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Comparative analysis of subjective optical quality after bilateral implantation of two diffractive trifocal intraocular lenses and one extended-depth-of-focus lens following lens removal

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Session Details

Session Title: EDOF vs Multifocal IOLs

Session Date/Time: Sunday 23/09/2018 | 14:15-16:00

Paper Time: 15:14

Venue: Room A4

First Author: : E.Hemkeppler GERMANY

Co Author(s): :    M. Böhm   K. Petermann   N. de Lorenzo   S. Schönbrunn   M. Herzog   T. Kohnen     

Abstract Details


In this comparative prospective case series the subjective optical quality (SOQ) of two multifocal intraocular lenses (MIOL) (AT LISA tri839MP, Carl Zeiss Meditec, Jena, Germany; AcrySof® IQ PanOptix®, Alcon Pharma GmbH, Freiburg, Germany) and one extended depth of focus lens (TECNIS Symfony®, Abbott Medical Optics, Ettlingen, Germany) was compared.


Department of Ophthalmology, Goethe University, Frankfurt, Germany.


18 patients had bilateral implantation of either AT LISA trifocal (ALT) or AcrySof® IQ PanOptix® (PO) IOL or TECNIS Symfony® (TS) pre-enrolment. Exclusion criteria were previous ocular surgeries, irregular corneal astigmatism of >1.5 diopter, and ocular pathologies or corneal abnormalities. Postoperative examination at 3 months included a quality of vision questionnaire (visual analogue scale (VAS) 0 (perfect) – 100 (extremely poor)) which requested “glare”, “halos”, “starbursts”, “blurred vision” and “ghosting” in three different lighting conditions, manifest refraction; monocular and binocular uncorrected (UCVA) and distance-corrected (DCVA) visual acuity in 4 m, 80 cm, and 40 cm; slit-lamp examination.


Monocular DCVA (logMAR) at distance, intermediate and near was -0.05±0.08, 0.02±0.09, 0.03±0.11 (ALT group), -0.06±0.07, 0.14±0.15, 0.03±0.08 (PO group) and 0.00±0.15, 0.04±0.08, 0.30±0.15 (TS group). Total SOQ showed no significant difference (PO/TS p=0.18, PO/ALT p=0.97, TS/ALT p=0.06). SOQ under photopic and low mesopic conditions was significantly better for PO (VAS: 14±19.6, 15±20.9) than ALT (VAS: 21±26.4, 27±30.5) (p=0.04, p=0.04). SOQ under all lighting conditions is better for TS (VAS: 9±10.1, 8±7.4, 12±11.2) than ALT (VAS: 21±26.4, 27±30.5, 30±22.8) (p=0.02, p=0.00, p=0.00).


Total subjective optical quality was rated to be good for all three lenses. This study showed no significant difference between the TS and PO MIOL regarding optical quality under photopic, low mesopic and high mesopic conditions. PO shows significantly better results as ALT in optical quality under photopic and low mesopic conditions. SOQ in all lighting conditions shows better results in the TS than in the ALT group. All tested IOLs showed good visual performance at far and intermediate distance (> 0.15 logMAR). TS shows worse visual performance in near distance than the PO and ALT IOLs.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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