Abstract
BACKGROUND: The visual and refractive performance of Bi-Flex Liberty 677MY trifocal and 677 MTY trifocal toric capsular bag intraocular lenses (IOL) were evaluated. METHODS: This prospective study included 190 eyes of 95 presbyopic patients with cataracts or clear lenses who underwent phacoemulsification and trifocal/trifocal toric IOL implantation to correct presbyopia. The patients were evaluated on postoperative -day 1, -week 1, -month 1, and –month 3. In addition to the complete eye examination, contrast sensitivity function test, visual acuity and contrast sensitivity defocus curves, visual quality, and patient satisfaction questionnaires were evaluated. RESULTS: 95.5% of the patients had a binocular UDVA of 0.00 logMAR (20/20), and 100% had a binocular UDVA of 0.02 logMAR or better (≥ 20/32). 83.9% of the patients had a binocular UIVA of 0.00 logMAR (20/20), and 100% had a binocular UIVA of 0.02 logMAR or better (≥ 20/32). 96.8% of the patients had a binocular UNVA of 0.00 logMAR (20/20), and 100% had a binocular UNVA of 0.01 logMAR or better (≥ 20/25). VA was < 0.1 logMAR over a broad range of defocus, ranging from approximately + 0.00 to -2.50 D. While 94.4% of patients reported never using spectacles, 5.6% reported using them rarely. Photopic contrast sensitivities (CS) with and without glare were within the normal range. Mesopic CS values without glare were also within the normal range. However, mesopic CS values with glare were low for spatial frequencies of 12 and 18 cpd. 31% of the subjects in our study reported haloes; however, 88% or 9% described them as “not at all bothersome” or “a little bothersome.” CONCLUSIONS: Liberty trifocal and trifocal toric IOL implantation provides good visual outcomes at all distances following cataract or clear lens extraction with an insignificant amount of dysphotopsic complaints. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12886-026-04735-7.