Long-term Clinical Outcomes After Trifocal Intraocular Lens Implantation: A Retrospective Observational Study

Abstract

Purpose: To evaluate the long-term stability of the AcrySof IQ PanOptix TFNT00 intraocular lens (IOL) (Alcon Laboratories, Inc). Methods: This was a retrospective review of 1,065 eyes (745 patients) who underwent implantation of a PanOptix IOL. A total of 296 eyes (mean age: 58.62 ± 5.63 years and preoperative refractive error: −0.68 ± 3.01 diopters [D]) met inclusion criteria for this study. The objective refraction, uncorrected distance and near visual acuity (UDVA and UNVA), and corrected distance visual acuity (CDVA) were evaluated at postoperative months 1, 2, 6, 12, 24, and 36. Results: The refractive error was −0.20 ± 0.36 D at 1 month, −0.20 ± 0.35 D at 2 months ( P = .503), −0.10 ± 0.37 D at 6 months ( P < .001), −0.02 ± 0.38 D at 12 months ( P < .001), 0.00 ± 0.38 D at 24 months ( P < .001), and 0.03 ± 0.39 D at 36 months ( P < .001). Multivariate analysis showed long-term, independent associations for young age (beta = −0.122; P = .029) and changes in mean keratometry (beta = −0.413; P < .001). A greater refractive change was associated with a greater change in UNVA ( r = 0.134; P = .026) but not with UDVA ( r = −0.029; P = .631) or CDVA ( r = −0.010; P = .875). Conclusions: Implantation of the PanOptix IOL yields stable clinical outcomes for visual acuity and refractive error for the first 3 years. A slight hyperopic shift, causing decreased near visual acuity, is anticipated for younger patients. [ J Refract Surg . 2023;39(4):236–241.]