Clinical Outcomes of Diffractive Aspheric Trifocal Intraocular Lens Implantation

Su Chan Lee; Jae Woo Kim; Tae Hyung Lim; Kee Yong Choi; Beom Jin Cho

doi:10.3341/jkos.2015.56.9.1338

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Lee, Kim, Lim, Choi, and Cho: Clinical Outcomes of Diffractive Aspheric Trifocal Intraocular Lens Implantation

Original Article

J Korean Ophthalmol Soc 2015;56(9):1338-1344.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.9.1338

Clinical Outcomes of Diffractive Aspheric Trifocal Intraocular Lens Implantation

Su Chan Lee, M.D., Jae Woo Kim, M.D., Tae Hyung Lim, M.D., Kee Yong Choi, M.D., Beom Jin Cho, M.D.

HanGil Eye Hospital, Incheon, Korea

Address reprint requests to Beom Jin Cho, MD HanGil Eye Hospital, #35 Bupyeong-daero, Bupyeong-gu, Incheon 21388, Korea Tel: 82-32-503-3322, Fax: 82-32-504-3322 E-mail: chobjn@empal.com

Received 13 March 20155 May 2015 Accepted 6 July 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical outcomes of patients with diffractive aspheric trifocal intraocular lens (AT.LISA tri839 MP^® IOL, Carl Zeiss Meditec, Jena, Germany) implantation.

Methods

Forty eyes of 53 patients received phacoemulsification and implantation of AT.LISA tri839 MP^® IOL (Carl Zeiss Meditec). Uncorrected distant visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acui-ty (UNVA), refractive values, and defocus curve were evaluated at postoperative 1 month and 3 months. Optical quality was evaluated with the Optical Quality Analysis System (OQAS^®, Visiometrics, Castelldefels, Spain).

Results

At the 3-month postoperative follow-up, the mean spherical equivalent was 0.01 ± 0.31 D and the mean UDVA, UIVA and UNVA were 0.023 ± 0.020, 0.155 ± 0.091, and 0.139 ± 0.069, respectively. The means of the objective scatter index, modu-lation transfer function cut-off value, Strehl ratio measured by OQAS^® (Visiometrics) were 1.83 ± 0.52, 33.58 ± 14.27 cycle per degree and 0.18 ± 0.11, respectively. Intermediate visual acuity did not fall sharply at defocus curve.

Conclusions

Implantation of the diffractive aspheric trifocal intraocular lens in patients with cataracts provided excellent distant, intermediate and near visual acuities with high visual quality.

Keywords: AT.LISA tri839 MP^®, IOL, Cataract, Intermediate visual acuity, Trifocal IOL

References

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Figure 1.

The aspheric diffractive trifocal intraocular lens (AT.LISA tri839 MP®, Carl Zeiss Meditec, Jena, Germany).

Figure 2.

Visual acuity after AT.LISA tri839 MP® IOL (Carl Zeiss Meditec, Jena, Germany) implantation. (A) Uncorrected distance visual acuity (UDVA). (B) Uncorrected intermediate visu-al acuity (UIVA). (C) Uncorrected near visual acuity (UNVA).

Figure 3.

Mean monocular defocus curve at 1 and 3 months af-ter surgery. PL = plano; D = diopter.

Table 1.

Patient demographics and clinical informations

Parameter	Values (range)
Age (years)	53.6 ± 7.8 (29, 65)
UDVA (log MAR)	0.55 ± 0.40 (0.10, 1.40)
CDVA (log MAR)	0.28 ± 0.31 (0.10, 1.40)
Manifest sphere (D)	-0.11 ± 1.93 (-4.25, 2.25)
Manifest cylinder (D)	-0.69 ± 0.54 (-2.0, 0)
Manifest S.E (D)	-0.39 ± 1.86 (-4.5, 1.875)
K2-K1 (D)	0.68 ± 0.36 (0, 1.9)
Mean K (D)	44.32 ± 1.48 (40.62, 47.61)
Axial length (mm)	23.83 ± 1.03 (22.53, 26.02)
Mean IOL power (D)	19.02 ± 2.74 (12.5, 22.5)
Preoperative target (D)	0.24 ± 0.17 (0.06, 0.56)

Values are presented as mean ± SD (range). UDVA = uncorrected distant visual acuity; log MAR = logarithm of the minimal angle of resolution; CDVA = corrected distant visu-al acuity; D = diopter; S.E = spherical equivalent; K2-K1= corneal cylinder; K = keratometry; IOL = intraocular lens.

Table 2.

Refractive value and visual acuity at preoperative, postoperative 1 month, and postoperative 3 months

	Value			p-value^∗
	Preop	1 month	3 months	Preop vs. 1 month	1 month vs.3 months
Manifest sphere (D)	-0.11 ± 1.93 (-4.25, 2.25	5) 10.06 ± 0.25 (-0.75, 0.5)	0.18 ± 0.24 (-0.75, 0.5)	0.826	0.231
Manifest cylinder (D)	) -0.69 ± 0.54 (-2.0, 0)	-0.36 ± 0.27 (-0.75, 0)	-0.39 ± 0.20 (-0.75, 0)	0.003	0.535
Manifest S.E (D)	-0.39 ± 1.86 (-4.5, 1.875	5) -0.07 ± 0.28 (0.75, 0.5)	0.01 ± 0.31 (-0.75, 0.5)	0.626	0.507
UDVA (log MAR)	0.54 ± 0.40 (0.04, 1)	0.025 ± 0.021 (0, 0.155)	0.023 ± 0.020 (0, 0.155)	0.000	0.629
CDVA (log MAR)	0.26 ± 0.29 (0, 1)	0.008 ± 0.018 (0, 0.155)	0.007 ± 0.011 (0, 0.155)	0.000	0.353
UIVA (log MAR)	-	0.167 ± 0.086 (0, 0.301)	0.155 ± 0.091 (0, 0.301)	-	0.428
UNVA (log MAR)	-	0.141 ± 0.069 (0.097, 0.301	1) 0.139 ± 0.069 (0.097, 0.301)	-	0.231

Values are presented as mean ± SD (range). Preop = preoperation; D = diopter; S.E = spherical equivalent; UDVA = uncorrected distance visual acuity at 4 m; log MAR = logarithm of the minimal angle of resolution; CDVA = corrected distance visual acuity at 4 m; UIVA = uncorrected intermediate visual acuity at 80 cm distance; UNVA = uncorrected near visual acuity at 40 cm distance.

^∗ p-value was acquired from Wilcoxon signed rank test.

Table 3.

OQAS® results at 1 and 3 months after the diffractive IOL implantation

Parameter	Values		p-value^∗
Parameter	1 month	3 months	p-value^∗
OSI	1.63 ± 0.60	1.83 ± 0.52	0.656
MTF cut-off (C/deg)	31.15 ± 12.54	33.58 ± 14.27	0.822
Strehl ratio	0.17 ± 0.08	0.18 ± 0.11	0.321

Values are presented as mean ± SD unless otherwise indicated. OQAS® = optical quality analysis system (Visiometrics, Castelldefels, Spain); IOL = intraocular lens; OSI = objective scatter index; MTF = modulation transfer function.

^∗ p-value was acquired from Wilcoxon signed rank test.

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