Three-year comparison of two mix-and-match strategies: enhanced monofocal and trifocal vs enhanced monofocal and trifocal EDOF intraocular lenses.

PURPOSE: To assess and compare 3-year visual and subjective outcomes after mix-and-match implantation of enhanced monofocal and trifocal or trifocal extended depth-of-focus (EDOF) intraocular lenses (IOLs).

SETTING

Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.

DESIGN

Single-center, prospective, clinical trial.

METHODS

50 patients (100 eyes) received bilateral cataract surgery with implantation of the enhanced monofocal Isopure IOL in the dominant eye and either the trifocal Finevision HP or trifocal EDOF Finevision Triumf IOL in the nondominant eye. At the 3-year examination, binocular uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA), binocular defocus curves, halo/glare simulation, Catquest-9SF questionnaire, spectacle dependence, and Nd:YAG rate were evaluated.

RESULTS

34 patients (68 eyes) were available at the 3-year follow-up examination. In the Isopure-HP group, binocular UDVA, UIVA (80 cm), UIVA (66 cm), and UNVA were -0.04 ± 0.10 (20/20) logMAR, 0.06 ± 0.07 (20/25) logMAR, 0.10 ± 0.08 (20/25) logMAR, and 0.17 ± 0.08 (20/32) logMAR, respectively. Corresponding values in the Isopure-Triumf group were 0.03 ± 0.11 (20/20) logMAR ( P = .08), 0.09 ± 0.10 (20/25) logMAR ( P = .40), 0.12 ± 0.11 (20/25) logMAR ( P = .56), and 0.27 ± 0.07 (20/40) ( P < .001). P values refer to the difference between both groups. Binocular defocus curves showed ≤0.2 logMAR visual acuities up to -3.0 diopters (D) (Isopure-HP) and -2.0 D (Isopure-Triumf). Halo, glare, and Catquest-9SF scores were comparable ( P > .05). Nd:YAG treatment was required in 15 (44%) of Isopure eyes, 2 (13%) of Finevision HP eyes, and 1 (6%) of Finevision Triumf eyes.

CONCLUSIONS

Combined implantation of enhanced monofocal and trifocal/trifocal EDOF IOLs yields excellent distance and intermediate vision. Near visual acuity and spectacle independence was higher in the Isopure-HP group. Low incidence of photic phenomena and high patient satisfaction highlight the long-term effectiveness of both mix-and-match strategies.