Purpose: To observe the outcome of bilateral femtosecond laser-assisted clear lens extraction with trifocal intraocular lens (IOL) implantation for presbyopia correction and evaluate its feasibility in early presbyopic adults.
Methods: Prospective case series of eyes with clear crystalline lenses that underwent femtosecond laser-assisted lens extraction and trifocal IOL (Acrysof IQ PanOptix, Model TFNT00, Alcon) implantation between 2021 and 2023 were followed up for at least 3 months after surgery. Outcome measures included monocular uncorrected visual acuity at near (UNVA, 40 cm), intermediate (UIVA, 60 cm), and distance (UDVA, 5 m), monocular manifest refraction, corrected distance visual acuity (CDVA), defocus curve assessment, and spectacle independence at both near and distance.
Results: A total of 60 eyes from 30 consecutive patients were included, and their mean age was 50.4± 6.5 years. After surgery, the mean UNVA (LogMAR) increased from 0.28± 0.16 to 0.08± 0.07, UIVA increased from 0.25± 0.12 to 0.09± 0.06, and UDVA increased from 0.27± 0.21 to 0.01± 0.08. The enhancements of UNVA, UIVA and UDVA were all significant (P < 0.05). The optometric results showed that the mean postoperative spherical equivalent (SE) was − 0.21± 0.24 D, and the mean postoperative CDVA (LogMAR) was − 0.00± 0.06. The preoperative spectacle independences at near and distance were 46.7% (14/30) and 56.7% (17/30), respectively, and both increased to 100% at 3 months after surgery.
Conclusion: Satisfactory visual outcomes and safe surgical procedures were observed in this study, which demonstrate that bilateral femtosecond laser-assisted clear lens extraction with PanOptix IOL implantation could be a feasible approach for presbyopia correction in working-age Chinese patients.

Keywords: presbyopia-correcting, clear lens extraction, refractive lens exchange, trifocal intraocular lens, refractive surgery