Visual outcome of a diffractive trifocal intraocular lens in eyes with short axial length

This study aimed to investigate the visual quality of short-axial length cataractous eyes after bilateral implantation of the trifocal intraocular lens (IOL) AcrySof IQ PanOptix. This prospective observational study enrolled bilateral short-axial lengths (≤ 22.5 mm) cataract patients after implantation of IOL AcrySof IQ PanOptix. Monocular and binocular uncorrected distance, corrected distance, uncorrected intermediate (60 cm), distance-corrected intermediate, uncorrected near (40 cm), and distance-corrected near (UDVA, CDVA, UIVA, DCIVA, UNVA and DCNVA) visual acuity were measured with follow-up of three months. Visual disturbances, patient satisfaction and spectacle independence were assessed using a questionnaire. The study included 40 patients with a total of 80 eyes, with 80.0% female. The average axial length was 22.05 ± 0.39 mm. Monocular UDVA were 0.05 ± 0.09, CDVA were 0.00 ± 0.07, UIVA were 0.09 ± 0.10, DCIVA were 0.04 ± 0.08, UNVA were 0.11 ± 0.13 and DCNVA were 0.05 ± 0.09. Binocular UDVA were 0.02 ± 0.08, CDVA were − 0.02 ± 0.05, UIVA were 0.03 ± 0.08, DCIVA were 0.00 ± 0.06, UNVA were 0.02 ± 0.06 and DCNVA were 0.02 ± 0.06. Regarding adverse visual phenomena, 37.5% of patients reported significant starbursts and 27.5% reported significant halos. However, overall satisfaction reached 95%, with all patients achieving complete spectacle independence. With detailed preoperative evaluation, the trifocal IOL provided satisfactory visual outcomes for patients with short-axial length. Since the trifocal IOL can significantly improve the symptoms of hyperopia and presbyopia, patient satisfaction may be higher.