Uncorrected Visual Acuity After Trifocal Iol Implantation In Eyes With Long Versus Non-Long Axial Length

Published 2026 - 44th Congress of the ESCRS

Reference: POCAT502 | Type: Poster | DOI: 10.82333/j13v-ct81

Authors: Dr Natsuko Osaka* ¹ , Dr Erisa Yotsukura ¹ , Dr Hidemasa Torii ¹ , Dr Yosai Mori ² , Dr So Goto ³ , Dr Yumi Hasegawa ⁴ , Prof. Kazutaka Kamiya ⁵ , Dr Takuya Shiba ⁶ , Dr Takashi Kojima ⁷ , Dr Mayumi Nagata ⁸ , Dr Hiroyuki Matsushima ⁸ , Dr Kazunori Miyata ² , Prof. Kazuno Negishi ¹

¹Ophthalmology,Keio University School of Medicine ,Tokyo,Japan, ²Miyata Eye Hospital,Miyazaki,Japan, ³Ophthalmology,National Hospital Organization Tokyo Medical Center,Tokyo,Japan;Ophthalmology,The University of Osaka,Osaka,Japan, ⁴Ophthalmology,University of Tsukuba,Ibaraki,Japan, ⁵Ophthalmology,Showa Medical University,Tokyo,Japan, ⁶Roppongi Shiba Eye Clinic,Tokyo,Japan, ⁷Nagoya Eye Clinic,Aichi,Japan, ⁸Ophthalmology,Dokkyo Medical University,Tochigi,Japan

Purpose

The global prevalence of myopia is increasing, and the number of cataract surgeries performed in patients with high myopia is expected to increase. Previous studies have reported greater postoperative refractive errors in eyes with long axial length (AL) following cataract surgery. Therefore, they may be at risk for poor uncorrected visual acuity (UCVA) after multifocal intraocular lens (IOL) implantation with high myopia. We compared the postoperative UCVA based on the AL in patients implanted with multifocal IOLs.

Setting

This retrospective comparative multicenter study was conducted with the prior approval of the Keio University School of Medicine Ethics Committee (approval number: 20256009) and the Meiwa Medical Corporation Institutional Review Board (approval number: CS-417-013). A total of 89 patients were enrolled and examined from 2019 to 2024.

Methods

This study included 153 eyes of 89 patients (age range, 55-65 years) after cataract surgery with implantation of the PanOptix® Trifocal (Alcon). The eyes were classified into a long AL group (AL ≧ 26.0 mm) and a non-long AL group (AL < 26.0 mm). Preoperatively, the pupil diameter and corneal higher order aberrations (from third to sixth order, Φ = 4.0 and 6.0 mm) were measured. One month postoperatively, the following outcomes were assessed in logarithm of the minimum angle of resolution: monocular uncorrected distance visual acuity (UDVA), monocular uncorrected intermediate visual acuity (UIVA) at 70 cm, monocular uncorrected near visual acuity (UNVA) at 40 cm, objective and subjective refractions, and postoperative refractive error.

Results

The long AL group included 54 eyes of 34 patients and the non-long AL group included 99 eyes of 63 patients. No statistically significant differences were seen in age, preoperative pupil diameter, corneal higher order aberrations, postoperative refractions, and refractive error between the two groups. The preoperative UCVA and corrected distance visual acuity (CDVA) were significantly worse in the long AL group (UCVA: 1.32 vs 0.51, P < 0.001; CDVA: 0.12 vs 0.06, P = 0.026). The postoperative UDVA, UIVA, and UNVA in the long AL group and in the non-long AL group were -0.03 and -0.04 (P = 0.721), 0.04 and 0.06 (P = 0.545), and 0.01 and 0.07 (P = 0.029), the last of which showed significantly better UNVA in the long AL group.

Conclusions

One month after trifocal IOL implantation, the UNVA was significantly better in the long AL group than in the non-long AL group, whereas the UDVA and UIVA were comparable between the groups.