: This study shows that corneal topographic and pachymetric characteristics of keratoconus may be different in atopic eyes from those in nonatopic eyes. Atopic keratoconus patients could possibly be evaluated as a separate entity in keratoconus disease.

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Purpose: To evaluate the visual quality, visual performance, and patient satisfaction after the implantation of the last generation supplementary intraocular lens (1stQ AddOn Trifocal) for achieving near vision spectacle-independence in pseudophakic patients who had primary monofocal capsular bag implantation. Methods: Patients who underwent monofocal lens surgery in the past year, and who expressed their explicit desire to become spectacle-independent were included in this prospective observational study. Uncorrected and corrected distance, intermediate and near visual acuities (CDVA, UDVA, DCIVA, UIVA, CNVA, and UNVA), refractive outcomes, lens positioning, contrast sensitivity and patient satisfaction were assessed 6 months postoperatively. Results: About 28 eyes of 18 patients were evaluated. No intra- or postoperative complications (iris chafing, iris capture, interlenticular opacification, IOL-dislocation, etc.) could be observed. The postoperative mean UDVA and CDVA were 0.05 ± 0.08 and 0.01 ± 0.03 (logMAR), respectively. The mean UNVA improved from the preoperative 0.50 ± 0.23 to 0.02 ± 0.05 (logMAR), postoperatively ( p = 0.0104). The postoperative mean UIVA and DCIVA were 0.06 ± 0.020 and 0.01 ± 0.00 (logMAR), respectively. Twenty-five eyes (89%) had a residual spherical equivalent within 1.0 D from the target refraction, emmetropia. Contrast sensitivity measured in photopic and mesopic conditions were statistically indifferent from the preoperative curves. All patients had better visual function and quality scores compared to the preoperative responses. The highest improvement could be achieved in near vision activities, dependency, and limitation of social functioning. Conclusion: The 1stQ AddOn Trifocal lens represents a safe and effective option for pseudophakic patients aiming for high quality, spectacle-free vision.