Comparison of three different presbyopia-correcting intraocular lenses

Objective (aim): to test the refractive and visual outcomes and the quality of vision after the bilateral implantation of three different multifocal intraocular lenses (MIOLs) in patients with age-related cataract. Methods: In this retrospective, comparative study including 90 eyes of 45 cataract patients, bilateral implantation of either the hydrophilic trifocal Liberty® 677MY capsular bag IOL, the hydrophilic AT LISA® tri 839M lens, or the hydrophobic AcrySof® IQ PanOptix® IOL was performed during routine cataract surgery. Refractive outcomes, visual acuities (VA) for far, intermediate and near distances, as well as visual quality, dysphotopic events and spectacle use were evaluated six months postoperatively. Results: VA curves were similar for the three MIOLs, however the Liberty lens seemed to be superior for far and near, while AT LISA tri provided somewhat better VA in the intermediate range. Refractive correction was the most effective with the Liberty IOL (p=0.0131). Dysphotopic phenomena were usually perceived in low light conditions. Their frequency was lower with the AT LISA tri and Liberty lenses. Symptoms were significantly less disturbing for patients implanted with the Liberty lens, two-thirds of AT LISA tri and Liberty patients, while only 57% of PanOptix patients achieved spectacle independence. Conclusions: All examined MIOLs were found to be safe and efficient in presbyopia-correction of cataract patients, however different models had different advantages. The vision preferences of each patient should always be taken into consideration when choosing a MIOL, and the possible occurrence of dysphotopic events should be also clearly communicated in each case. Abbreviations: ACD = Anterior chamber depth, ANOVA = Analysis of variance, AXL = Axial length, CDVA = Corrected distance visual acuity, CYL = Cylinder; Cylindric refraction, D = Diopter, IOL = Intraocular lens, K1; K2 = Keratometry values, MIOL = Multifocal intraocular lens, n = Number of cases, n.a. = Not applicable, Postop = Postoperative, QoV = Quality of Vision, SD = Standard deviation, SEQ = Spherical equivalent, SPH = Sphere; Spherical refraction, UDVA = Uncorrected distance visual acuity, UIVA = Uncorrected intermediate visual acuity, UNVA = Uncorrected near visual acuity, VA = Visual acuity.