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    Early results of trifocal IOL exhibit solid performance

    Take-home: Researchers conducted a 6-month study of patients implanted with the AcrySof IQ PanOptix presbyopia-correcting IOL to determine the binocular defocus curve of the lens. They concluded that these early results show good visual performance across the whole range of defocus. No unexpected adverse events were reported

    Monofocal intraocular lenses (IOLs) provide optimal vision at a single distance but do not accommodate well for other distances. Multifocal IOLs provide patients with vision over a range of distances. However, there have been limited improvements for intermediate vision.The AcrySof IQ PanOptix IOL is an aspheric hydrophobic IOL with a blue filter. A 6.0-mm optical zone is composed of a 4.5-mm large diffractive area with 15 diffractive zones and an outer refractive rim. (Images provided by Thomas Kohnen, MD, PhD)

    A novel trifocal lens, the AcrySof IQ PanOptix presbyopia-correcting IOL (Alcon Laboratories), attempts to address this deficit by creating an additional focal point for intermediate vision. The multifocal diffractive structure divides incoming light to create intermediate and near add powers of +2.17 D and +3.25 D, respectively.

    Prof. Thomas Kohnen, MD, PhD, Goethe University, Frankfurt, Germany, and colleagues presented the results of a study to determine the binocular defocus curve of the AcrySof IQ PanOptix IOL at 6 months post-implantation. The prospective, single arm, non-randomized, multicenter study involved bilateral implantation of the IOL in 151 patients over 21 years of age with bilateral cataracts surgically removed by phacoemulsification.

    Study methods/results

    The mean binocular defocus curve was obtained at 6 months, and the binocular defocus testing was performed under photopic conditions (~85 cd/m2) using a 100% ETDRS chart at 4 m. Patients were defocused from manifest refraction using a -5 D and +2 D spherical correction. Minus or plus power was decreased in 0.5-D increments until only the best distance correction remained (0.0 D defocus). Visual acuity was recorded in logMAR, and adverse events were summarized descriptively.

    A total of 143 patients (38% male, 62% female) with a mean age of 68.9 ± 9.3 years were implanted bilaterally with the PanOptix IOL and had their binocular defocus curve assessed at 6-months post-op. A total of 149 patients received implants but 4 patients were discontinued from the study (3 because of death and 1 to an adverse event), and 2 were unable to attend a study visit before database lock.

    Patients who received the IOL achieved a mean visual acuity of 20/25 or better from +0.50 D to -2.50 D. The mean defocus curve visual acuity from 0 D to -3 D ranged from 0.1 to 0.0 logMAR. Average visual acuity at distance (0 D), intermediate (-1.50 D), and near (-2.50 D) was 0.0 D ± 0.1 D, 0.0 ± 0.1 D and 0.1 D ± 0.1 D, respectively. 

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