Spectacle Independence for Pseudophakic Patients - Experience with a Trifocal Supplementary Add-on Intraocular Lens

Purpose: To evaluate the refractive and functional outcomes of the trifocal 1stQ AddOn (R) (Medicontur) supplementary intraocular lenses (IOLs) designed for implantation into the ciliary sulcus. Patients and Methods: The study included 18 eyes of 11 pseudophakic patients with uncomplicated previous implantation of monofocal capsular bag IOLs. These patients had a desire for spectacle independence. Distance, intermediate and near visual acuities were measured, and defocus curves were plotted over a period of 6 months following implantation of the add-on IOLs. Intraocular pressure (IOP), endothelial cell density measurements and biomicroscopic evaluation were also performed. Results: In this study, 83.3% of eyes had spherical refractions within +/- 0.5 D from emetropia and 100% of eyes had spherical equivalent refractions that were within +/- 1.0 D of the target refraction. Visual acuities and defocus curves clearly confirmed trifocal optical performance (UDVA=0.03 +/- 0.05; UIVA=0.21 +/- 0.04; UNVA=0.12 +/- 0.04 logMAR; expressed as mean +/- SD). Depth of focus showed identical results (DOF=0.486 D) compared to a trifocal capsular bag IOL, while the defocus curve was found to be superior in the intermediate and near ranges when compared to a trifocal capsular bag IOL. All patients achieved spectacle independence at all distances. All add-on IOLs were well positioned in the ciliary sulcus. No negative changes were noted in connection with endothelial cell counts, IOPs, the angle structure during surgery and during the follow-up period. Conclusion: The supplementary trifocal add-on IOL seems to be a safe, efficient and stable solution for achieving spectacle independence in pseudophakic patients with monofocal primary IOLs.