When considering which of the newer-generation intraocular lenses (IOLs) may be best for your cataract patients, a study in Eye & Contact Lens reports both a diffractive trifocal and an extended depth-of-focus (EDOF) lens performed well in distance and intermediate vision, but the trifocal did better for near vision.

In the prospective, six-month study, researchers from India compared the visual results of both lenses. The investigation enrolled 160 eyes of 80 patients who had bilateral cataract surgery and divided them into two equal groups. The patients were then implanted with either the trifocal or EDOF lens in both eyes. In addition to visual acuity measurements, subjects also filled out a spectacle dependence questionnaire.

The study found no statistically significant difference between the groups in monocular and binocular uncorrected distance visual acuity and corrected distance visual acuity. Researchers noted monocular and binocular uncorrected intermediate visual acuity and monocular distance-corrected intermediate visual acuity were also comparable. However, the trifocal had better results at all near visual acuity measurements. Still, the study reported no differences in visual quality and symptoms between the groups.

While the trifocal had a clear advantage over the EDOF in near visual acuity, both showed excellent performance in distance and intermediate visual acuity, investigators noted. “Both IOLs provided high percentage of spectacle independence and patient satisfaction with minimal level of disturbing photic phenomena,” the researchers wrote in their paper.

Investigators noted several limitations of their study, including the inclusion of just one trifocal lens design. Significantly, patients completed the questionnaire six months after surgery—any photic phenomena may have decreased by then, and patients may also have adjusted to new routines over the time period. Also, the IOLs were targeted for emmetropia, which may confound near and intermediate vision results, and the follow-up period of six months was relatively short to assess the consistency of results and occurrence of posterior capsule opacification, the researchers said. 

Singh B, Sharma S, Dadia S, et al. Comparative evaluation of visual outcomes after bilateral implantation of a diffractive trifocal intraocular lens and an extended depth of focus intraocular lens. Eye Contact Lens. July 5, 2019. [Epub ahead of print].