Extended depth of focus versus trifocal for intraocular lens implantation : an updated systematic review and meta-analysis
Karam, Mohammad Alkhowaiter, Nahlaa Alkhabbaz, Ali Aldubaikhi, Ahmed Alsaif, Abdulmalik Shareef, Eiman Alazaz, Rand Alotaibi, Abdulaziz Koaik, Mona Jabbour, Samir
Karam, Mohammad
Alkhowaiter, Nahlaa
Alkhabbaz, Ali
Aldubaikhi, Ahmed
Alsaif, Abdulmalik
Shareef, Eiman
Alazaz, Rand
Alotaibi, Abdulaziz
Koaik, Mona
Jabbour, Samir
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Affiliation
Ibn Sina Hospital; King Saud bin Abdulaziz University for Health Sciences; Kuwait University; King Faisal Specialist Hospital and Research Center; Walsall Healthcare NHS Trust; King Khaled Eye Specialist Hospital; University of Ottawa Eye Institute; University of Montréal
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Publication date
2023-02-01
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Abstract
Purpose: To compare the extended depth of focus (EDOF) vs trifocal intraocular lenses (IOLs) in patients undergoing IOL implantation.
Design: Systematic review and meta-analysis.
Methods: An electronic search was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to include studies comparing EDOF vs trifocal IOLs. Refraction and visual acuity were primary outcomes. Secondary outcomes included defocus curves, intraocular aberrations, contrast sensitivity (CS), quality of vision (QoV) questionnaire score, haloes and glare, spectacle independence, and patient satisfaction.
Results: A total of 22 studies enrolling 2200 eyes were identified. Trifocal IOL showed a significant improvement in sphere (mean difference [MD] = -0.23; P = .001) and spherical equivalence (MD = -0.11, P = .0001) compared to EDOF IOL. No difference was observed in cylinder (MD = -0.03, P = .25) or astigmatism. Trifocal IOL had superior near visual acuity outcomes, namely uncorrected near visual acuity (MD = 0.12, P < .00001) and distance-corrected near visual acuity (MD = 0.12, P = .002). Postoperative corrected distance visual acuity (MD = -0.01, P = .01) was significantly improved for the EDOF group, although no difference was noted in postoperative uncorrected distance visual acuity (MD = 0.00, P = .84), uncorrected intermediate visual acuity (MD = 0.01, P = .68) or distance-corrected intermediate visual acuity (MD = -0.01, P = .39). Defocus curve favored trifocal IOLs at near vision and EDOF IOLs at intermediate vision. Ocular aberration, CS, haloes (odds ratio = 0.64, P = .10), glare, and patient satisfaction were not statistically significant between the groups. The trifocal IOL was associated with an improved QoV questionnaire score (MD = 1.24, P = 0.03) and spectacle independence (odds ratio = 0.26, P = .02).
Conclusions: Trifocal IOLs improved uncorrected near visual acuity compared to EDOF IOLs. Uncorrected distance and intermediate visual acuity, halos, and glare were not statistically different between both groups.
Citation
Karam M, Alkhowaiter N, Alkhabbaz A, Aldubaikhi A, Alsaif A, Shareef E, Alazaz R, Alotaibi A, Koaik M, Jabbour S. Extended Depth of Focus Versus Trifocal for Intraocular Lens Implantation: An Updated Systematic Review and Meta-Analysis. Am J Ophthalmol. 2023 Jul;251:52-70.
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Article