To compare the visual, refractive, and optical performance of two diffractive trifocal intraocular lenses (IOLs) with analogous designs but different light distribution profiles.

A total of 54 eyes from 48 patients undergoing cataract surgery received either the Gemetric^TM (GM; Hoya Surgical Optics, Singapore) or the Gemetric^TM Plus (GMP; Hoya Surgical Optics) IOLs. Preoperative demographics were comparable between the two groups. Generalized estimating equations (GEE) were utilized for statistical analysis to adjust for inter-eye correlations.

A total of 48 patients (54 eyes) were included in the analysis, of which 30 patients (33 eyes) received the GM IOL and 18 patients (21 eyes) the GMP IOL. The mean age was 59.6±6.1y (range: 48–72) in the GM group and 61.6±5.8y (range: 49–69) in the GMP group (P=0.339). At 3mo postoperatively, there were no statistically significant differences in uncorrected distance visual acuity (VA) and uncorrected near vision at 40 cm. However, the GM group showed statistically significantly better outcomes in corrected distance VA (P=0.003) and uncorrected intermediate VA at 66 cm (P=0.033). Conversely, uncorrected near VA at 33 cm was significantly superior in the GMP group (P=0.048). The objective assessment of optical quality showed improved distance and intermediate performance with the GM, while the GMP performed better at near, consistent with the patients’ measured visual outcomes.

Adjusting light distribution in otherwise identical trifocal IOLs results in distinct clinical and optical advantages, allowing surgeons to tailor IOL selection to patients’ specific visual demands.