Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Clinical prospective intra-individual comparison after mix-and-match implantation of a monofocal EDOF and a diffractive trifocal IOL

Eye volume 38, pages 321–327 (2024)Cite this article

Subjects

Abstract

Objectives

To assess intra-individually visual acuity (VA) and subjective outcome after mix-and-match implantation of a monofocal EDOF IOL and a diffractive trifocal IOL.

Methods

The monofocal EDOF Isopure IOL was implanted in the dominant eye and the trifocal FineVision HP IOL in the non-dominant eye. Postoperative evaluation included VA at various distances, contrast acuity, monocular defocus curves, decentration and tilt, wavefront aberrometry, VF-7 questionnaire and a halo and glare simulator.

Results

50 eyes of 25 subjects were enroled. The trifocal IOL performed better at monocular DCNVA (p < 0.01) and at defocus levels of –1.5D to –4.0D (p < 0.01), the monofocal EDOF IOL was better at –0.5D (p = 0.013). No differences in monocular BCDVA, DCIVA, contrast acuity, decentration or tilt were observed (p > 0.05). Wavefront analysis revealed lower HOAs in the trifocal group at 5 mm (p < 0.01) and no difference (p = 0.107) at 3 mm pupil aperture. The monofocal EDOF IOL displayed increased negative SA at 5 mm (p < 0.01) and 3 mm (p < 0.01) pupil diameter. Low values of optical phenomena and satisfying results of the VF-7 questionnaire were obtained.

Conclusion

Excellent visual performance and low rates of optical phenomena were achieved after mix-and-match implantation of the monofocal EDOF Isopure IOL and the trifocal FineVision HP IOL. Trifocal IOL implantation in the non-dominant eye may decrease optical disturbing phenomena. Similar results were observed for monocular distance, intermediate and contrast VA. The trifocal IOL provided better monocular near VA. Decentration and tilt and HOAs were low.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2

Data availability

Data are available from the authors upon reasonable request.

References

  1. Yoon CH, Shin IS, Kim MK. Trifocal versus bifocal diffractive intraocular lens implantation after cataract surgery or refractive lens exchange: a meta-analysis. J Korean Med Sci. 2018;33:e275.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Montes-Mico R, Alio JL. Distance and near contrast sensitivity function after multifocal intraocular lens implantation. J Cataract Refract Surg. 2003;29:703–11.

    Article  PubMed  Google Scholar 

  3. de Vries NE, Webers CA, Touwslager WR, Bauer NJ, de Brabander J, Berendschot TT, et al. Dissatisfaction after implantation of multifocal intraocular lenses. J Cataract Refract Surg. 2011;37:859–65.

    Article  PubMed  Google Scholar 

  4. Woodward MA, Randleman JB, Stulting RD. Dissatisfaction after multifocal intraocular lens implantation. J Cataract Refract Surg. 2009;35:992–7.

    Article  PubMed  PubMed Central  Google Scholar 

  5. de Silva SR, Evans JR, Kirthi V, Ziaei M, Leyland M. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database Syst Rev. 2016;12:CD003169.

    PubMed  Google Scholar 

  6. Cochener B, Concerto Study G. Clinical outcomes of a new extended range of vision intraocular lens: International Multicenter Concerto Study. J Cataract Refract Surg. 2016;42:1268–75.

    Article  PubMed  Google Scholar 

  7. Akella SS, Juthani VV. Extended depth of focus intraocular lenses for presbyopia. Curr Opin Ophthalmol. 2018;29:318–22.

    Article  PubMed  Google Scholar 

  8. Pieh S, Artmayr C, Pai V, Schartmuller D, Kriechbaum K. Through-focus response of extended depth of focus intraocular lenses. J Refract Surg. 2022;38:497–501.

    Article  PubMed  Google Scholar 

  9. Kohnen T, Suryakumar R. Extended depth-of-focus technology in intraocular lenses. J Cataract Refract Surg. 2020;46:298–304.

    Article  PubMed  Google Scholar 

  10. MacRae S, Holladay JT, Glasser A, Calogero D, Hilmantel G, Masket S, et al. Special report: American academy of ophthalmology task force consensus statement for extended depth of focus intraocular lenses. Ophthalmology 2017;124:139–41.

    Article  PubMed  Google Scholar 

  11. Mencucci R, Favuzza E, Caporossi O, Savastano A, Rizzo S. Comparative analysis of visual outcomes, reading skills, contrast sensitivity, and patient satisfaction with two models of trifocal diffractive intraocular lenses and an extended range of vision intraocular lens. Graefes Arch Clin Exp Ophthalmol. 2018;256:1913–22.

    Article  PubMed  Google Scholar 

  12. Escandon-Garcia S, Ribeiro FJ, McAlinden C, Queiros A, Gonzalez-Meijome JM. Through-focus vision performance and light disturbances of 3 new intraocular lenses for presbyopia correction. J Ophthalmol. 2018;2018:6165493.

    PubMed  PubMed Central  Google Scholar 

  13. Ruiz-Mesa R, Abengozar-Vela A, Ruiz-Santos M. A comparative study of the visual outcomes between a new trifocal and an extended depth of focus intraocular lens. Eur J Ophthalmol. 2018;28:182–7.

    Article  PubMed  Google Scholar 

  14. Ruiz-Mesa R, Abengozar-Vela A, Aramburu A, Ruiz-Santos M. Comparison of visual outcomes after bilateral implantation of extended range of vision and trifocal intraocular lenses. Eur J Ophthalmol. 2017;27:460–5.

    Article  PubMed  Google Scholar 

  15. Liu J, Dong Y, Wang Y. Efficacy and safety of extended depth of focus intraocular lenses in cataract surgery: a systematic review and meta-analysis. BMC Ophthalmol. 2019;19:198.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lee JH, Chung HS, Moon SY, Park SY, Lee H, Kim JY, et al. Clinical outcomes after mix-and-match implantation of extended depth of focus and diffractive multifocal intraocular lenses. J Ophthalmol. 2021;2021:8881794.

    PubMed  PubMed Central  Google Scholar 

  17. McNeely RN, Moutari S, Stewart S, Moore JE. Visual outcomes and patient satisfaction 1 and 12 months after combined implantation of extended depth of focus and trifocal intraocular lenses. Int Ophthalmol. 2021;41:3985–98.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lee JH, Lee H, Lee JA, Yoo A, Kim JY, Tchah H. Clinical outcomes after mix-and-match implantation of diffractive multifocal intraocular lenses with + 2.75 and + 4.00 diopter add powers. BMC Ophthalmol. 2020;20:193.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Gunenc U, Celik L. Long-term experience with mixing and matching refractive array and diffractive CeeOn multifocal intraocular lenses. J Refract Surg. 2008;24:233–42.

    Article  PubMed  Google Scholar 

  20. Goes FJ. Visual results following implantation of a refractive multifocal IOL in one eye and a diffractive multifocal IOL in the contralateral eye. J Refract Surg. 2008;24:300–5.

    Article  PubMed  Google Scholar 

  21. Roth HL, Lora AN, Heilman KM. Effects of monocular viewing and eye dominance on spatial attention. Brain 2002;125:2023–35.

    Article  PubMed  Google Scholar 

  22. Cheng CY, Yen MY, Lin HY, Hsia WW, Hsu WM. Association of ocular dominance and anisometropic myopia. Invest Ophthalmol Vis Sci. 2004;45:2856–60.

    Article  PubMed  Google Scholar 

  23. Uusitalo RJ, Brans T, Pessi T, Tarkkanen A. Evaluating cataract surgery gains by assessing patients' quality of life using the VF-7. J Cataract Refract Surg. 1999;25:989–94.

    Article  CAS  PubMed  Google Scholar 

  24. Bilbao-Calabuig R, Llovet-Rausell A, Ortega-Usobiaga J, Martinez-Del-Pozo M, Mayordomo-Cerda F, Segura-Albentosa C, et al. Visual outcomes following bilateral lmplantation of two diffractive trifocal intraocular lenses in 10084 eyes. Am J Ophthalmol. 2017;179:55–66.

    Article  PubMed  Google Scholar 

  25. Bova A, Vita S. Clinical and aberrometric evaluation of a new monofocal IOL with intermediate vision improvement. J Ophthalmol. 2022;2022:4119698.

    PubMed  PubMed Central  Google Scholar 

  26. Song JE, Han SY, Khoramnia R, Tandogan T, Auffarth GU, Choi CY. Clinical outcomes of combined implantation of an extended depth of focus IOL and a trifocal IOL in a Korean population. J Ophthalmol. 2021;2021:9034258.

    PubMed  PubMed Central  Google Scholar 

  27. Ortiz C, Esteve-Taboada JJ, Belda-Salmeron L, Monsalvez-Romin D, Dominguez-Vicent A. Effect of decentration on the optical quality of two intraocular lenses. Optom Vis Sci. 2016;93:1552–9.

    Article  PubMed  Google Scholar 

  28. Fujikado T, Saika M. Evaluation of actual retinal images produced by misaligned aspheric intraocular lenses in a model eye. Clin Ophthalmol. 2014;8:2415–23.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Xu J, Zheng T, Lu Y. Effect of decentration on the optical quality of monofocal, extended depth of focus, and bifocal intraocular lenses. J Refract Surg. 2019;35:484–92.

    Article  PubMed  Google Scholar 

  30. Ashena Z, Maqsood S, Ahmed SN, Nanavaty MA. Effect of intraocular lens tilt and decentration on visual acuity, dysphotopsia and wavefront aberrations. Vis (Basel). 2020;4:41.

    Google Scholar 

  31. Schartmueller D, Roeggla V, Schwarzenbacher L, Abela-Formanek C, Leydolt C, Menapace R Intraindividual correlation of crystalline lens decentration and tilt with postoperative intraocular lens (IOL) decentration and tilt with a new hydrophobic acrylic IOL with modified c-loop haptics [Abstract]. 39th Congress of the ESCRS; Amsterdam 2021.

  32. Kasper T, Buhren J, Kohnen T. Intraindividual comparison of higher-order aberrations after implantation of aspherical and spherical intraocular lenses as a function of pupil diameter. J Cataract Refract Surg. 2006;32:78–84.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We thank all study participants for their contribution, and we thank Thalia Soucek for performing the visual testing.

Author information

Authors and Affiliations

  1. Medical University of Vienna, Department of Ophthalmology and Optometry, Vienna, Austria

    Victor Danzinger, Daniel Schartmüller, Luca Schwarzenbacher, Veronika Röggla, Claudette Abela-Formanek, Rupert Menapace & Christina Leydolt

Authors
  1. Victor Danzinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniel Schartmüller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Luca Schwarzenbacher
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Veronika Röggla
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Claudette Abela-Formanek
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rupert Menapace
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Christina Leydolt
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

CL conceptualized and supervised the trial and interpreted the data. VD, DS, LS and VR performed the investigation and acquired the data. VD analysed the data and CA-F and RM participated in the trial design, review and interpretation of the data. VD drafted the manuscript and was critically revised by all authors. All authors approved the final manuscript.

Corresponding author

Correspondence to Christina Leydolt.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Danzinger, V., Schartmüller, D., Schwarzenbacher, L. et al. Clinical prospective intra-individual comparison after mix-and-match implantation of a monofocal EDOF and a diffractive trifocal IOL. Eye 38, 321–327 (2024). https://doi.org/10.1038/s41433-023-02682-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41433-023-02682-x

Search

Advanced search

Quick links