RT Journal Article T1 Influence of angle kappa on visual and refractive outcomes after implantation of a diffractive trifocal intraocular lens A1 Garzón Jiménez, Nuria A1 García Montero, María A1 López Artero, Esther A1 Albarrán Diego, Cesar Antonio A1 Pérez Cambrodí, Rafael José A1 Illarramendi Mendicute, Igor A1 Poyales Galán, Francisco AB Purpose: To evaluate changes in angle kappa following the implantation of a trifocal intraocular lens (IOL), and to assess the postoperative outcomes of patients with different angle kappa values.Setting: IOA Madrid Innova Ocular, Madrid, SpainDesign: Prospective trialMethods: Sixty-three patients due to have bilateral implantation of the diffractive trifocal IOL (POD F, PhysIOL, Belgium) were included. Pupil offset was used as the best estimate of angle kappa and was measured using Pentacam (Oculus, Wetzlar, Germany) preoperatively and at 3-months after surgery. Postoperative refractive outcomes (sphere, cylinder, and MRSE) and visual outcomes at far, intermediate and near distance were assessed and compared between eyes with small pupil offset and eyes with large pupil offset. Quality of vision was assessed using a subjective questionnaire.Results: There was significant decrease in pupil offset post-operatively (mean: 0.197 ± 0.12 mm) compared to preoperatively (mean: 0.239 ± 0.12 mm), with a mean decrease of -0.042 mm (P = 0.0002). The same significant decrease was found for both the right eyes and left eyes, when analysed separately. No statistically significant difference was found in any of the refractive and visual acuity outcomes between eyes with small pupil offset and eyes with large pupil offset. The majority of patients (14 out of 16) complaining of significant halos had eyes with small pupil offset.Conclusion: Large pupil offset did not negatively affect visual and refractive outcomes. The tolerance to larger pupil offset might be due to the IOL optical design, with the first diffractive ring being larger than other commonly used multifocal IOLs. More studies comparing various diffractive IOL models will be useful to confirm such hypothesis. PB Wolter Kluwer SN 0886-3350 YR 2020 FD 2020-02-14 LK https://hdl.handle.net/20.500.14352/6101 UL https://hdl.handle.net/20.500.14352/6101 LA eng NO Received April 05, 2019; revised form November 27, 2019; Accepted February 08, 2020 DS Docta Complutense RD 16 may 2024