Visual outcomes, spectacle independence and satisfaction after diffractive trifocal intraocular lens implantation

• Published in: Archivos de la Sociedad Española de Oftalmología (English ed.) 2018-10, Vol.93 (10), p.481-490
• Main Authors: Llovet-Rausell, A., Llovet-Osuna, F., Bilbao-Calabuig, R., Martínez del Pozo, M., Ortega-Usobiaga, J., Baviera-Sabater, J.
• Format: Article
• Language: English
• Subjects: Dissatisfaction; Eyeglasses; Humans; Insatisfacción; Intraocular lens; Lens Implantation, Intraocular; Lente intraocular; Multifocal; Night Vision; Patient Satisfaction; Phacoemulsification; Refraction, Ocular; Retrospective Studies; Satisfacción; Satisfaction; Treatment Outcome; Trifocal; Vision, Binocular; Visual Acuity
• ISSN: 2173-5794; 2173-5794
• DOI: 10.1016/j.oftale.2018.08.002

To investigate visual outcomes, spectacle independence, and patient satisfaction after trifocal intraocular lens implantation. A retrospective study conducted on 5186 patients who underwent phacoemulsification and were implanted with a diffractive trifocal intraocular lens (FineVision Micro F, PhysIOL SA, Liège, Belgium). The mean pre-operative keratometry was 43.61±1.55 D, and mean keratometric cylinder was −0.86±0.66 D. At 3 months post-operatively, values changed to 43.59±1.56 and −0.71±0.46 D, respectively. Mean sphere varied from 2.04±2.60 to 0.14±0.38 D, and mean spherical equivalent from 1.64±2.61 to −0.05±0.36 D. More than 60% of the patients achieved better corrected distance visual acuity. The majority had a final residual refractive error (predictability) lower than 1 D (99.1%), with 14.3% needing optical adjustment (bioptics). Posterior capsulotomy was performed in 2.2%, and the lens was replaced in 5 patients. A high percentage of patients were satisfied in terms of vision and spectacle independence at all distances. Although 2% referred to worsening of night vision quality, only 2% were not very satisfied and 20 patients were dissatisfied. The causes were: blurred vision (7 cases), spectacle dependence (10), dysphotopsia (7), and dry eye (4). The implantation of this model provided good visual performance in all distances, as well as high levels of spectacle independence and satisfaction. Evaluar los resultados visuales, la independencia de gafas y la satisfacción tras el implante de una lente intraocular trifocal. Estudio retrospectivo de 5.186 sujetos intervenidos de facoemulsificación con implante de la lente trifocal difractiva FineVision Micro F12 (PhysIOL, Liège, Bélgica). La queratometría media preoperatoria fue 43,61±1,55 D y el cilindro queratométrico medio −0,86±0,66 D. A los 3 meses, cambiaron a 43,59±1,56 y −0,71±0,46 D respectivamente. La esfera media pasó de 2,04±2,60 a 0,14±0,38 D y el equivalente esférico medio de 1,64±2,61 a −0,05±0,36 D. Más del 60% alcanzaron una mejor agudeza visual corregida de lejos. La mayoría presentó un defecto residual final (predictibilidad) menor de 1 D (99,1%). El 14,3% precisó un ajuste refractivo, el 2,2% capsulotomía posterior y se recolocó la lente intraocular en 5 casos. Un porcentaje elevado estaba satisfecho en términos de visión e independencia de gafas en todas las distancias. Aunque un 2% refirió un empeoramiento en la visión nocturna, únicamente un 2% estaba poco satisfecho y 20 pacient