Visual Outcomes and IOL Stability After Panoptix Trifocal Intraocular Lens Implantation in Eyes With High Myopia

Purpose To observe and explore the correlation between visual outcomes and intraocular lens (IOL) stability after tri-focal IOL implantation in eyes with high myopia. Methods Patients with highly myopic cataract (axial length > 26 mm) were enrolled in this prospective study. Thirty-one eyes (31 patients) received implantation of a trifocal IOL (AcrySof IQ PanOptix TFNT00). Uncorrected distance, intermediate, and near visual acuity (UDVA 5 m, UIVA 60 cm, UNVA 40 cm) and refractive status were evaluated at 1 day, 1 week, 4 weeks, and 3 months postoperatively. The defocus curve was plotted 3 months postoperatively. The IOL tilt, IOL decentration, postoperative aqueous depth, and adhesion of the capsule with IOL were evaluated at 2 hours, 1 week, 4 weeks, and 3 months postoperatively. The correlation between postoperative visual outcomes and dynamic changes in IOL positioning was analyzed. Results In total, 29 eyes of 29 patients were available for analysis. UDVA, UIVA, and UNVA were 0.03 ± 0.01, 0.03 ± 0.01, and 0.02 ± 0.01 logarithm of the minimum angle of resolution (logMAR) at 3 months postoperatively (mean spherical equivalent [SE]: −0.10 ± 0.04 D). From 1 to 7 days postoperatively, UIVA ( P = .031) and UNVA ( P = .02) improved, SE shifted to myopic ( P = .001), and the IOL moved forward ( P < .001). A bimodal defocus curve showed that the visual acuity achieved 0.2 logMAR from +0.50 to −2.50 D, and the peaks were at plano and −2.50 D, reaching 0.04 ± 0.01 and 0.08 ± 0.01 logMAR. The capsular bend index reached 3.35 ± 0.06 at 3 months postoperatively. There were no significant changes in tilt and decentration during the postoperative follow-up period. Conclusions This trifocal IOL provides excellent visual acuity at far, intermediate, and near distance in high myopia eyes. The postoperative position of the IOL was relatively stable in eyes with highly myopic cataracts. [ J Refract Surg . 2025;41(1):e56–e64.]