Visual Outcomes After Bilateral Implantation of a Trifocal Intraocular Lens Pairing Two Complementary Optic Light Distributions

Purpose: To assess visual, refractive, and optical outcomes and patient-reported satisfaction following bilateral implantation of two trifocal intraocular lenses (IOLs) sharing the same optical architecture but differing in their photopic light distribution: Vivinex Gemetric and Vivinex Gemetric Plus (HOYA Surgical Optics). Methods: This was an observational, prospective, consecutive, non-comparative case series. Fifty-four eyes of 27 patients underwent bilateral cataract surgery or refractive lens exchange. Each patient received the Gemetric IOL in the dominant eye and the Gemetric Plus in the non-dominant eye. Examinations included full refractive and visual assessment, defocus curves, mesopic contrast sensitivity, pyramidal aberrometry, and validated patient-reported outcome measures (Quality of Vision Questionnaire and Near Activity Visual Questionnaire), with follow-up at 1 day and 1, 3, and 6 months. Results: The paired IOL combination provided a visual acuity of 0.15 logarithm of the minimum angle of resolution (logMAR) or better between defocus levels of +0.50 to −3.00 diopters (D). Maximum mean value of visual acuity was obtained at 0.00 D (−0.07 ± 0.05 logMAR) and a second peak was found at −3.00 D (0.07 ± 0.09 logMAR). It was 0.13 ± 0.10 logMAR at a defocus level of −1.50 D. Monocular corrected near visual acuity was significantly better for the Gemetric Plus IOL ( P = .03). Better monocular distance visual function was obtained with the Gemetric IOL ( P = .05). Contrast sensitivity remained within or above age-matched normative values. Ocular aberrations remained low and stable, with no significant differences between lens types. Ninety-six percent of patients reported no or minor difficulties in conducting prolonged near work. Conclusions: The pairing strategy of the Vivinex Gemetric and Gemetric Plus trifocal IOLs delivers excellent visual acuity across all distances, preserves contrast sensitivity, and maintains a high level of optical quality and patient satisfaction.