Visual and Refractive Outcomes of Diffractive Trifocal Versus Hybrid Multifocal-extended Depth of Focus Intraocular Lenses

Purpose: We compared the clinical outcomes of patients who received AcrySof IQ Panoptix TFNT00 (Alcon, Fort Worth, TX, USA), a diffractive trifocal intraocular lens (IOL), or TECNIS Synergy ZFR00V (Johnson & Johnson Vision, Santa Ana, CA, USA), a hybrid multifocal-extended depth of focus (EDOF) IOL.Methods: In total, 26 eyes of 13 patients who underwent bilateral implantation of the diffractive trifocal IOL (group A) and 24 eyes of 12 patients who underwent bilateral implantation of the hybrid multifocal-EDOF IOL (group B) were included. We assessed visual acuity using the logarithm of the minimal angle of resolution (logMAR) scale and evaluated the visual performance of both groups, including uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA) and the defocus curve at 1 month postoperatively. In addition, we measured contrast sensitivity and administered a satisfaction questionnaire at 3 months postoperatively.Results: At 1 month postoperatively, group B demonstrated significantly better monocular UDVA, UNVA and binocular UNVA compared to group A (0.07 ± 0.07, 0.24 ± 0.16, and 0.18 ± 0.15 vs. 0.13 ± 0.09, 0.33 ± 0.14, and 0.29 ± 0.11; p < 0.05). In addition, group B exhibited higher visual acuities in the monocular and binocular defocus curves at +1.00 diopters (D), -3.00 D, -3.50 D, and +1.00 D (p < 0.05). Notably, the binocular defocus curves of both groups demonstrated excellent logMAR visual acuities (better than 0.2) in the range of 0.00 to -3.00 D. However, no significant differences were observed between the groups in contrast sensitivity or satisfaction questionnaire responses for visual acuity at 3 months postoperatively (p > 0.05).Conclusions: The hybrid multifocal-EDOF IOL demonstrates superior near visual acuity compared to the diffractive trifocal IOL. However, both IOLs exhibit excellent visual acuity at distant, intermediate, and near distances.