Bilateral Refractive Lens Exchange with a Hydrophobic Trifocal Intraocular Lens

Purpose: To evaluate the visual and refractive outcomes in patients who underwent bilateral refractive lens exchange (RLE) with the trifocal hydrophobic FineVision HP IOL. Methods: This prospective, single-center, non-comparative study enrolled 70 eyes of 35 patients implanted bilaterally with the FineVision HP IOL (Beaver-Visitec International, Inc. USA). Postoperative outcomes at 3 months included manifest refraction, monocular and binocular logMAR uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), distance-corrected intermediate visual acuity (DCIVA, at 60 cm), and distance-corrected near visual acuity (DCNVA, at 40 cm). The binocular defocus curve was also registered. Results: 94.29% of eyes showed a spherical equivalent within ± 0.50D and all within ± 1.00D. 95.71% of eyes showed a refractive cylinder of ≤ 0.50D and all ≤ 1.00D. The mean spherical equivalent and refractive cylinder were 0.16 ± 0.27D and − 0.18 ± 0.21D, respectively. Mean binocular CDVA, DCIVA and DCNVA were − 0.12 ± 0.06, 0.15 ± 0.07 and 0.03 ± 0.05 logMAR, respectively. 88.57% and 100% of patients achieved a cumulative binocular CDVA of ≥ 20/16 and ≥ 20/20, respectively. Furthermore, 51.43% and 91.43% patients achieved a cumulative binocular DCIVA of ≥ 20/25 and ≥ 20/32, respectively; and 71.43% and 100% of patients achieved a cumulative binocular DCNVA of ≥ 20/20 and ≥ 20/25, respectively. The safety and efficacy indexes were 1.07 and 1.01, respectively. The defocus curve showed a peak of maximum visual acuity, better than 20/16, at distance, with a continuous smooth reduction in visual acuity for intermediate distances, followed by a secondary peak close to 20/20 at near. Conclusions: The FineVision HP IOL demonstrated favorable short-term refractive accuracy and visual performance in this prospective cohort, although larger comparative studies with longer follow-up are warranted. Keywords: refractive lens exchange, trifocal, intraocular lens, hydrophobic, diffractive