Clinical Outcomes After Bilateral Mix-and-match Implantation of Extended Depth of Focus and Trifocal Intraocular Lenses

Purpose: To evaluate the clinical outcomes after bilateral mix-and-match implantation of Ex-tended Depth of Focus (EDOF) and trifocal intraocular lenses (IOLs). Methods: 134 eyes out of 67 patients who had met all inclusion and exclusion criteria and un-derwent bilateral cataract surgery, were included. The Symfony or Symfony toric EDOF IOL (J&J Inc.) was implanted in the dominant eye, and the PanOptix or PanOptix toric trifocal IOL (Alcon Inc.) in the non-dominant eye. The uncorrected distance visual acuity (UDVA), uncorrected in-termediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), defocus curve, contrast sensitivity, and satisfaction questionnaire were obtained preoperatively and at 1, 6, and 12 months after surgery. Results: At 12 months after surgery, the mean UDVA (logMAR) was 0.03±0.06 in the EDOF IOL-implanted eyes, 0.07 ± 0.11 in the trifocal IOL-implanted eyes, and 0.02±0.06 in both eyes. The mean UIVA was 0.08±0.08 in EDOF IOL-implanted eyes, 0.09±0.11 in trifocal IOL-implanted eyes, and 0.03±0.08 in both eyes. Mean UNVA was 0.51±0.26 in EDOF IOL-implanted eyes, 0.22 ± 0.16 in trifocal IOL-implanted eyes, and 0.17±0.12 in both eyes. Overall satisfaction rates were 43.3%, 41.1%, and 38.5% at 1, 6, and 12 months, respectively, while more than 70% of patients consistently reported that they would recommend the surgery to others. The most common causes of dissatisfaction were dry eye symptoms and reduced near vision. Conclusions: Bilateral Mix-and-match Implantation of EDOF and Trifocal IOL implantation showed good visual outcomes for distance, intermediate, and near vision until 12 months. Most of patients satisfied with visual quality, but more dissatisfied with dry eye disease and poor near vision than photopic phenomena like glare and halos.