Clinical Outcomes After Phacoemulsification With Implantation of Trifocal and Toric Trifocal Intraocular Lenses

PURPOSE: To evaluate the visual and refractive outcomes, visual quality, patient satisfaction, and spectacle independence after phacoemulsification with bilateral implantation of a diffractive trifocal intraocular lens (IOL). METHODS: The study sample comprised 36 consecutive patients (72 eyes). Twenty-three (64%) patients underwent refractive lens exchange and 13 (36%) underwent cataract surgery. Exclusion criteria included previous ocular surgery, corneal higher order aberrations of greater than 0.4 µm, angle kappa of greater than 0.6 mm, and corneal astigmatism of greater than 5.00 diopters (D). All eyes were targeted for emmetropia. A toric IOL was used in 35 (48.6%%) eyes with corneal astigmatism of greater than 1.00 D. Uncorrected distance visual acuity (UDVA) and distance-corrected visual acuity were measured at 4 m and 80 and 40 cm. Patients underwent routine ophthalmic examination for 6 months postoperatively. Patient satisfaction was assessed with a subjective questionnaire at 6 months postoperatively. A P value of less than .05 was statistically significant. RESULTS: At 6 months postoperatively, the mean manifest refractive spherical equivalent was −0.01 ± 0.51 D. Binocular UDVA at 4 m and 80 and 40 cm was −0.02 ± 0.10, −0.07 ± 0.11, and 0.08 ± 0.10 logMAR, respectively. Binocular defocus curves presented two peaks of −0.07 and −0.02 logMAR for 0.00 and −2.00 D defocus, respectively. The Objective Scatter Index score decreased significantly in the cataract group and increased significantly in the refractive lens exchange group ( P < .05, both cases). All patients were satisfied or very satisfied with the postoperative outcome. CONCLUSIONS: Bilateral implantation of a diffractive trifocal IOL resulted in good visual performance at all distances with high patient satisfaction and spectacle independence at 6 months postoperatively. [ J Refract Surg . 2021;37(6):372–379.]