Visual Outcomes and Satisfaction in Patients with High Myopia Following Cataract Surgery with Trifocal Intraocular Lens Implantation

Purpose: To investigate the 3-month outcomes of visual performance and satisfaction of patients with high myopia after implantation of trifocal intraocular lens (IOL). Setting: Army Medical Center of PLA, Chongqing, China. Design: Retrospective case series. Methods: Patients were divided to 2 groups according to the spherical equivalent (SEQ) (high myopia ≤ -6.0D and non-high myopia >-6.0 D). Corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA) at 5m, uncorrected intermediate visual acuity (UIVA) at 60cm, uncorrected near visual acuity (UNVA) at 40cm, defocus curve, refraction, visual quality and satisfaction were compared at 3 months postoperatively. Results: Of 57 patients (89 eyes) enrolled, 32 eyes (36%) were highly myopic and 57 eyes (64%) were non-highly myopic. At 3 months, both groups exhibited smooth defocus curves, with better visual acuity at 0D, -0.5D and -2.0D. Mean SEQ was -0.19(-0.25, 0.00) D and 0.00(-0.25, 0.00) D in the highly myopic and non-highly myopic groups, respectively, with no significant difference (p = 0.34). There were no significant differences between the 2 groups in CDVA, UDVA, UIVA, UNVA, spectacle independence or satisfaction (p > 0.05). Higher order aberrations (HOA) and trefoil aberration were greater in highly myopic group (p < .05). Conclusions: Trifocal IOL implantation provides satisfactory full-range visual acuity on the premise of no complications, with a spectacle independence rate of over 90%. Although HOA and trefoil aberration were greater in patients with high myopia, they achieve comparable visual acuity and spectacle independence rates, with a high satisfaction.