Visual and patient-reported factors leading to satisfaction after implantation of diffractive extended depth-of-focus and trifocal intraocular lenses.

Purpose: To evaluate factors that influence postoperative satisfaction in patients with diffractive extended depth-of-focus (EDoF) and multifocal intraocular lenses (mIOLs).

Setting: Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany.

Design: Observational case study.

Methods: Patients were evaluated after implantation of a diffractive EDoF (Symfony, AT LARA) or trifocal/quadrifocal (AT LISAtri, Panoptix) 3 months postoperatively. A subjective refraction was performed, uncorrected and corrected visual acuities were tested for distance (UDVA, CDVA), intermediate (at 60 cm and 80 cm, UIVA, DCIVA), and near (at 40 cm, UNVA, DCNVA). A test for contrast sensitivity was performed, and the patients filled 2 different questionnaires on daily activities and optical phenomena. Parameters with a potential correlation to the postoperative overall satisfaction were investigated.

Results: 94 patients with a mean age of 66 ± 19 years were included. Patients with a better UDVA and UIVA at 60 cm were more likely to choose the same IOL again. The intensity of subjective optical phenomena and the visual quality at different tasks of daily living influenced overall satisfaction. UIVA at 80 cm, UNVA, and corrected visual acuity demonstrated no significant influence on patient satisfaction. The uncorrected visual acuity at specific distances had a direct impact on the subjective visual quality regarding the task performed at those distances.

Conclusions: For patients with diffractive EDoF and tri-/quadrifocal IOLs, the UDVA and UIVA at 60 cm seem to be more important than the UNVA and UIVA at 80 cm. Subjective visual quality and optical phenomena influence patient satisfaction, as well.