Visual and patient-reported factors leading to satisfaction after implantation of diffractive EDOF and trifocal intraocular lenses.

Purpose To evaluate factors that influence postoperative satisfaction in patients with diffractive EDOF and multifocal IOLs. Setting Department of Ophthalmology, Goethe University Frankfurt, Germany. Design Observational case study. Methods Patients were evaluated after implantation of a diffractive EDOF (Symfony, JJ AT LARA, CZM, Germany) or tri-/quadrifocal (AT LISAtri, CZM, Germany; Panoptix, Alcon, USA) 3 months postoperatively. A subjective refraction was performed, uncorrected and corrected visual acuity was tested for distance (UDVA, CDVA), intermediate (at 60 & 80cm, UIVA, DCIVA), and near (at 40cm, UNVA, DCNVA). A test for contrast sensitivity was done and the patients filled out two different questionnaires on daily activities and optical phenomena. Parameters with a potential correlation to the postoperative overall satisfaction were investigated. Results We included 94 patients with a mean age of 66 years ± 19. Patients with a better UDVA and UIVA at 60cm were more likely to choose the same IOL again. The intensity of subjective optical phenomena and the visual quality at different tasks of daily living influenced the overall satisfaction. UIVA at 80cm, UNVA, and corrected VA demonstrated no significant influence on patient satisfaction. The uncorrected visual acuity at specific distances had a direct impact on the subjective visual quality regarding the task performed at those distances. Conclusion For patients with diffractive EDOF and multifocal IOLs, the UDVA and UIVA at 60cm seem to be more important than the UNVA and UIVA at 80cm. Subjective visual quality and optical phenomena influence patient satisfaction, as well.