Comparison of two-year clinical and patient-reported outcome measures between Acrysof IQ and Clareon PanOptix multifocal intraocular lenses.

Abstract

Purpose: To compare the 2-year clinical and patient-reported outcome measures of PanOptix multifocal intraocular lenses (MIOLs) based on the lens material.

Design: Retrospective matched cohort study.

Subjects: One hundred twenty-two eyes of 122 patients in each group.

Methods: A comparison between bilaterally operated patients with Acrysof IQ versus Clareon PanOptix MIOLs was done by one-to-one matching of age, axial length, mean keratometry, and corneal astigmatism.

Main outcome measures: The uncorrected near and distance visual acuities (UNVA and UDVA), prediction error in spherical equivalent and postoperative refraction stability, glistening, sub-surface nano-glistening (SSNG), Nd:YAG laser posterior capsulotomy rates, the area under the log contrast sensitivity function (AULCSF) under photopic and mesopic conditions, Strehl ratio and Area ratio were analyzed. Furthermore, patient-reported outcome measures such as dysphotopsia and modified spectacle-independent Visual Function Index (VF)-14 questionnaire scores were collected at 2 years.

Results: Throughout the study period, comparable UNVA, UDVA, and refractive stability were observed between the groups, except for better UNVA among eyes with Clareon than Acrysof IQ at 2 years (0.00±0.02 vs. 0.02±0.04, P<0.001). Clareon implantation resulted in better photopic (1.47±0.19 vs. 1.38±0.21 logCWeber units; P<0.001), and mesopic (1.16±0.22 vs. 1.06±0.19 logCWeber units; P<0.001) AULCSF, lower prevalence of glistening (0% vs. 88%, P<0.001) and SSNG (0% vs. 26%, P<0.001) and cumulative Nd:YAG laser capsulotomy rates (HR 0.632; 95%CI 0.482-0.830, P<0.001) when compared to those with Acrysof IQ. No differences were observed in the incidence of clinically significant glare or halos, but the incidence of starburst (5% vs. 16%, P=0.002) tended to favor Clareon over Acrysof IQ. Modified VF-14 questionnaire scores were greater for Clareon than Acrysof IQ (93.4±10.3 vs. 90.4±13.6 points, P<0.001). A multivariable regression analysis showed that the patient's age (beta=-0.394, P<0.001; beta=-0.352, P<0.001) and glistening grade (beta=-0.163, P=0.010; beta=-0.232, P<0.001) remained significantly associated with the photopic and mesopic AULCSF, respectively. Furthermore, higher glistening grade (r=-0.144, P=0.003; beta=-1.771, P=0.001 when age and sex-adjusted) associated with worse modified VF-14 questionnaire scores.

Conclusions: Clareon PanOptix outperformed Acrysof IQ PanOptix in visual quality and spectacle-independent visual function, potentially resulting from a lower prevalence of glistening.