Introduction of a new diffractive trifocal intraocular lens. Comparison with a former diffractive trifocal IOL.

Barcelona 2018

Presentation by Dr. Detlev Breyer at the World Ophthalmology Congress in Barcelona, 2018.

Presenter / Co-Authors: Timon Ax (1,4), Detlev Breyer (1,4), Hakan Kaymak (1,4), Karsten Klabe (1,4), Philipp Hagen(1,4), Florian Kretz (2,4), Gerd Auffarth (3,4)

Affiliations: (1) Breyer, Kaymak & Klabe Augenchirurgie,(2) Dr. Gerl & Kollegen Ahaus-Raesfeld-Rheine,(3) Universitaets-Augenklinik Heidelberg, (4) International Vision Correction Research Center Network(

Ring patterns in diffractive MIOL can be designed such that the first order diffraction coincides with the zeroth, effectively improving the far focus of the lens. Within this retrospective analysis we evaluate the visual outcome and quality of vision after implantation of such a new diffractive trifocal IOL and compare the results with those of a former trifocal generation.

All MIOL implantations were performed at the Breyer-Kaymak-Klabe Eyesurgery in Duesseldorf, Germany, which is part of the International Vision Correcton Research Center (

This retrospective quality management investigation comprises results after bilateral implantation of the new trifocal aspheric AcrySof IQ PanOptix (Alcon) in 15 patients and of the (bitoric) trifocal AT Lisa Tri (Carl Zeiss Meditec) in 104 patients. Follow up exams were performed 1, 3 and 6 months after surgery. Manifest refraction, defocus curves, halos & glare assessment and a patient questionnaire were documented.

The mean postoperative UDVA at 3 months was 0.04logMAR and -0.03logMAR for PanOptix and LISA tri, respectively, whereas. UNVA was 0.03logMAR and 0.13logMAR. The defocus curves showed better far vision for LISA tri, whereas PanOptix had higher visual acuity in for 40cm. A deviation from target SE of +/-0.5D was achieved in 71% and 64% of eyes and 93% and 91% of eyes were within +/-1.0D. Halo & Glare were significantly higher than in phakic eyes but predominantly described as undisturbing. The questionnaire revealed a high patient safisfaction: 95% of patients would choose the trifocal IOL again.

Our first results indicate that the new PanOptix has slightly better near vision whereas LISA tri is better at far. Both diffractive trifocal lenses accomplish patients’ needs very well.