Visual quality after implantation of trifocal intraocular lenses with different diopter values in the two eyes

This retrospective, non-randomized, comparative study aimed to evaluate visual quality and patient satisfaction after implantation of trifocal intraocular lens (IOL) with different diopter values in the two eyes.It was conducted from September 2021 to June 2023 at Lixiang Eye Hospital of Soochow University. Patients were divided into two groups.There were 62 eyes (31 patients) with IOL diopter difference > 1.0D (degree) in the study group and 62 eyes (31 patients) with IOL diopter difference ≤ 1.0D in the control group. Far, intermediate, and near vison, modulation transfer function (MTF), Strehl ratio (SR), higher-order aberrations, pupil shift during day and night, tertiary visual function, subjective visual quality in both groups were comparatively assessed.There were no statistically significant differences in uncorrected distance visual acuity (UDVA) and uncorrected intermediate visual (UIVA) for both eyes and the right eyes between the two groups. There were also no statistically significant differences in MTF, SR, simultaneous vision, fusion vision, coma, spherical aberration, VF-14-CN scores ,UDVA, UIVA and uncorrected near visual acuity (UNVA) for the left eyes between the two groups. UNVA levels of both eyes and the right eyes, higher-order, trefoil aberrations and glare were better in the control group than in the study group. Stereopsis was improved in the control group versus the study group. Night glare correlated with IOL diopter difference. The spectacle independence rate reached 100% in both groups.The study group had corrected anisometropia in both eyes, but stereopsis and near vision were inferior in these patients compared with the control group.