Six-Month Visual and Patient-Reported Outcomes of a Biaspheric Trifocal IOL in Asian and European Cataract Patients: A Comparative Study.

PURPOSE: To compare six-month refractive accuracy, visual performance, and patient-reported outcomes of a bi-aspheric trifocal intraocular lens (IOL) in Asian and European patients.

METHODS

In this prospective observational study at Chang Gung Memorial Hospital (Taiwan) and Oftalvist Alicante (Spain), 50 patients (25 Taiwanese, 25 Spanish) received bilateral implantation of the same trifocal IOL during routine phacoemulsification. Visual acuity and defocus curves were measured with Landolt C charts (culturally neutral). Binocular contrast sensitivity was tested under photopic (85 cd/m2) and mesopic (3 cd/m2) conditions, with and without glare. Patient satisfaction was evaluated using the Catquest-9SF.

RESULTS

Both groups achieved near-emmetropic outcomes, with 98% of Spanish and 80% of Taiwanese eyes within ±0.50 D of target refraction. Spanish eyes showed significantly lower residual astigmatism (-0.11 ± 0.20 D) than Taiwanese eyes (-0.72 ± 0.41 D; p < 0.001), corresponding to superior monocular and binocular acuities at distance, intermediate, and near. Despite this, Taiwanese patients reported comparable or higher satisfaction scores, suggesting cultural factors and visual demands affect perceived quality of vision. Contrast sensitivity for both cohorts fell within or above normative ranges, with minor losses at higher spatial frequencies under mesopic glare.

CONCLUSION

The bi-aspheric trifocal IOL delivers excellent refractive and functional results in both Asian and European eyes. The divergence between objective metrics and patient-reported satisfaction underlines the necessity of including subjective outcomes in multifocal IOL assessments.