This document summarizes a case series study that evaluated the correlation between subjective and objective outcomes in patients who received a diffractive trifocal intraocular lens (IOL) called Physiol Finevision. Objective outcomes such as visual acuity, aberrometry measurements, and contrast sensitivity were assessed. Subjective outcomes were evaluated using quality of life questionnaires. The results found good correlations between objective measures like visual acuity and Strehl ratio with high scores on subjective questionnaires. The conclusion is that if objective surgical and patient selection variables are optimized, excellent subjective patient outcomes can be predicted.

1. Correlation of subjective and
objective outcomes in a diffractive
trifocal IOL, a case series.
Dr. Ivo Ferreira Ríos
Dra. Karla Zuñiga Posselt
Dr. Eduardo Chávez Mondragón

2. Disclosure
• No conflict of interest.

3. Collaborators
• Dra. Karla Zuñiga
• Dra. Aida Corona
• Dr. Eduardo Chávez Mondragón
• Dr. Yonathan Garfias

4. The key to success
• Subjective outcomes

5. It’s coming…

6. It’s coming…

7. It’s here…

8. It’s here…

9. It’s here…

10. It’s here…!!!

11. It’s here…!!!
• Patient Reported Outcomes
Measures (PROMs)
• Subjective outcomes it’s what
matters the most in these days….

12. Our idea..
If the subjective outcomes are
so important…
DO THEY CORRELATE?
With the objective outcomes
we have control during cataract
surgery and patient selection?

13. Purpose
• To evaluate the results and the
relationship between Subjective and
Objective outcomes of the latest trifocal
Intraocular Lens (IOL) Physiol Finevision.

14. Objective outcomes
• VA, Aberrometry (RMS, PSF, MTF)

15. Subjective outcomes
• VFQ-25 & CATQUEST-9SF

16. Design
• Prospective non-interventional study.

17. Methods
• 24 eyes of 12 patients
• Bilateral cataract surgery with implantation
of Physiol trifocal IOL.
We analysed:
UDVA
UNVA
VA 70, 60, 50, 40
1, 3 and 6 months

18. Methods
• With a OPD Scan III Software we performed:
Aberrometry measurements of:
• Higher-order root mean-square (RMS)
• Point Spread Function (PSF) with the Strehl
Ratio.

19. Methods
With a OPD Scan III Software we performed:
• Bilateral contrast sensitivity was obtained with
Modulation Transfer Function (MTF).

20. Methods
The subjective outcomes were obtained:
• National Eye Institute VFQ-25 questionnaire
• Catquest-9SF

21. Methods
• Descriptive analysis of our data
• Kolmogorov-Smirnov analysis that presented:
normal distribution of UNVA far, near and
intermediate
abnormal distribution of questionnaries results.
• Pearson correlation to between our objective
and subjective variables.

22. Results
Pearson correlation to between our objective and
subjective variables.

23. Results
• Intermediate VA in Logmar

24. Results
Mean Monocular UNVA LogMar 0.06 +/- 0.07
Spherical Equivalent (3months) 0.52 =/- 0.47
Mean RMS 0.07
PSF Strehl Ratio 0.38

25. Results
• Score for the VFQ- 25 was global of 91.03
over 100.
• The results of catquest-SF9 the
questionnaire was evaluated with rasch
analysis for obtaining the final score.

26. Results
• UDVA (r = 0.89)
• UNVA (r=0.71), and
• VA at 70, 60, 50 and
40 cm
• Strehl ratio
Good score in
both
questionnaires.
Good correlation between

27. Conclusion
• We found a strong correlation in our objective and
subjective outcomes in the variables we described.
• If do a good selection and perform an excellent surgery
technique (objective variables) we can predict to have
excellent subjective outcomes in our patients.

28. Bibliography
• 1) Zhang F, Sugar A, Jacobsen G, Collins M. Visual function and spectacle independence after cataract surgery:
bilateral diffractive multifocal intraocular lenses versus monovision pseudophakia. J Cataract Refract Surg.
2011;
37:853-8.
• 2) Vryghem JC, Heireman S. Visual performance after the implantation of a new trifocal intraocular lens. Clin
Ophthalmol. 2013;7:1957-65.
• 3) Gatinel D, Pagnoulle C, Houbrechts Y, Gobin L. Design and qualification of a diffractive trifocal optical profile for
intraocular lenses. J Cataract Refract Surg. 2011;37(11):2060-7.
• 4) Cochener B, Vryghem J, Rozot P, Lesieur G, Heireman S, Blanckaert JA, et al. Visual and refractive outcomes
after implantation of a fully diffractive trifocal lens. Clin Ophthalmol. 2012;6:1421-7.
• 5) Sheppard AL, Shah S, Bhatt U, Bhogal G, Wolffsohn JS. Visual outcomes and subjective experience after
bilateral implantation of a new diffractive trifocal intraocular lens. J Cataract Refract Surg. 2013;39(3):343-9.
• 6) Lesieur G. Outcomes after implantation of a trifocal diffractive IOL. J Fr Ophtalmol. 2012;35(5):338-42.
• 7) Carson D, Hill WE, Hong X, Karakelle M. Optical bench performance of AcrySof(®) IQ ReSTOR(®), AT LISA(®)
tri, and FineVision(®) intraocular lenses. Clin Ophthalmol. 2014;8:2105-13.
• 8) Jonker SM, Bauer NJ, Makhotkina NY, Berendschot TT, van den Biggelaar FJ, Nuijts RM. Comparison of a
trifocal intraocular lens with a +3.0 D bifocal IOL: results of a prospective randomized clinical trial. J Cataract
Refract Surg. 2015;41(8):1631-40.

29. Thank you
Correo: ivo.ferreira@institutodeoftalmologia.org
ferreira.ivo11@gmail.com
LinkedIn: Dr. Ivo Ferreira Ríos
Twitter: Ivo Ferreira Ríos MD