Introduction: In this study, clinical performance of a hydrophobic acrylic diffractive trifocal intraocular lens (IOL) with double C-loop haptics was evaluated in Japanese cataract eyes. Methods: Twenty-three patients had bilateral cataract surgery with the implantation of a trifocal IOL with double C-loop haptics. Postoperative examinations at 6 months included assessing uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) at 5 m, uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA) at 80 cm, uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) at 40 cm. Binocular defocus, contrast sensitivity, spectacle independence, symptoms of photic phenomena and quality of vision (QOV) were also observed. Results: Twenty-three patients received 46 IOLs binocularly. Manifest refraction spherical equivalent was -0.227 ± 0.385 D (mean ± standard deviation) at 6 months postoperatively. Binocular UDVA, binocular UIVA and binocular UNVA were -0.101 ± 0.065, -0.021 ± 0.079 and 0.022 ± 0.095 logMAR units, respectively. Binocular CDVA, binocular DCIVA and binocular DCNVA were -0.151 ± 0.044, -0.042 ± 0.067 and -0.011 ± 0.080 logMAR, respectively. Binocular CDVA of 0.00 logMAR or better was obtained in the defocus from -3.0 D until ? 0.5 D. Only 8.7% of patients required the use of spectacles postoperatively. There were no symptoms of glare, halo and light disturbance in 78.3%, 56.5% and 69.6% of patients, respectively. QOV scores significantly improved postoperatively (P \ 0.0001). Conclusion:The hydrophobic acrylic trifocal IOL with double C-loop haptics provides good visual performance at all distances and produces high spectacle independence rate and patient satisfaction. Trial Registration Number: NCT04699266 (Clinicaltrials.gov).
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