ABSTRACT
Purpose: To compare the visual and refractive outcomes, patient satisfaction and spectacle independence
between three novel designs of diffractive IOLs. Method: Prospective study including
150 patients with implantation of three IOLs: trifocal diffractive IOL AT LISA tri 839 MP (ATLISA, n
= 50), trifocal diffractive IOL PhysIOL FineVision (FineVision, n = 50) and the extended range of vision
IOL Tecnis Symfony ZRX00 (Symfony, n = 50). Patients were followed up for 6 months after
surgery. Major parameters were monocular and binocular uncorrected (UDVA) and corrected
(CDVA) distance, uncorrected (UIVA) and distance corrected (DCIVA) intermediate (80 cm), and
uncorrected (UNVA) and distance corrected (DCNVA) near (40 cm) visual acuities (UNVA), contrast
sensitivity (CS), defocus curve as well as patient satisfaction and spectacle use. Results: Mean
postoperative decimal UDVA was 1.01 for Symfony, 0.96 for ATLISA and 0.95 for the FineVision
IOL. Postoperative UIVA was 0.95 with Symfony, 0.72 with ATLISA and 0.85 with the FineVision
IOL. Postoperative UNVA was 0.96 with the FineVision, 0.72 with the ATLISA and 0.63 with the
Symfony IOL. The Symfony defocus curve showed the smoothest profile. Mean mesopic CS was 0.84
log units with the Symfony, 0.83 with the ATLISA (0.83) and 0.65 with the FineVision IOL. Mean
photopic CS with the Symfony, ATLISA and FineVision was 1.05, 0.85 and 0.69 log units, respectively.
Twenty percent of the patients with the ATLISA and FineVision IOLs and 5.6% of the Symfony
patients reported halos and glare as troublesome or disabling. Reading glasses were frequently
used by 5.6% of the Symfony patients. All patients with the trifocal IOLs reported to be
spectacle-free for any distance. Conclusion: All 3 IOLs produce excellent results with high levels of
spectacle independence. The Symfony produces better levels of distance and intermediate visual
acuity, whereas the trifocal IOLs produced better near vision. Higher frequency of dysphotopsia
was seen with the trifocal IOLs.