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JCRS Highlights

Volume 45, Issue 2

Thomas Kohnen

Posted: Monday, April 1, 2019

VISUAL QOL WITH TRIFOCAL IOLs
Trifocal IOLs appear to be living up to the expectation that they satisfy patients’ need for intermediate vision in addition to distance and far, a small study suggests. Researchers in Turkey evaluated 48 patients who had received bilateral implantation of a new trifocal IOL (PanOptix). A subgroup of 14 patients received monocular implantation. Patients were asked to complete the National Eye Institute Visual Function Questionnaire-14 (VF-14 QOL questionnaire) three months after the surgery in the second eye. Reading small print, driving at night and doing fine handwork were the most difficult tasks to perform. Mean values obtained with the QOL questionnaire were 0.94 ± 0.81 (SD), 0.89 ± 0.68 and 0.64 ± 0.67. Binocular implantation was associated with improvement in vision-related QOL when compared with monocular implantation, with significant differences in doing fine handwork such as sewing (p=.02) and using a computer (p=.03). Overall, those receiving bilateral trifocal IOL implantation had high satisfaction rates and a high vision-related QOL.
A Akman et al., “Evaluation of quality of life after implantation of a new trifocal intraocular lens”, Volume 45, Issue 2, 135-145.

TRIFOCAL IOL COMPARISON TRIAL
A prospective, controlled clinical trial enrolled 126 cataractous eyes with a mean age of 62.5 years. Patients underwent bilateral implantation with either a trifocal spherical hydrophilic IOL (FineVision POD F) if corneal astigmatism was 1.0D or less, or with a trifocal toric hydrophilic IOL (FineVision POD FT) if astigmatism was more than 1.0D. The spherical IOL group consisted of 33 bilateral patients and the toric IOL group consisted of 30 bilateral patients. An analysis at three months showed significant improvement in functional uncorrected visual acuity across all distances in both groups. There was no difference between the groups in contrast sensitivity, defocus curves or cylinder. Satisfaction was high with both IOL types. F Poyales et al., “Comparison of 3-month visual outcomes of a spherical and a toric trifocal intraocular lens”, Volume 45, Issue 2, 135-145.

TORIC IOLs COST-EFFECTIVE?
Dutch researchers evaluated the cost-effectiveness of toric versus monofocal intraocular lens implantation in 77 cataract patients with 1.25D or more of bilateral corneal astigmatism. All relevant resources were included in the cost analysis. Although this study confirmed that toric IOLs improve UDVA and spectacle independence compared with monofocal IOLs, no improvement in generic health-related quality of life was found. Furthermore, toric IOLs increased healthcare and societal costs in the short-term. The researchers suggest that based on these findings, co-payment by patients should therefore be considered for toric IOLs.
R Simons et al., “Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands”, Volume 45, Issue 2, 146-152.


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