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Comparative analysis of visual outcomes, reading skills, contrast sensitivity, and patient satisfaction with two models of trifocal diffractive intraocular lenses and an extended range of vision intraocular lens

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To compare visual and contrast sensitivity (CS) outcomes, reading skills, and spectacle independence in patients implanted with two models of trifocal intraocular lenses (IOLs) or an extended range of vision (ERV) IOL.


This non-randomized prospective series of cases included 120 eyes of 60 patients undergoing cataract surgery with bilateral implantation of three different IOLs: the ERV IOL Tecnis Symfony (40 eyes) (Abbott Medical Optics), the trifocal IOLs PanOptix IQ (40 eyes) (Alcon), and AT LISA tri 839MP (40 eyes) (Carl Zeiss Meditec). Visual results, photopic and mesopic CS, binocular reading skills (MNREAD charts), and patient satisfaction were evaluated 3 months after surgery.


There was no statistically significant difference between groups regarding uncorrected and corrected distance visual acuity. The Tecnis Symfony IOL showed better mesopic intermediate visual outcomes than the two trifocal IOLs (p < 0.05 vs AT LISA). Under photopic conditions, AT LISA tri 839MP and PanOptix IQ showed better near visual outcomes compared with the ERV IOL (p < 0.05 to p < 0.001). The Tecnis Symfony IOL provided significantly better photopic and mesopic CS outcomes than the other IOL models (p < 0.001). Reading skills were not significantly different between the three IOL models (p > 0.05). Less patients implanted with the two trifocal IOLs required a near addition than patients with the ERV IOL.


All the tested IOLs provided good visual outcome, reading performance, and spectacle independence after cataract surgery. While trifocal IOLs gave better near visual acuity results, the ERV IOL provided better contrast sensitivity.

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We would also thank prof. Gianni Virgili for additional statistical assistance.


No public or private financial support was received for the study. The authors received third-party statistical support facilitated by Abbott.

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Correspondence to Rita Mencucci.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Mencucci, R., Favuzza, E., Caporossi, O. et al. Comparative analysis of visual outcomes, reading skills, contrast sensitivity, and patient satisfaction with two models of trifocal diffractive intraocular lenses and an extended range of vision intraocular lens. Graefes Arch Clin Exp Ophthalmol 256, 1913–1922 (2018).

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