Trifocal IOL for Presbyopia Correction: Clinical and Refractive Results
To present the results after refractive lens exchange (RLE) with implantation of AT LISA tri 839MP (Carl Zeiss Meditec) intraocular lens to presbyopic patients.
Prospective, nonrandomized study. Inclusion criteria: patients who underwent implantation of trifocal lens AT LISA tri 839MP after RLE for correction of presbyopia; more than 6 months follow-up; preoperative astigmatism less than 1.00 D. Parameters evaluated: uncorrected and corrected visual acuity (Snellen decimal) at distances far, intermediate (80 cm) and near (40 cm); spherical and cylindrical manifest refraction; YAG posterior capsulotomy rate. All surgeries were performed under topical anesthesia, using a 2.40 to 3.20 mm incision performed on the steepest meridian, preceded by implantation of a preloaded capsular tension ring (Morcher). The lens power was selected using optical biometry with coherence interferometry (IOL-Master, Carl Zeiss Meditec) by SRK-T and Haigis formulas.
A total of 110 eyes were analyzed with a follow-up that ranges from 6 to 15 months. The mean axial length was 23.42 mm (range: 21.40 - 27.32 mm). Postoperative refractive results: mean spherical error +0.02 D, mean cylindrical refractive error -0.54 D, mean cylinder topographic error -0.36 D. Postoperative visual outcomes in uncorrected monocular vision: 0.94, 0.94 and 0.75 for distances far, intermediate and near, respectively. All patients achieved an uncorrected visual acuity of 0.8 or better in binocular vision for all distances. Thirteen YAG posterior capsulotomies (11.81% at 12 months) were performed and 6 patients wear glasses to read J1 or + J1 (10.09% of patients). No patient wears glasses for intermediate vision (computer work). The rate of halos/glare reported was less than 20% of patients.
The trifocal lens AT LISA tri 839MP proved to be effective and safe in the correction of presbyopia, revealing a high level of visual acuity for distances far, intermediate and near. Performing preoperative topography and biometry by optical coherence allow greater refractive predictability.