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.].

中文翻译：

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植入三焦和复曲面三焦人工晶状体的超声乳化术后的临床结果。

目的 评估双侧衍射三焦人工晶状体 (IOL) 超声乳化术后的视觉和屈光结果、视觉质量、患者满意度和眼镜独立性。方法 研究样本包括 36 名连续患者（72 只眼）。23 名 (64%) 患者接受了屈光性晶状体置换术，13 名 (36%) 患者接受了白内障手术。排除标准包括既往眼科手术、角膜高阶像差大于 0.4 µm、kappa 角大于 0.6 mm 和角膜散光大于 5.00 屈光度 (D)。所有眼睛都针对正视眼。角膜散光大于 1.00 D 的 35 只眼 (48.6%%) 使用了环面人工晶状体。在 4 m、80 和 40 cm 处测量了未矫正远视力 (UDVA) 和远距矫正视力。术后 6 个月对患者进行常规眼科检查。术后 6 个月通过主观问卷评估患者满意度。AP 值小于 0.05 具有统计学意义。结果术后 6 个月时，平均明显屈光球面等效值为 -0.01 ± 0.51 D。4 m、80 和 40 cm 处的双眼 UDVA 分别为 -0.02 ± 0.10、-0.07 ± 0.11 和 0.08 ± 0.10 logMAR。双目散焦曲线在 0.00 和 -2.00 D 散焦时分别呈现 -0.07 和 -0.02 logMAR 的两个峰值。白内障组的客观散射指数评分显着下降，而屈光性晶状体置换组的客观散射指数评分显着增加（P < .05，两种情况）。所有患者对术后效果均满意或非常满意。结论双侧植入衍射三焦人工晶状体在术后 6 个月内在所有距离均具有良好的视觉表现，患者满意度高，眼镜独立性高。[J 屈光手术。2021;37(6):372-379.]。