LAUSR

PURPOSE To compare visual outcomes and patient satisfaction between unilateral and bilateral trifocal diffractive intraocular lens (IOL) implantation in emmetropic patients with presbyopia. DESIGN Retrospective observational cases series METHODS: This is a multicenter, multisurgeon study of emmetropic presbyopes who underwent refractive lens exchange (RLE) followed by an implantation of FineVision IOL (Physiol, Liège, Belgium). Inclusion criteria were emmetropic eyes; with a sphere between -0.25 and +0.50 dioptres (D), cylinder of less than 0.75 D and spherical equivalent (SE) between -0.25 and +0.25 D. In addition, uncorrected distance visual acuity (UDVA) had to be Snellen >0.9 in each eye. A total of 171 eyes of 122 patients were evaluated. This sample was divided into two groups depending on whether they have been operated monocular or binocularly. Visual and refractive performance, patient satisfaction and spectacle independence were evaluated. RESULTS UDVA and Corrected Distance Visual Acuity (CDVA) remained almost unchanged after monocular and binocular surgery. Binocular uncorrected intermediate (UIVA) and near visual acuity (UNVA) were better in those operated binocularly (0.3±0.12 vs 0.22±0.06 p<0.063 and 0.09±0.08 vs 0.04±0.05 p<0.027 respectively). Predictability and efficacy were higher in the binocular group; while safety was better in the monocular group. Visual dysphotopsia was worse and spectacle independence for all distances was higher in binocular group. CONCLUSIONS Our research shows that RLE with binocular implantation of a trifocal diffractive IOL in presbyopic emmetropic patients is more successful in UNVA than monocular implantation. However, no significative differences were observed in UDVA, UIVA and patient´s satisfaction.