Cataract Refract Surg. 1987; 13: 557-560
        • Pedrotti E
        • Bruni E
        • Bonacci E
        • Badalamenti R
        • Mastropasqua R
        • Marchini G.
        Comparative analysis of the clinical outcomes with a monofocal and an extended range of vision intraocular lens.
        J Refract Surg. 2016; 32: 436-442
        • Ruiz-Mesa R
        • Abengózar-Vela A
        • Aramburu A
        • Ruiz-Santos M.
        Comparison of visual outcomes after bilateral implantation of extended range of vision and trifocal intraocular lenses.
        Eur J Ophthalmol. 2017; 27: 460-465
        • Mojzis P
        • Kukuckova L
        • Majerova K
        • Liehneova K
        • Piñero DP.
        Comparative analysis of the visual performance after cataract surgery with implantation of a bifocal or trifocal diffractive IOL.
        J Refract Surg. 2014; 30: 666-672
        • Carson D
        • Xu Z
        • Alexander E
        • Choi M
        • Zhao Z
        • Hong X
        Optical bench performance of 3 trifocal intraocular lenses.
        J Cataract Refract Surg. 2016; 42: 1361-1367
        • Ruiz-Mesa R
        • Abengózar-Vela A
        • Ruiz-Santos M.
        A comparative study of the visual outcomes between a new trifocal and an extended depth of focus intraocular lens.
        Eur J Ophthalmol. 2018; 28: 182-187
        • Monaco G
        • Gari M
        • Di Censo F
        • Poscia A
        • Ruggi G
        • Scialdone
        Visual performance after bilateral implantation of 2 new presbyopia-correcting intraocular lenses: trifocal versus extended range of vision.
        Cataract Refract Surg. 2017; 43: 737-747
        • Cochener B
        • Boutillier G
        • Lamard M
        • Auberger-Zagnoli C.
        A comparative evaluation of a new generation of diffractive trifocal and extended depth of focus intraocular lenses.
        J Refract Surg. 2018; 34: 507-514
        • Mencucci R
        • Favuzza E
        • Caporossi O
        • Savastano A
        • Rizzo S.
        Comparative analysis of visual outcomes, reading skills, contrast sensitivity, and patient satisfaction with two models of trifocal diffractive intraocular lenses and an extended range of vision intraocular lens.
        Graefes Arch Clin Exp Ophthalmol. 2018; 256: 1913-1922
        • Escandón-García S
        • Ribeiro FJ
        • McAlinden C
        • Queirós A
        • González-Méijome JM.
        Through-focus vision performance and light disturbances of 3 new intraocular lenses for presbyopia correction.
        J Ophthalmol. 2018; 20186165493