Comparison of Mix-and-Match Implanted Bifocal IOLs and Bilateral Implanted Trifocal IOLs After Femtosecond Laser-Assisted Cataract Surgery

Purpose: To compare the visual performance of mix-and-match implanted bifocal intraocular lenses (IOLs) and bilateral implanted trifocal IOLs from the same manufacturer with the same IOL platform after femtosecond laser-assisted cataract surgery (FLACS).

Methods: This prospective, comparative, non-randomized study included patients who underwent FLACS (LenSx; Alcon Laboratories, Inc., Fort Worth, Texas) with bilateral implantation of bifocal IOLs (ReSTOR +2.50 D/+3.00 D; Alcon Laboratories, Inc.) or trifocal IOLs (PanOptix; Alcon Laboratories, Inc.). Visual acuities, manifest refraction, defocus curve, contrast sensitivity, quality of life measured by the Visual Function Index (VF-14), and spectacle independence were assessed at 6 months after surgery.

Results: A total of 70 eyes of 35 patients were included in this study. There was no difference in patient demographics and preoperative measurements between groups (P > .05). There was no difference in uncorrected distance visual acuity and corrected distance visual acuity outcomes between groups (P > .05), but uncorrected intermediate visual acuity and uncorrected near visual acuity outcomes were significantly better in the PanOptix group (P < .01). Correspondingly, the binocular defocus curve of the PanOptix IOLs showed significantly better visual acuity between -1.00 and -3.00 diopters compared to the ReSTOR IOLs (P < .05). The PanOptix group showed higher contrast sensitivity scores than the ReSTOR group for 12 and 18 spatial frequencies in photopic conditions and for 18 spatial frequencies in mesopic conditions (P < .05). The average VF-14 score was similar between groups (P = .78). None of the patients required spectacles.

Conclusions: Bilateral implanted PanOptix IOLs seem to provide better intermediate and near vision, defocus curve, and contrast sensitivity compared to mix-and-match implanted ReSTOR IOLs. However, similar vision-related quality of life and spectacle independence were achieved with both IOLs. [J Refract Surg. 2019;35(9):559-564.].