Comparison of Visual Field Outcomes After Monofocal, Bifocal, and Trifocal Intraocular Lens Implantation

PURPOSE: To compare the visual field (VF) outcomes after implantation of monofocal, bifocal and trifocal Intraocular Lenses (IOL) from the same manufacturer platform. SETTING: Shandong Eye HospitalDesign: prospective, non-randomized, controlled study. METHODS: A total of 102 patients (123 eyes) with age-related cataract were divided into monofocal, bifocal, and trifocal IOL groups. Best-corrected visual acuity (BCVA), refraction, Humphrey 30-2 standard automated perimetry (SAP), and defocus curve were assessed preoperatively and 3 months postoperatively. Outcome measures included visual field index (VFI), mean deviation (MD), and pattern standard deviation (PSD), as well as regional mean sensitivity (MS) in 3 predefined visual field regions: central (0°-5°, zone I), paracentral (6°-15°, zone II), and peripheral (16°-30°, zone III). RESULTS: All three IOL groups showed significant postoperative improvements in BCVA, VFI, MD, PSD, and MS in all zones (P < 0.05). Postoperative MS did not differ significantly among groups in zone I. In zone II, MS was higher in the bifocal and trifocal groups than in the monofocal group, with no significant difference between bifocal and trifocal IOLs. In zone III, MS was highest in the trifocal group, followed by the bifocal and monofocal groups (P < 0.05). Intergroup differences in ΔMS were not significant in zone I but were greater in zone II for bifocal and trifocal IOLs. For zone III, ΔMS was significantly larger in the trifocal group than in the monofocal group. CONCLUSION: Postoperative VF sensitivity improved after all three IOL types. Central MS did not differ significantly among groups, whereas multifocal IOLs, particularly trifocal IOLs, showed higher MS in paracentral and peripheral zones.