Clinical Outcomes of Trifocal Intraocular Lens with Glistening-Free Hydrophobic Acrylic: A One-Year Follow-Up Study

PURPOSE The Clareon PanOptix (CNWT) IOL is a newer trifocal IOL made from a glistening-free hydrophobic acrylic material incorporating hydroxyethyl methacrylate (HEMA). While its predecessor (TFNT) has established clinical outcomes, long-term data. This study aimed to evaluate the refractive and visual outcomes during a 1-year follow-up after CNWT implantation in one eye, with a different type of refractive multifocal or extended depth of focus IOL in the contralateral eye (mix- and match setting). METHOD This was a retrospective, single-arm case series conducted at the single eye clinic, Seoul, Republic of Korea. The study included patients who underwent cataract surgery with mix-and-match IOL implantations, receiving a CNWT in one eye. Data were collected from the eyes with a CNWT. Monocular uncorrected distance visual acuity (UCDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UCNVA), and manifest refraction were analyzed from measurements taken at 1, 3, 6, and 12 months postoperatively. Rates and causes of secondary surgical intervention, such as IOL exchange and toric IOL axis readjustment, were also investigated. Statistical analysis involved Kolmogorov-Smirnov tests for normality and t-tests for comparisons, with p < 0.05 considered significant. RESULTS Data from 897 eyes (out of 1282 initially screened) with continuous measurements and no secondary interventional surgeries were included in the primary monocular visual acuity and refractive analysis. UCDVA of LogMAR 0.0 or better increased from 50.91% at 1 month to 85.95% at 12 months. CDVA of LogMAR 0.0 or better improved from 89.52% at 1 month to 98.1% at 12 months. At 12 months, 94.09% of eyes achieved UCNVA of LogMAR 0.1 or better. A slight mean hyperopic shift (+ 0.07D) was observed up to 12 months. Toric CNWT IOLs were used in 71.0% of these eyes, with 88.07% achieving manifest refractive astigmatism of ≤ -0.75D at 12 months. Overall, 85 out of 1282 eyes (6.63%) underwent secondary surgery: 4.45% for IOL exchange and 2.18% for toric IOL axis readjustment. Post-reoperation, UCDVA and UCNVA significantly improved. CONCLUSIONS The new hydrophobic acrylic trifocal IOL (CNWT) with HEMA demonstrated significant improvements in visual acuity and stable refractive outcomes over one year in a mix-and-match setting. The use of toric CNWT IOLs effectively reduced astigmatism. These findings suggest that this IOL is a reliable option for enhancing visual quality and reducing spectacle dependency in this specific implantation context. Despite the low rate of reoperations, the results underscore the ongoing need for advancements in biometric measurements and IOL power calculation formulas to further minimize such interventions. Trial registration Retrospectively registered. This study was approved by the Institutional Review Board of First Samsung Eye Clinic (No. FSEC202311HR00901, approved November 2023).