Comparison of Visual Performance and Patient Satisfaction Between Two Trifocal Intraocular Lenses: A Prospective, Paired-Eye Comparative Study

Sujin Kang,1 Samantha M Arsenault,1,2 Robert C O’Brien,1 Marina S Chatzea,3 Siamak Zarei-Ghanavati,4 Luiz AF Beniz,5 Sonia H Yoo1 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Ophthalmology, Henry Ford Health System, Detroit, MI, USA; 3 1st Department of Ophthalmology, “G. Gennimatas” Hospital, National and Kapodistrian University of Athens, Athens, Greece; 4Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; 5Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, São Paulo, SP, BrazilCorrespondence: Sonia H Yoo, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA, Email syoo@med.miami.eduPurpose: This study compared the visual performance, patient-reported outcomes, and spectacle independence of two advanced trifocal intraocular lens (IOL) platforms, Clareon PanOptix and TECNIS Odyssey, in a paired-eye design. The primary hypothesis was that differences in optical design would yield distinct strengths in distance, intermediate, and near visual acuity (VA), contrast sensitivity (CS), and patient satisfaction.Patients and Methods: In this prospective, single-center, single-surgeon trial at the Bascom Palmer Eye Institute, 19 patients (38 eyes; mean age 66.37 ± 10.61 years) undergoing bilateral cataract surgery were stratified by ocular dominance and randomized for dominant-eye IOL allocation. Each patient received a PanOptix (toric or non-toric) in one eye and an Odyssey (toric or non-toric) in the fellow eye, implanted one week apart. Postoperative assessments (≥ 1 month) included monocular distance-corrected VA at distance (CDVA, 4 m), intermediate (DCIVA, 60 cm), and near (DCNVA, 40 cm), uncorrected VAs, residual refraction, CS, and patient-reported visual quality and spectacle independence.Results: Compared with PanOptix, Odyssey achieved significantly better CDVA (EMD=0.03 logMAR, 95% CI [0.01, 0.06], P=0.009) and UCDVA (EMD=0.06 logMAR, 95% CI [0.01, 0.12], P=0.03), while PanOptix demonstrated superior DCIVA (EMD=− 0.05 logMAR, 95% CI [− 0.09, − 0.01], P=0.03). DCNVA, UCIVA, and UCNVA did not differ significantly (P≥ 0.07). CS was higher in Odyssey eyes (EMD=− 5.47, 95% CI [− 10.50, − 0.42], P=0.03). Residual spherical equivalent was similar between groups (− 0.10 D vs − 0.09 D, P=0.91). Rates of starburst, halo, and glare were not significantly different (P≥ 0.34). Spectacle independence was achieved by 17 of 19 patients (89.47%) in both groups.Conclusion: In a paired-eye comparison, PanOptix provided superior intermediate VA, while Odyssey delivered better distance VA and CS. Both lenses yielded high spectacle independence and comparable rates of photic phenomena, supporting their viability as presbyopia-correcting options in cataract surgery.Keywords: cataract surgery, multifocal intraocular lenses, visual acuity, patient reported outcome measures, contrast sensitivity