OBJECTIVES: AcrySof IQ PanOptix (TFNTXX, TFATXX) is the first trifocal IOL launched in the USA in 2019. A systematic literature review and meta-analysis was conducted to identify and pool published evidence on complete spectacle independence rate in patients with bilateral implantation of TFNTXX/TFATXX.

METHODS: PubMed was searched from Jan 2017 to Sep 2021; congress abstract databases were also searched for recent studies that are yet to be published in peer-reviewed journals. Search terms included the technology name (TFNTXX, TFATXX, PanOptix) and “spectacle independence” or “visual outcomes”. A Bayesian random effects meta-analysis was conducted, providing a pooled estimate (posterior median treatment effect and its 95% credible interval (CI)) of complete spectacle independence rate among cataract or refractive lens exchange (RLE) surgery patients. Sub-group analyses evaluated spectacle independence across different distances (near, intermediate, far).

RESULTS: Twenty-six unique clinical studies were identified (20 peer-reviewed publications, 6 congress presentations). Among patients who underwent cataract surgery with TFNTXX/TFATXX IOL, meta-analysis demonstrates complete spectacle independence rate of 91.6% (95% CI 0.87–0.96; N=13 studies). Sub-group analyses of pooled spectacle independence rates at each focal point of near, intermediate, and far among cataract surgery patients were 89.6%, 96.3%, and 95.9%, respectively (N=13). Including studies with all patient populations, i.e. patients who underwent cataract or RLE surgery with TFNTXX/TFATXX IOL, complete spectacle independence rate further improved to 92.8% (95% CI 0.89–0.96; N=19).

CONCLUSIONS: This meta-analysis demonstrates at least 9 out of 10 patients receiving TFNTXX/TFATXX IOL for cataract surgery can be expected to achieve complete spectacle independence. This study provides informative data for clinicians and patients to feel confident in the use of TFNTXX/TFATXX as a trifocal IOL with high rate of complete spectacle independence.