Abstract
PURPOSE: This study aimed to compare visual performance, defined and quantified as the visual acuity reserve through the area under the distance-corrected defocus curve (AUC), along with visual acuity at discrete distances and modulation transfer function (MTF), following implantation of PanOptix TFNT00 trifocal and Symfony ZXR00 extended depth-of-focus intraocular lenses (IOLs). METHODS: This prospective study included patients, with only one eye per patient studied, who underwent cataract extraction with PanOptix or Symfony IOL implantation between May 2023 and May 2024 at Chongqing Aier Eye Hospital, China. Clinical data were collected at 3 months postoperatively. The total AUC (ST: 0.5D to -3.0D) and partial AUCs for distance (SD, + 0.5 to -0.5 D), intermediate (SI, -0.5 to -2.0 D), and near (SN, -2.0 to -3.0 D) ranges were calculated from distance-corrected defocus curves. Corrected visual acuity at discrete distance and MTF were also assessed. RESULTS: A total of 69 participants (69 eyes) were included, with 36 in the PanOptix group and 33 in the Symfony group. ST and SD did not differ significantly between groups. SI was greater in the Symfony group (P = 0.029), whereas SN was greater in the PanOptix group (P = 0.005). PanOptix achieved better near visual acuity (P < 0.001), while the best corrected distance visual acuity (BCDVA) and MTF values were similar. Postoperative refraction was more myopic in the Symfony group (P < 0.001). CONCLUSIONS: Defocus curve area analysis effectively delineated the distinct performance profiles of the two IOLs, with Symfony favoring intermediate and PanOptix favoring near vision. TRIAL REGISTRATION: MR-50-25-076077, July 1, 2022.