Patient Preference, Visual Quality, and Multivariate Regression Analysis with Contralateral Bifocal and Trifocal Intraocular Lenses

PURPOSE: To compare patient preference and visual quality of a bifocal IOL versus a trifocal IOL when one of each lens is implanted in the same patient. PATIENTS AND METHODS: Patients received a +3.25 Tecnis bifocal IOL in one eye and a PanOptix trifocal IOL in the opposite eye. Eyes were unilaterally evaluated and included UDVA, UIVA, UNVA, mesopic contrast sensitivity testing, and subjective questionnaires about overall satisfaction, and IOL preference. Regression was used to detect which objective or subjective metrics significantly predicted overall satisfaction for each eye. RESULTS: Sixty eyes of thirty patients were evaluated. Patients preferred (p=0.028) +3.25 to PanOptix. Overall satisfaction was significantly greater (p=0.05) for +3.25 (4.70 vs 4.43/5.00). UDVA (p=0.032) and “freq. of glasses use distance” (p=0.05) were significantly better for +3.25 eyes. Objective intermediate (Jaeger) vision was significantly better (p=0.034) for PanOptix eyes. “Freq. of glasses use intermediate” favored +3.25. Regression revealed variables related to intermediate vision and “ability to read fine print without glasses” were significant predictors of overall satisfaction for both IOLs. Variables related to contrast sensitivity both with and without glare were significant predictors exclusively for PanOptix eyes. CONCLUSION: Patient preference favored +3.25 eyes (p=0.022). Individual rankings for each eye of “overall satisfaction” were significantly greater (p=0.05) for +3.25 eyes. UNVA and distance vision trended in favor of +3.25. Regression strongly suggests issues related to contrast sensitivity with PanOptix may be responsible for the significant patient preference of +3.25.