Clinical Outcomes In Patients After Duet Procedure For Reversible Trifocality Using A Supplementary Trifocal Iol

We report the clinical outcomes of patients who had primary lens implantation in the capsular bag and subsequently a supplementary trifocal lens implanted in the ciliary sulcus (duet procedure) to create reversible trifocality. 

This single center retrospective interventional study was conducted in a university eye clinic in Germany.

Twenty-five patients who had undergone either refractive lens exchange for presbyopia correction or cataract surgery and duet procedure to achieve reversible trifocality were included. Preoperatively and at the three months follow-up, uncorrected (UDVA) and corrected distance visual acuity (CDVA), uncorrected (UNVA), distance corrected (DCNVA) and corrected near visual acuity (CNVA) were assessed. The postoperative examination additionally included uncorrected (UIVA), distance corrected (DCIVA) and corrected intermediate visual acuity (CIVA) and defocus curve testing as well as dysphotopsia evaluation. 

Monocular UDVA and CDVA improved from 0.71 ± 0.43 logMAR and 0.12 ± 0.16 logMAR preoperatively to 0.04 ± 0.10 logMAR and -0.01 ± 0.09 logMAR postoperatively. Monocular UNVA and DCNVA were both 0.06 ± 0.08 logMAR and UIVA and DCIVA 0.00 ± 0.10 logMAR and -0.02 ± 0.10 logMAR postoperatively. Monocular defocus curve testing revealed a visual acuity of 0.2 logMAR or better from +0.75 to -3.5 diopters. 

Duet procedure using a trifocal supplementary IOL provided visual acuity results for far, near and intermediate distance that were comparable to those reported for capsular bag fixated trifocal IOLs. The Duet procedure offers the advantage of an exit-strategy in case of a future loss of function or intolerance of side effects associated with the optic.