Eyeworld

16 | EYEWORLD | NOVEMBER 2019 ASCRS NEWS by Rachel Patel, MD, Christopher Bair, MD, Bradley Jacobsen, MD, Theresa Long, MD, and William Barlow, MD EYEWORLD JOURNAL CLUB T he choice of intraocular lens (IOL) is an increasingly complex and import- ant component of cataract surgery. The single focal length of a traditional monofocal lens gives excellent focal clarity at a single distance. Early gen- eration multifocal IOLs with bifocal design give a discrete focal point at near and at far, while intermediate vision often required spectacles. Nowadays patients increasingly desire a surgical outcome allowing functional uncorrected vision at a variety of working dis- tances, generating a market interest in presby- opia-correcting IOLs. Moreover, the availability of presbyopia-correcting IOLs may provide an attractive option for presbyopic patients who have not developed visually significant cataracts but seek to minimize their reliance on near correction. Today we have a variety of potential presbyopia-correcting IOLs at our disposal for patients seeking increased spectacle indepen- dence. The AcrySof PanOptix trifocal IOL (Alcon) received FDA approval in August 2019 and is available for use in the United States. Fortuitously, U.S.-based ophthalmologists can learn from the experience of our international colleagues who have already had access to the PanOptix IOL. Thus, we herein take a look at the outcomes of the PanOptix as used in two papers published in this month's JCRS. Study #1 In "Visual and refractive outcomes, spectacle independence, and visual distrubances after cataract or refractive lens exchange surgery: Comparison of 2 trifocal intraocular lenses," Dr. Bilgehan Sezgin Asena compared the Pan- Optix to the trifocal AT LISA tri839MP IOL (Carl Zeiss Meditec). The study enrolled patients who under- went bilateral cataract surgery or refractive lens exchange; complicated cataracts and those with more than 1 D of corneal astigmatism were excluded. Uncorrected and corrected visual acuity at distance and near were similar between Review of two studies examining trifocal lens use Visual and refractive outcomes, spectacle independence, and visual disturbances after cataract or refractive lens exchange surgery: Comparison of 2 trifocal intraocular lenses Bilgehan Sezgin Asena, MD J Cataract Refract Surg. 2019;Epub ahead of print. diffractive IOL group than in the hydrophilic diffractive IOL group (0.07 logarithm of the minimum angle of resolution [logMAR] ± 0.07 [SD] versus 0.22 ± 0.10 logMAR; P < .001). The mean CIVA at 80 cm was better in the hydrophilic IOL group (0.07 ± 0.08 logMAR versus 0.17 ± 0.09 logMAR; P < .001). Visual acuity at 1.00 diopter (D) to -2.50 D was significantly better in the hydrophobic diffractive group (P = .011 to <.001). The rate of severe and bothersome halos was higher in the hydrophilic diffractive group (P = .032 and P = .004, respectively). The percentage of patients reporting never using spectacles for intermediate vision was significantly higher in the hydrophobic group (P = .016). n Conclusions: Both IOLs gave similar and favorable visual and refractive outcomes. The hydrophobic diffractive IOL might be more suitable for patients who require good closer intermediate viewing. n Purpose: To compare the clinical performance of a hydrophobic (AcrySof PanOptix) and a hydrophilic (AT LISA tri 839MP) diffractive trifocal intraocular lens (IOL). n Setting: Kaskaloglu Eye Hospital, Izmir, Turkey. n Design: Prospective case series. n Methods: Patients had bilateral cataract surgery or refractive lens exchange with implantation of the hydrophobic diffractive IOL or hydrophilic diffractive IOL. The binocular corrected distance visual acuity (CDVA) at 4 m, corrected intermediate visual acuity (CIVA) at 80 cm and 60 cm, and corrected near visual acuity at 40 cm; low-contrast CDVA; spherical equivalent refraction; binocular corrected defocus curve; photic phenomena; and spectacle use were compared. n Results: The study comprised 238 eyes (119 patients). The mean CIVA at 60 cm was better in the hydrophobic Jeff Pettey, MD Director of education John Moran Eye Center Salt Lake City

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