Take-home message: Multifocal IOLs with a trifocal diffractive optic design are available outside of the United States. They provide good visual acuity for distance, intermediate, and near and appear to provide slightly better intermediate vision than bifocal diffractive multifocal IOLs.
Maastricht, The Netherlands—If the ultimate goal of implanting a multifocal IOL (MFIOL) is to achieve spectacle independence after cataract surgery, then choosing a lens with a trifocal diffractive optic may be more advantageous than one with a bifocal diffractive design.
Such is a conclusion based on data from studies investigating visual outcomes and optical performance with trifocal diffractive MFIOLs, said Rudy M.M.A. Nuijts, MD, PhD, professor of ophthalmology, Maastricht University Medical Center, Maastricht, The Netherlands.
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Dr. Nuijts provided an overview of existing literature on trifocal MFIOLs (not commercially available in the United States), including a randomized, controlled trial his group conducted comparing trifocal and bifocal diffractive MFIOLs.
“Overall, the evidence suggests a trifocal MFIOL provides slightly better intermediate vision than a bifocal MFIOL while maintaining good near and distance vision,” Dr. Nuijts said. “Nevertheless, the incidence of optical phenomena, which is also considered a limitation of bifocal diffractive MFIOLs, appears similar with the bifocal and trifocal designs.”
The study conducted by Dr. Nuijts and colleagues is in press in the Journal of Cataract and Refractive Surgery and is scheduled for publication in August 2015.1 It enrolled 28 patients randomly assigned to bilateral implantation with a trifocal diffractive MFIOL (FineVision MicroF, PhysIOL) or a bifocal diffractive MFIOL (AcrySof ReSTOR IQ +3, model SN6AD1; Alcon Laboratories).