They’re all the rage in Europe but unavailable in the US, and ophthalmologists on the continent continue to learn more about how trifocal intraocular lenses (IOLs) perform best. A team of German researchers found that while implanting this design in highly myopic eyes with lower IOL power provided satisfactory short-term visual and refractive outcomes, the results did not measure up to those obtained in eyes with higher IOL power.

The retrospective study evaluated 36 eyes of 19 patients—18 eyes of 10 patients belonged to the highly myopic group (IOL power up to 10.0D) and the remaining 18 eyes of nine patients belonged to the control group (power >10.0D). At three months, the researchers analyzed uncorrected visual acuity at distance, intermediate  and near. They also looked at corrected distance visual acuity, spherical equivalent and refractive astigmatism.

Three months post-op, the team found the following mean uncorrected acuities—all expressed in logMAR units—in the highly myopic group vs. controls

  • Distance 0.06 ±0.08 vs. –0.01 ±0.10
  • Intermediate 0.13 ±0.09 vs. 0.04 ±0.10
  • Near 0.12 ±0.07 vs. 0.04 ±0.11

The study concludes that distance and intermediate vision were significantly worse in highly myopic eyes compared with control eyes, while near vision differences  were not statistically significant.

Steinwender G, Schwarz L, Böhm M, et al. Visual results after implantation of a trifocal intraocular lens in high myopes. J Cataract Refract Surg. 2018;44(6):680-5.