Binocular visual function in middle-aged patients with unilateral cataract: multifocal versus enhanced monofocal intraocular lens.

Purpose: To compare binocular visual function of middle-aged patients in the process of presbyopia progression with unilateral cataract who received a trifocal intraocular lens (IOL; Alcon PanOptix^®) with those who received an enhanced monofocal (EM) IOL (Johnson & Johnson Eyehance^®).

Study design: Nonrandomized comparative study.

Methods: This study enrolled patients in their 40s and 50s with unilateral cataract whose fellow eyes were myopic and the operated eyes were implanted with either a trifocal IOL (n=28, targeting emmetropia) or an EM IOL (n=28, targeting myopia), and patients whose fellow eyes were emmetropic and the operated eyes were implanted with a trifocal IOL (n=25, targeting emmetropia) or an EM IOL (n=23; targeting emmetropia). At 3 months postoperatively, binocular uncorrected and corrected all-distance VA and contrast VA were compared between patients receiving the trifocal and EM IOLs.

Results: In the myopia category, mean binocular uncorrected VA from ∞ to 1.0 m was significantly better (P<0.001) and at near distance was significantly worse (P<0.001) in the trifocal group than in the EM group. In the emmetropia category, binocular uncorrected VA from ∞ to 2.0 m and binocular contrast VA at most contrasts were significantly better in the EM group than in the trifocal group (P≤0.043).

Conclusion: Trifocal IOLs provide significantly better binocular uncorrected far to intermediate VAs and worse near VA than EM IOLs in patients whose fellow eye is myopic, while EM IOLs provide significantly better far VA and contrast sensitivity in patients whose fellow eye is emmetropic.