Visual outcomes and patient satisfaction in refractive lens exchange with trifocal intraocular lens in presbyopic hyperopia, emmetropia, and myopia.

PURPOSE: To compare visual and refractive outcomes and visual function after bilateral refractive lens exchange (RLE) with a trifocal intraocular lens (IOL) in myopic, hyperopic, and emmetropic eyes with presbyopia.

STUDY

DESIGN

Retrospective comparative case series.

METHODS

Charts of presbyopic patients who underwent RLE with implantation of RayOne Trifocal IOL were retrospectively reviewed. Visual and refractive outcomes were evaluated at 3 months. Patient satisfaction, spectacle independence, and visual disturbance were assessed by patient reported outcomes measures (PROMs) questionnaires.

RESULTS

A total of 6788 eyes were classified into refractive groups. Mean (± standard deviation) visual acuity (logMAR) at 3 months: Group A (emmetropic), binocular uncorrected distance visual acuity (UDVA), 0.01 ± 0.11; monocular corrected distance visual acuity (CDVA), 0.01 ± 0.03; binocular uncorrected near visual acuity (UNVA) at 40 cm, 0.08 ± 0.07; binocular uncorrected intermediate visual acuity (UIVA) at 66 cm, 0.12 ± 0.11; postoperative spherical equivalent (SE) (diopters (D)), -0.05 ± 0.29. Group B (myopic), binocular UDVA, 0.03 ± 0.23; monocular CDVA, 0.01 ± 0.02; binocular UNVA, 0.07 ± 0.07; binocular UIVA, 0.12 ± 0.08; SE, -0.05 ± 0.52. Group C (hyperopic), binocular UDVA, 0.00 ± 0.03; monocular CDVA, 0.01 ± 0.02; binocular UNVA, 0.08 ± 0.07; binocular UIVA, 0.21 ± 0.09; SE, -0.08 ± 0.30. PROMs showed high levels of satisfaction and spectacle independence at all distances with worse results in myopes. Night vision was worse in hyperopes.

CONCLUSIONS

In this retrospective analysis, RayOne Trifocal provided good visual performance at all distances, resulting in excellent levels of spectacle independence and satisfaction despite the preoperative refraction.