Comparison of postoperative visual performance between bifocal and trifocal intraocular Lens based on randomized controlled trails: A meta-analysis

Shanshan Jin, David S Friedman, Kai Cao, Mayinuer Yusufu, Jingshang Zhang, Jinda Wang, Simeng Hou, Guyu Zhu, Bingsong Wang, Ying Xiong, Jing Li, Xiaoxia Li, Hailong He, Xiuhua Wan

Research output: Contribution to journalArticle

Abstract

Background: To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted. Methods: A comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction. Results: There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no significance [MD = 0.02, 95%CI: (- 0.03,0.06)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95%CI (- 0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD = 0.09,95%CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA (DCIVA) [MD = 0.09, 95%CI: (- 0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839 M) [MD = 0.18, 95%CI: (0.12, 0.24) for UIVA and MD = 0.19, 95%CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA (UDVA) and corrected distance visual acuity (CDVA) [MD = 0.01, 95%CI: (- 0.01,0.04) for UDVA; MD = 0.00, 95%CI: (- 0.01,0.01) for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD = -0.08, 95% CI: (- 0.19, 0.03) for spherical equivalent; MD = -0.09, 95%CI: (- 0.21, 0.03) for cylinder; MD = -0.09, 95% CI: (- 0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR = 0.89, 95% CI: (0.71, 1.12) for spectacle independence; RR = 1.81, 95% CI: (0.50, 6.54) for PCO incidence; RR = 0.98, 5% CI: (0.86, 1.12) for patient satisfaction]. Conclusion: Patients receiving trifocal IOLs, especially AT LISA tri 839 M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.

Original languageEnglish (US)
Article number78
JournalBMC Ophthalmology
Volume19
Issue number1
DOIs
StatePublished - Mar 14 2019

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Intraocular Lenses
Visual Acuity
Meta-Analysis
Patient Satisfaction
Contrast Sensitivity
Incidence
PubMed
Cataract
Randomized Controlled Trials

Keywords

  • Bifocal
  • Cataract surgery
  • Intraocular lenses
  • IOLs
  • Meta-analysis
  • Randomized
  • Trifocal

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Comparison of postoperative visual performance between bifocal and trifocal intraocular Lens based on randomized controlled trails : A meta-analysis. / Jin, Shanshan; Friedman, David S; Cao, Kai; Yusufu, Mayinuer; Zhang, Jingshang; Wang, Jinda; Hou, Simeng; Zhu, Guyu; Wang, Bingsong; Xiong, Ying; Li, Jing; Li, Xiaoxia; He, Hailong; Wan, Xiuhua.

In: BMC Ophthalmology, Vol. 19, No. 1, 78, 14.03.2019.

Research output: Contribution to journalArticle

Jin, Shanshan ; Friedman, David S ; Cao, Kai ; Yusufu, Mayinuer ; Zhang, Jingshang ; Wang, Jinda ; Hou, Simeng ; Zhu, Guyu ; Wang, Bingsong ; Xiong, Ying ; Li, Jing ; Li, Xiaoxia ; He, Hailong ; Wan, Xiuhua. / Comparison of postoperative visual performance between bifocal and trifocal intraocular Lens based on randomized controlled trails : A meta-analysis. In: BMC Ophthalmology. 2019 ; Vol. 19, No. 1.
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title = "Comparison of postoperative visual performance between bifocal and trifocal intraocular Lens based on randomized controlled trails: A meta-analysis",
abstract = "Background: To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted. Methods: A comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction. Results: There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no significance [MD = 0.02, 95{\%}CI: (- 0.03,0.06)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95{\%}CI (- 0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD = 0.09,95{\%}CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA (DCIVA) [MD = 0.09, 95{\%}CI: (- 0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839 M) [MD = 0.18, 95{\%}CI: (0.12, 0.24) for UIVA and MD = 0.19, 95{\%}CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA (UDVA) and corrected distance visual acuity (CDVA) [MD = 0.01, 95{\%}CI: (- 0.01,0.04) for UDVA; MD = 0.00, 95{\%}CI: (- 0.01,0.01) for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD = -0.08, 95{\%} CI: (- 0.19, 0.03) for spherical equivalent; MD = -0.09, 95{\%}CI: (- 0.21, 0.03) for cylinder; MD = -0.09, 95{\%} CI: (- 0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR = 0.89, 95{\%} CI: (0.71, 1.12) for spectacle independence; RR = 1.81, 95{\%} CI: (0.50, 6.54) for PCO incidence; RR = 0.98, 5{\%} CI: (0.86, 1.12) for patient satisfaction]. Conclusion: Patients receiving trifocal IOLs, especially AT LISA tri 839 M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.",
keywords = "Bifocal, Cataract surgery, Intraocular lenses, IOLs, Meta-analysis, Randomized, Trifocal",
author = "Shanshan Jin and Friedman, {David S} and Kai Cao and Mayinuer Yusufu and Jingshang Zhang and Jinda Wang and Simeng Hou and Guyu Zhu and Bingsong Wang and Ying Xiong and Jing Li and Xiaoxia Li and Hailong He and Xiuhua Wan",
year = "2019",
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day = "14",
doi = "10.1186/s12886-019-1078-1",
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TY - JOUR

T1 - Comparison of postoperative visual performance between bifocal and trifocal intraocular Lens based on randomized controlled trails

T2 - A meta-analysis

AU - Jin, Shanshan

AU - Friedman, David S

AU - Cao, Kai

AU - Yusufu, Mayinuer

AU - Zhang, Jingshang

AU - Wang, Jinda

AU - Hou, Simeng

AU - Zhu, Guyu

AU - Wang, Bingsong

AU - Xiong, Ying

AU - Li, Jing

AU - Li, Xiaoxia

AU - He, Hailong

AU - Wan, Xiuhua

PY - 2019/3/14

Y1 - 2019/3/14

N2 - Background: To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted. Methods: A comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction. Results: There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no significance [MD = 0.02, 95%CI: (- 0.03,0.06)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95%CI (- 0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD = 0.09,95%CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA (DCIVA) [MD = 0.09, 95%CI: (- 0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839 M) [MD = 0.18, 95%CI: (0.12, 0.24) for UIVA and MD = 0.19, 95%CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA (UDVA) and corrected distance visual acuity (CDVA) [MD = 0.01, 95%CI: (- 0.01,0.04) for UDVA; MD = 0.00, 95%CI: (- 0.01,0.01) for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD = -0.08, 95% CI: (- 0.19, 0.03) for spherical equivalent; MD = -0.09, 95%CI: (- 0.21, 0.03) for cylinder; MD = -0.09, 95% CI: (- 0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR = 0.89, 95% CI: (0.71, 1.12) for spectacle independence; RR = 1.81, 95% CI: (0.50, 6.54) for PCO incidence; RR = 0.98, 5% CI: (0.86, 1.12) for patient satisfaction]. Conclusion: Patients receiving trifocal IOLs, especially AT LISA tri 839 M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.

AB - Background: To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted. Methods: A comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction. Results: There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no significance [MD = 0.02, 95%CI: (- 0.03,0.06)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95%CI (- 0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD = 0.09,95%CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA (DCIVA) [MD = 0.09, 95%CI: (- 0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839 M) [MD = 0.18, 95%CI: (0.12, 0.24) for UIVA and MD = 0.19, 95%CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA (UDVA) and corrected distance visual acuity (CDVA) [MD = 0.01, 95%CI: (- 0.01,0.04) for UDVA; MD = 0.00, 95%CI: (- 0.01,0.01) for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD = -0.08, 95% CI: (- 0.19, 0.03) for spherical equivalent; MD = -0.09, 95%CI: (- 0.21, 0.03) for cylinder; MD = -0.09, 95% CI: (- 0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR = 0.89, 95% CI: (0.71, 1.12) for spectacle independence; RR = 1.81, 95% CI: (0.50, 6.54) for PCO incidence; RR = 0.98, 5% CI: (0.86, 1.12) for patient satisfaction]. Conclusion: Patients receiving trifocal IOLs, especially AT LISA tri 839 M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.

KW - Bifocal

KW - Cataract surgery

KW - Intraocular lenses

KW - IOLs

KW - Meta-analysis

KW - Randomized

KW - Trifocal

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U2 - 10.1186/s12886-019-1078-1

DO - 10.1186/s12886-019-1078-1

M3 - Article

C2 - 30871503

AN - SCOPUS:85062997764

VL - 19

JO - BMC Ophthalmology

JF - BMC Ophthalmology

SN - 1471-2415

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