Visual performance and patient-reported outcomes of a non-apodized diffractive trifocal intraocular lens in Chinese cataract patients: a prospective multicenter real-world study
Purpose To assess clinical visual performance and patient-reported satisfaction following bilateral implantation of a non-apodized diffractive trifocal intraocular lens (IOL), the AcrySof® IQ PanOptix® Trifocal IOL, in a real-world clinical setting in China. Methods This was a prospective, multicenter registry study including patients aged ≥ 18 years with bilateral age-related or complicated cataracts who underwent bilateral implantation of the PanOptix IOL. The primary endpoint was the proportion of patients achieving binocular uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuity of ≤0.200 logMAR at 3 months postoperatively. Secondary endpoints included best-corrected distance visual acuity (BCDVA), binocular defocus curves ranging from +2.00 D to −4.00 D, refractive predictability, and patient-reported outcomes assessed using the Catquest-9SF and IOLSAT questionnaires. The study was registered at Chinese Clinical Trial Registry (ChiCTR2100052791; 2021-11-05). Results A total of 137 patients completed the 3-months postoperative follow-up. At 3 months, the mean binocular UDVA, UIVA, and UNVA were 0.017 ± 0.086, 0.061 ± 0.110, and 0.061 ± 0.103 logMAR, respectively. Overall, 91.24% of patients achieved the composite endpoint of ≤0.200 logMAR binocularly at all three distances. The binocular defocus curve demonstrated a broad plateau of visual acuity, maintaining ≤0.200 logMAR between +0.50 D and −2.50 D. Refractive predictability was high, with 84.62% of eyes within ±0.50 D of emmetropia. Complete spectacle independence was reported by 96.90% of patients. Conclusion Bilateral implantation of the PanOptix trifocal IOL provides excellent and early stable visual performance at distance, intermediate, and near in Chinese cataract patients. High refractive predictability and a high rate of spectacle independence are associated with substantial patient satisfaction in real-world clinical practice.