Trifocal and extended depth of focus intraocular lenses – comparative analysis

Aim of the study
Comparative analysis of trifocal and extended depth of focus (EDoF) lenses, taking into account visual acuity (VA) at different distances, con-trast sensitivity (CS), defocus curve, spectacle independence, reading speed and the presence of photic phenomena, and assessment of patient satisfaction.

Methodology
Review of scientific papers and articles on high technology lenses found in PubMed, American Academy of Ophthalmology, ESCRS databases and own observations.

Results
Regarding VA, the studies we analyzed showed significantly better uncorrected (UNVA) and corrected near visual acuity (CNVA) for trifocal than EDoF lenses, while the EDoFs showed slightly better results for uncorrected distance visual acuity (UDVA), uncorrected (UIVA) and cor-rected intermediated visual acuity (CIVA). CS in most of articles showed no significant differences, only a few presented a slightly better results in EDoF group. Analysis of defocus curve shows that trifocal lenses exhibit better close-range vision acuity compared to EDoF of intraocular lenses (IOLs). Most of authors summarize the patient-assessed incidence and severity of dysphotopsia as low and statistically insignificant in both groups of lenses (range is < 1% to 25%). Spectacle independence for near vision was observed for both types of lenses, but slightly better for trifocal IOLs than EDoF IOLs (87% vs. 79.83%). The differences in reading speed were not statistically significant. Patients’ satisfaction was high for both lenses and all of them will choose the same lens again.

Conclusions
Visual function results are very good and comparable for both analyzed types of IOLs. However trifocal lenses presented better near vision, but EDoF IOLs had a slightly lower frequency and severity of dysphotopsia. The significant superiority of the EDoF lenses over the trifocals is not proven.