{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T21:44:49Z","timestamp":1791755089625,"version":"4.3.4"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To evaluate the visual performance of a diffractive bifocal intraocular lens (IOL) with +\u20094.0 D near addition (ZMB00) and a diffractive trifocal IOL with +\u20092.17 D and +\u20093.25 D near addition (AcrySof IQ PanOptix TFNT00), we investigated the 10-week postoperative parameters after cataract surgery in which ZMB00 or TFNT00 lenses were implanted bilaterally from 2011 to 2020 (with a 3-month interval between implantation of the right and left lenses). The study included 1448 eyes of 724 patients. The diffractive bifocal group comprised 1326 eyes of 663 patients (aged 67.0\u2009\u00b1\u20097.8\u00a0years; females\/males, 518\/145), and the diffractive trifocal group comprised 122 eyes of 61 patients (aged 66.6\u2009\u00b1\u20097.3\u00a0years; females\/males, 35\/26). A linear mixed-effects model using data for both eyes, with strict adjustments for sex, age, subjective refraction spherical equivalent, subjective refraction cylinder, corneal astigmatism, axial length, corneal higher-order aberrations, and pupil diameter, ensured statistical validity. Uncorrected near visual acuity and higher-order aberrations (ocular\/internal, scaled to a pupil size of 4\u00a0mm) (Wavefront_4mm_postoperative_Ocular\/Internal_Spherical) were significantly better in the bifocal group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.00068, Wald test). Uncorrected intermediate visual acuity, contrast sensitivity (6.3\/4.0\/2.5\/1.6\/1.0\/0.7 degrees), and contrast sensitivity with glare (4.0\/1.6\/1.0\/0.7 degrees) were significantly better in the trifocal group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.00068, Wald test).<\/jats:p>","DOI":"10.1038\/s41598-024-55926-5","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T12:02:47Z","timestamp":1709553767000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Comparison of visual performance between diffractive bifocal and diffractive trifocal intraocular lenses"],"prefix":"10.1038","volume":"14","author":[{"given":"Junya","family":"Kawamura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1948-7408","authenticated-orcid":false,"given":"Hirotaka","family":"Tanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Shojo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomofusa","family":"Yamauchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Takase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Tabuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,4]]},"reference":[{"key":"55926_CR1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s40662-017-0076-8","volume":"4","author":"M Lawless","year":"2017","unstructured":"Lawless, M. et al. Visual and refractive outcomes following implantation of a new trifocal intraocular lens. Eye Vis. 4, 10 (2017).","journal-title":"Eye Vis."},{"key":"55926_CR2","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.ajo.2017.09.016","volume":"184","author":"T Kohnen","year":"2017","unstructured":"Kohnen, T. et al. Visual performance of a quadrifocal (Trifocal) intraocular lens following removal of the crystalline lens. Am. J. Ophthalmol. 184, 52\u201362 (2017).","journal-title":"Am. J. Ophthalmol."},{"key":"55926_CR3","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.jcrs.2018.12.003","volume":"45","author":"A Akman","year":"2019","unstructured":"Akman, A., Asena, L., Ozturk, C. & G\u00fcng\u00f6r, S. G. Evaluation of quality of life after implantation of a new trifocal intraocular lens. J. Cataract. Refract. Surg. 45, 130\u2013134 (2019).","journal-title":"J. Cataract. Refract. Surg."},{"key":"55926_CR4","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/s12886-017-0462-y","volume":"17","author":"JL Garc\u00eda-P\u00e9rez","year":"2017","unstructured":"Garc\u00eda-P\u00e9rez, J. L., Gros-Otero, J., S\u00e1nchez-Ramos, C., Bl\u00e1zquez, V. & Contreras, I. Short term visual outcomes of a new trifocal intraocular lens. BMC Ophthalmol. 17, 72 (2017).","journal-title":"BMC Ophthalmol."},{"key":"55926_CR5","first-page":"403","volume":"6","author":"CP Bautista","year":"2012","unstructured":"Bautista, C. P., Gonz\u00e1lez, D. C. & G\u00f3mez, A. C. Evolution of visual performance in 70 eyes implanted with the Tecnis(\u00ae) ZMB00 multifocal intraocular lens. Clin. Ophthalmol. 6, 403\u2013407 (2012).","journal-title":"Clin. Ophthalmol."},{"key":"55926_CR6","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.12659\/MSM.890585","volume":"20","author":"W Lubi\u0144ski","year":"2014","unstructured":"Lubi\u0144ski, W., Gronkowska-Serafin, J. & Podbor\u0105czy\u0144ska-Jodko, K. Clinical outcomes after cataract surgery with implantation of the Tecnis ZMB00 multifocal intraocular lens. Med. Sci. Monit. 20, 1220\u20131226 (2014).","journal-title":"Med. Sci. Monit."},{"key":"55926_CR7","doi-asserted-by":"publisher","first-page":"2330","DOI":"10.1016\/j.jcrs.2015.11.012","volume":"41","author":"T Kohnen","year":"2015","unstructured":"Kohnen, T. First implantation of a diffractive quadrafocal (trifocal) intraocular lens. J. Cataract. Refract. Surg. 41, 2330\u20132332 (2015).","journal-title":"J. Cataract. Refract. Surg."},{"key":"55926_CR8","doi-asserted-by":"publisher","first-page":"1560","DOI":"10.1136\/bjophthalmol-2013-304010","volume":"97","author":"S Schmickler","year":"2013","unstructured":"Schmickler, S., Bautista, C. P., Goes, F., Shah, S. & Wolffsohn, J. S. Clinical evaluation of a multifocal aspheric diffractive intraocular lens. Br. J. Ophthalmol. 97, 1560\u20131564 (2013).","journal-title":"Br. J. Ophthalmol."},{"key":"55926_CR9","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.ophtha.2013.06.034","volume":"121","author":"G Cillino","year":"2014","unstructured":"Cillino, G. et al. Working-age cataract patients: Visual results, reading performance, and quality of life with three diffractive multifocal intraocular lenses. Ophthalmology 121, 34\u201344 (2014).","journal-title":"Ophthalmology"},{"key":"55926_CR10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0068236","volume":"8","author":"T Yamauchi","year":"2013","unstructured":"Yamauchi, T. et al. Comparison of visual performance of multifocal intraocular lenses with same material monofocal intraocular lenses. PLoS One 8, e68236 (2013).","journal-title":"PLoS One"},{"key":"55926_CR11","doi-asserted-by":"publisher","first-page":"15490","DOI":"10.1038\/s41598-020-72473-x","volume":"10","author":"H Tanabe","year":"2020","unstructured":"Tanabe, H., Tabuchi, H., Shojo, T., Yamauchi, T. & Takase, K. Comparison of visual performance between monofocal and multifocal intraocular lenses of the same material and basic design. Sci. Rep. 10, 15490 (2020).","journal-title":"Sci. Rep."},{"key":"55926_CR12","doi-asserted-by":"publisher","first-page":"19394","DOI":"10.1038\/s41598-022-24123-7","volume":"12","author":"H Tanabe","year":"2022","unstructured":"Tanabe, H. et al. Comparative visual performance of diffractive bifocal and rotationally asymmetric refractive intraocular lenses. Sci. Rep. 12, 19394 (2022).","journal-title":"Sci. Rep."},{"key":"55926_CR13","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1016\/S0886-3350(02)01648-6","volume":"29","author":"R Mont\u00e9s-Mic\u00f3","year":"2003","unstructured":"Mont\u00e9s-Mic\u00f3, R. & Ali\u00f3, J. L. Distance and near contrast sensitivity function after multifocal intraocular lens implantation. J. Cataract. Refract. Surg. 29, 703\u2013711 (2003).","journal-title":"J. Cataract. Refract. Surg."},{"key":"55926_CR14","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1016\/j.jcrs.2009.01.031","volume":"35","author":"MA Woodward","year":"2009","unstructured":"Woodward, M. A., Randleman, J. B. & Stulting, R. D. Dissatisfaction after multifocal intraocular lens implantation. J. Cataract. Refract. Surg. 35, 992\u2013997 (2009).","journal-title":"J. Cataract. Refract. Surg."},{"key":"55926_CR15","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1016\/S0161-6420(99)00704-6","volume":"106","author":"RF Steinert","year":"1999","unstructured":"Steinert, R. F., Aker, B. L., Trentacost, D. J., Smith, P. J. & Tarantino, N. A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens. Ophthalmology 106, 1243\u20131255 (1999).","journal-title":"Ophthalmology"},{"key":"55926_CR16","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1136\/bjo.85.7.816","volume":"85","author":"S Pieh","year":"2001","unstructured":"Pieh, S. et al. Halo size under distance and near conditions in refractive multifocal intraocular lenses. Br. J. Ophthalmol. 85, 816\u2013821 (2001).","journal-title":"Br. J. Ophthalmol."},{"key":"55926_CR17","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1016\/S0161-6420(03)00722-X","volume":"110","author":"M Leyland","year":"2003","unstructured":"Leyland, M. & Zinicola, E. Multifocal versus monofocal intraocular lenses in cataract surgery: A systematic review. Ophthalmology 110, 1789\u20131798 (2003).","journal-title":"Ophthalmology"},{"key":"55926_CR18","doi-asserted-by":"publisher","first-page":"2015","DOI":"10.1016\/j.jcrs.2006.08.029","volume":"32","author":"WW H\u00fctz","year":"2006","unstructured":"H\u00fctz, W. W., Eckhardt, H. B., R\u00f6hrig, B. & Grolmus, R. Reading ability with 3 multifocal intraocular lens models. J. Cataract. Refract. Surg. 32, 2015\u20132021 (2006).","journal-title":"J. Cataract. Refract. Surg."},{"key":"55926_CR19","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1001\/archopht.120.1.23","volume":"120","author":"S Pieh","year":"2002","unstructured":"Pieh, S. et al. Quantitative performance of bifocal and multifocal intraocular lenses in a model eye: point spread function in multifocal intraocular lenses. Arch. Ophthalmol. 120, 23\u201328 (2002).","journal-title":"Arch. Ophthalmol."},{"key":"55926_CR20","doi-asserted-by":"publisher","first-page":"146","DOI":"10.3928\/1081597X-20160114-01","volume":"32","author":"B Cochener","year":"2016","unstructured":"Cochener, B. Prospective clinical comparison of patient outcomes following implantation of trifocal or bifocal intraocular lenses. J. Refract. Surg. 32, 146\u2013151 (2016).","journal-title":"J. Refract. Surg."},{"key":"55926_CR21","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1016\/j.jcrs.2007.02.037","volume":"33","author":"U Mester","year":"2007","unstructured":"Mester, U., Hunold, W., Wesendahl, T. & Kaymak, H. Functional outcomes after implantation of Tecnis ZM900 and Array SA40 multifocal intraocular lenses. J. Cataract. Refract. Surg. 33, 1033\u20131040 (2007).","journal-title":"J. Cataract. Refract. Surg."},{"key":"55926_CR22","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/j.jcrs.2006.10.035","volume":"33","author":"A Denoyer","year":"2007","unstructured":"Denoyer, A., Le Lez, M. L., Majzoub, S. & Pisella, P. J. Quality of vision after cataract surgery after Tecnis Z9000 intraocular lens implantation: Effect of contrast sensitivity and wavefront aberration improvements on the quality of daily vision. J. Cataract. Refract. Surg. 33, 210\u2013216 (2007).","journal-title":"J. Cataract. Refract. Surg."},{"key":"55926_CR23","doi-asserted-by":"publisher","first-page":"1508","DOI":"10.1016\/j.ophtha.2008.04.017","volume":"115","author":"S Cillino","year":"2008","unstructured":"Cillino, S. et al. One-year outcomes with new-generation multifocal intraocular lenses. Ophthalmology 115, 1508\u20131516 (2008).","journal-title":"Ophthalmology"},{"key":"55926_CR24","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1016\/j.ajo.2009.10.022","volume":"149","author":"M Packer","year":"2010","unstructured":"Packer, M. et al. Evaluation of the aspheric tecnis multifocal intraocular lens: One-year results from the first cohort of the food and drug administration clinical trial. Am. J. Ophthalmol. 149, 577-584.e571 (2010).","journal-title":"Am. J. Ophthalmol."},{"key":"55926_CR25","doi-asserted-by":"publisher","first-page":"300","DOI":"10.3928\/1081597X-20080301-13","volume":"24","author":"FJ Goes","year":"2008","unstructured":"Goes, F. J. Visual results following implantation of a refractive multifocal IOL in one eye and a diffractive multifocal IOL in the contralateral eye. J. Refract. Surg. 24, 300\u2013305 (2008).","journal-title":"J. Refract. Surg."},{"key":"55926_CR26","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1097\/APO.0000000000000253","volume":"8","author":"RR Sudhir","year":"2019","unstructured":"Sudhir, R. R., Dey, A., Bhattacharrya, S. & Bahulayan, A. AcrySof IQ PanOptix intraocular lens versus extended depth of focus intraocular lens and trifocal intraocular lens: a clinical overview. Asia Pac. J. Ophthalmol. (Phila) 8, 335\u2013349 (2019).","journal-title":"Asia Pac. J. Ophthalmol. (Phila)"},{"key":"55926_CR27","doi-asserted-by":"publisher","first-page":"507","DOI":"10.3928\/1081597X-20180530-02","volume":"34","author":"B Cochener","year":"2018","unstructured":"Cochener, B., Boutillier, G., Lamard, M. & Auberger-Zagnoli, C. A comparative evaluation of a new generation of diffractive trifocal and extended depth of focus intraocular lenses. J. Refract. Surg. 34, 507\u2013514 (2018).","journal-title":"J. Refract. Surg."},{"key":"55926_CR28","doi-asserted-by":"publisher","first-page":"492","DOI":"10.3928\/1081-597X-20070501-13","volume":"23","author":"K Pesudovs","year":"2007","unstructured":"Pesudovs, K. Takagi glare tester CGT-1000 for contrast sensitivity and glare testing in normal individuals and cataract patients. J. Refract. Surg. 23, 492\u2013498 (2007).","journal-title":"J. Refract. Surg."},{"key":"55926_CR29","doi-asserted-by":"publisher","first-page":"1631","DOI":"10.1016\/j.jcrs.2015.08.011","volume":"41","author":"SM Jonker","year":"2015","unstructured":"Jonker, S. M. et al. Comparison of a trifocal intraocular lens with a +3.0 D bifocal IOL: Results of a prospective randomized clinical trial. J. Cataract. Refract. Surg. 41, 1631\u20131640 (2015).","journal-title":"J. Cataract. Refract. Surg."},{"key":"55926_CR30","doi-asserted-by":"publisher","first-page":"612","DOI":"10.5301\/ejo.5000777","volume":"26","author":"AB Plaza-Puche","year":"2016","unstructured":"Plaza-Puche, A. B., Alio, J. L., Sala, E. & Mojzis, P. Impact of low mesopic contrast sensitivity outcomes in different types of modern multifocal intraocular lenses. Eur. J. Ophthalmol. 26, 612\u2013617 (2016).","journal-title":"Eur. J. Ophthalmol."},{"key":"55926_CR31","doi-asserted-by":"publisher","first-page":"666","DOI":"10.3928\/1081597X-20140903-06","volume":"30","author":"P Mojzis","year":"2014","unstructured":"Mojzis, P., Kukuckova, L., Majerova, K., Liehneova, K. & Pi\u00f1ero, D. P. Comparative analysis of the visual performance after cataract surgery with implantation of a bifocal or trifocal diffractive IOL. J. Refract. Surg. 30, 666\u2013672 (2014).","journal-title":"J. Refract. Surg."},{"key":"55926_CR32","doi-asserted-by":"publisher","first-page":"659","DOI":"10.3928\/1081597X-20160630-01","volume":"32","author":"R Bilbao-Calabuig","year":"2016","unstructured":"Bilbao-Calabuig, R. et al. Comparison between mix-and-match implantation of bifocal intraocular lenses and bilateral implantation of trifocal intraocular lenses. J. Refract. Surg. 32, 659\u2013663 (2016).","journal-title":"J. Refract. Surg."},{"key":"55926_CR33","doi-asserted-by":"publisher","first-page":"2878","DOI":"10.1167\/iovs.09-4494","volume":"51","author":"M Marella","year":"2010","unstructured":"Marella, M. et al. The psychometric validity of the NEI VFQ-25 for use in a low-vision population. Invest. Ophthalmol. Vis. Sci. 51, 2878\u20132884 (2010).","journal-title":"Invest. Ophthalmol. Vis. Sci."},{"key":"55926_CR34","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1186\/1477-7525-3-65","volume":"3","author":"Y Suzukamo","year":"2005","unstructured":"Suzukamo, Y. et al. Psychometric properties of the 25-item national eye institute visual function questionnaire (NEI VFQ-25), Japanese version. Health Qual. Life Outcomes 3, 65 (2005).","journal-title":"Health Qual. Life Outcomes"},{"key":"55926_CR35","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.survophthal.2018.08.003","volume":"64","author":"V Vargas","year":"2019","unstructured":"Vargas, V. et al. Methods for the study of near, intermediate vision, and accommodation: an overview of subjective and objective approaches. Surv. Ophthalmol. 64, 90\u2013100 (2019).","journal-title":"Surv. Ophthalmol."},{"key":"55926_CR36","doi-asserted-by":"publisher","first-page":"986","DOI":"10.1016\/j.jcrs.2003.10.022","volume":"30","author":"M Packer","year":"2004","unstructured":"Packer, M., Fine, I. H., Hoffman, R. S. & Piers, P. A. Improved functional vision with a modified prolate intraocular lens. J. Cataract. Refract. Surg. 30, 986\u2013992 (2004).","journal-title":"J. Cataract. Refract. Surg."},{"key":"55926_CR37","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1016\/j.jcrs.2004.08.049","volume":"31","author":"R Bellucci","year":"2005","unstructured":"Bellucci, R. et al. Visual acuity and contrast sensitivity comparison between Tecnis and AcrySof SA60AT intraocular lenses: A multicenter randomized study. J. Cataract. Refract. Surg. 31, 712\u2013717 (2005).","journal-title":"J. Cataract. Refract. Surg."},{"key":"55926_CR38","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2019","unstructured":"R Core Team. R: A language and environment for statistical computing (R Foundation for Statistical Computing, 2019)."},{"key":"55926_CR39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v045.i03","volume":"45","author":"S van Buuren","year":"2011","unstructured":"van Buuren, S. & Groothuis-Oudshoorn, K. mice: Multivariate imputation by chained equations in R. J. Stat. Softw. 45, 1\u201367 (2011).","journal-title":"J. Stat. Softw."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-55926-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-55926-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-55926-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T12:07:54Z","timestamp":1709554074000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-55926-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,4]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["55926"],"URL":"https:\/\/doi.org\/10.1038\/s41598-024-55926-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,4]]},"assertion":[{"value":"26 April 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 February 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"5292"}}