EDOF, trifocal IOL or monovision ... which is better?

Purpose:

The aim of this paper is to compare the different optical principles for spectacle independence with intraocular lenses following lens exchange regarding their effectiveness.

Material and Methods:

Based on a literature review and analysis of own clinical data, different IOL principles were compared regarding distance visual acuity (with and without correction), near visual acuity (uncorrected, with distance correction and if necessary, with additional addition), reading speed (Radner charts), contrast vision (Vistech charts) as well as defocus curve. Specific indications, subjective complaints as well as the respective limitations were discussed in detail.

Results:

The principle of multifocal lenses proved to be the most reliable principle in terms of complete spectacle independence, but at the same time carries the highest risk of optical side effects. Overall, the new MIOLs showed comparable functional results with the AT Lisa tri, also with regard to subjective photopic side effects. Intraindividual comparison showed slightly inferior results for the Trinova for defocus curve and reading speed, as well as in the subjective assessment by the patient. The question about specific halos showed a superiority for the Symfony EDOF IOL, all other questions were answered equally for each lens type in the median.

Conclusion:

Trifocal intraocular lenses are the most reliable when spectacle independence is the primary concern. Optical side effects are inherent to the system, but due to modern lens technologies and with careful perioperative setting, they very rarely interfere functionally in daily life. All lensexchanging procedures for spectacle independence have in common that they are compromise solutions.