Visual Field Stability After Trifocal Intraocular Lens Implantation: A Longitudinal Standard Automated Perimetry Study

Purpose: To investigate whether implantation of a diffractive trifocal intraocular lens (IOL) is followed by systematic changes in standard automated perimetry (SAP) global indices and test reliability in a paired pre–post design. Methods: Patients who underwent uncomplicated cataract surgery with PanOptix trifocal IOL implantation and completed SAP before and after surgery under the same institutional protocol were analyzed. Baseline SAP was obtained within 6 months preoperatively, and follow-up SAP was obtained within 12 months postoperatively. Unreliable examinations were excluded, and right and left eyes were analyzed separately. Outcomes included mean deviation (MD), pattern standard deviation (PSD), visual field index (VFI), foveal threshold, and reliability indices. Pre- and postoperative values were compared using paired tests. Results: Reliability remained comparable to baseline. False-positive rates were 1.7% ± 2.6% preoperatively versus 1.6% ± 1.6% postoperatively in right eyes (p = 0.88) and 1.5% ± 2.1% versus 1.3% ± 1.9% in left eyes (p = 0.73). False-negative rates were 0.9% ± 1.5% versus 1.7% ± 2.1% in right eyes (p = 0.24) and 1.5% ± 2.2% versus 1.9% ± 2.5% in left eyes (p = 0.62). Global indices showed no significant pre–post differences: MD was − 1.3 ± 1.2 dB versus − 1.2 ± 0.9 dB in right eyes (p = 0.54) and − 1.7 ± 1.6 dB versus − 1.5 ± 1.6 dB in left eyes (p = 0.65). VFI was 99.0% ± 0.4% versus 98.9% ± 0.9% in right eyes (p = 0.77) and 98.2% ± 0.8% versus 97.8% ± 1.8% in left eyes (p = 0.45). PSD was unchanged (right p = 0.34; left p = 0.08). Foveal threshold decreased slightly in right eyes (35.9 ± 1.3 to 35.0 ± 1.1 dB, p = 0.06). Conclusion: Trifocal IOL implantation was not associated with clinically meaningful deterioration in SAP global indices or reliability measures during follow-up.