Satisfaction and Visual and Refractive Outcomes Combining an Enhanced Monofocal and a Trifocal Intraocular Lens in Patients with Specific Visual Demands.

Background: To assess subjective satisfaction and visual and refractive outcomes after combining an enhanced monofocal intraocular lens (IOL) and trifocal IOL in patients with specific visual demands.

Methods: Patients underwent refractive lens exchange and received an enhanced monofocal lens (Tecnis Eyhance) in the dominant eye and a trifocal lens (FineVision) in the nondominant eye. At least 3 months after surgery, we evaluated subjective satisfaction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), predictability, safety, and efficacy.

Results: Sixty eyes from 30 patients met the inclusion criteria. At completion, postoperative binocular logMAR UNVA, UIVA, and UDVA were 0.10, 0.30, and 0.00, respectively. The change in visual acuity (before and after surgery, binocular) was statistically significant for UNVA and UDVA (p<0.01 and 0.004, respectively). Safety was better for the enhanced monofocal lens than for the trifocal lens (p=0.032), with no statistically significant differences in efficacy between the eyes. No eyes lost lines of CDVA. Predictability for ±0.5 D and ±1 D was better in eyes with FineVision and Eyhance, respectively, although the differences were not statistically significant. Patient satisfaction was high, enabling most patients to meet their special visual needs.

Conclusion: Combining an enhanced monofocal IOL in the dominant eye with a trifocal IOL in the nondominant eye provides considerable satisfaction and spectacle independence and is safe and efficacious in patients with special visual requirements.