Functional Outcomes After Refractive Lens Exchange With Implantation of a Glistening-Free Diffractive Trifocal Intraocular Lens

PURPOSE: To evaluate visual outcomes and patient- reported results after bilateral femtosecond-laser-assisted refractive lens exchange (RLE) with the implantation of a diffractive trifocal intraocular lens. center dot DESIGN: Prospective interventional case series. METHODS: A study of 27 patients (54 eyes) implanted with the Clareon PanOptix (Alcon) multifocal intraocular lens during femtosecond-laser-assisted RLE in a university hospital setting. The uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuity at 60 cm, uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity at 40 and 33 cm were evaluated at 3 months postoperatively and compared with the preoperative values. In addition, we assessed the postoperative defocus curve, mesopic and photopic contrast sensitivity, and patient-reported spectacle independence. RESULTS: The mean postoperative binocular UDVA was-0.02 +/- 0.06 logMAR and CDVA was-0.11 +/- 0.05 logMAR. The UIVA was-0.07 +/- 0.05 logMAR and DCIVA was-0.07 +/- 0.07 logMAR. The UNVA at 40 cm was 0.03 +/- 0.09 logMAR and DCNVA was-0.02 +/- 0.06 logMAR; and, at 33 cm UNVA was 0.14 +/- 0.10 logMAR and DCNVA was 0.11 +/- 0.08 logMAR. In comparison to the preoperative binocular CDVA (-0.12 +/- 0.08 logMAR), no statistically significant change was observed ( P = 1.0), while all the other binocular visual acuities improved ( P < .01). In the mean binocular defocus curve, the visual acuity was better than 0.10 logMAR in the range between + 0.5 D and-3.0 D. The mean contrast sensitivity was within the normal range, and most patients reported complete spectacle independence. CONCLUSIONS: The RLE surgery improved uncorrected visual acuity at far, intermediate, and near distances without negatively affecting the CDVA. Patients achieved a high level of spectacle independence. (Am J Ophthalmol 2024;268: 296-305. (c) 2024 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC- ND license ( http://creativecommons.org/licenses/by-ncnd/4.0/ ))