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Unilateral vs bilateral refractive lens exchange with trifocal intraocular lens in emmetropic presbyopic patients

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First Author: J.Fernandez Garcia SPAIN

Co Author(s):    J. Ortega-Usobiaga   F. Llovet-Osuna   A. Llovet-Rausell   J. Beltran-Sanz           

Abstract Details


To compare visual outcomes and patient satisfaction between unilateral and bilateral trifocal diffractive intraocular lens (IOL) implantation in emmetropic patients with presbyopia.


Clinica Baviera (Aier Eye Hospital), Spain


This is a retrospective study of emmetropic presbyopes who underwent refractive lens exchange (RLE) followed by an implantation of FineVision IOL (Physiol, Liège, Belgium). Inclusion criteria were emmetropic eyes; with sphere between -0.25 and +0.50 diopters (D), cylinder less than 0.75 D and spherical equivalent (SE) between -0.25 and +0.25 D; whose uncorrected distance visual acuity (UDVA) was Snellen 0.9 in each eye. This sample was divided into two groups depending on whether they have been operated monocular or binocularly. Visual and refractive performance, patient satisfaction and spectacle independence were evaluated.


A total of 269 eyes of 183 patients were evaluated. Snellen UDVA decreased from 0.97±0.19 to 0.90±1.08 after monocular surgery and from 0.96±0.19 to 0.92±0.81 after binocular surgery. Corrected Distance Visual Acuity (CDVA) remained unchanged in both groups. Uncorrected intermediate (UIVA) and near (UNVA) visual acuity were better in those operated binocularly. Predictability and efficacy were higher in the binocular group; while security was better in the monocular group. Night driving and vision were worse rated in binocular group rather monocular. Spectacle independence was higher in binocular group for all distances.


RLE with binocular FineVision implantation in presbyopic emmetropic patients offers better results in UIVA and UNVA than monocularly. No significative difference was observed in UDVA.

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