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Background: To prospectively evaluate binocular visual outcomes after implantation of trifocal intraocular lenses (IOLs) with high-water-content hydrophobic acrylic material in Japanese patients., Methods: In 59 patients (mean age 65.1 ± 7.9 years), Clareon PanOptix (CNWTT0: Alcon) with a high-water-content hydrophobic acrylic material was implanted bilaterally. Three months postoperatively, binocular uncorrected visual acuity (BUCVA) and distance-corrected visual acuity (BDCVA) at distances of 5 m, 80, 60, and 40 cm, binocular defocus curves, and binocular photopic contrast sensitivity were examined. Subjective symptoms (night vision disturbance, glare, halos, haze, or blurry vision) were also assessed., Results: The mean postoperative BUCVA/BDCVA at 5 m, 80 cm, 60 cm, and 40 cm were - 0.115/-0.163, -0.052/-0.047, -0.054/-0.075, and - 0.043/-0.067 logMAR, respectively. A smooth defocus curve, contrast sensitivity within the normal range, and acceptable subjective symptom rates were obtained., Conclusions: The trifocal IOL, composed of a high-water-content hydrophobic acrylic material, provides good continuous binocular vision from distance to near., Trial Registration: This investigator-initiated study was registered in the Japan Registry for Clinical Trials (identifier: jRCTs032220042) on April 26, 2022., (© 2024. The Author(s).)

Purpose: To evaluate differences in subjective and objective refractions in eyes with extended-depth-of-focus intraocular lenses (EDOF IOLs) using echelette optics, and the effect of the light wavelength used during examinations., Methods: In the prospective study, subjective and objective refractions of 128 eyes of 64 patients were examined 3 months after implantation of the EDOF IOLs (ZXR00V, Johnson & Johnson Surgival Vision). Objective refractions were measured using an autorefractor with a near-infrared (NIR) light source. Clinical differences in the spherical, cylindrical and spherical equivalent (SE) refractions between the subjective and objective refractions were evaluated. Then, lens powers of monofocal, EDOF and diffractive bifocal IOLs in the use of a 850-nm light source were measured experimentally for using a lensmeter, and the differences from the monofocal IOLs were calculated., Results: The mean objective refractions were more myopic (p < 0.001) than the subjective refractions; the differences in the spherical, cylindrical and SE refractions were -0.71, -0.26 and -0.84 dioptre, respectively. Experimental investigation resulted that there was the mean difference of 0.83 D with the EDOF from monofocal IOLs at 850 nm, while the difference was -0.20 D with bifocal IOLs., Conclusions: The diffractive EDOF IOLs using echelette gratings inherently induced constant differences in the subjective and objective refractions, which arose from the chromatic difference in IOL powers for the visible and NIR lights., (© 2020 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)

Purpose: To evaluate the effectiveness and safety of a new trifocal intraocular lens (IOL) after cataract removal in patients living in Japan., Study Design: Prospective multicenter clinical study., Methods: One hundred and thirty-five eyes of 68 patients (19 men, 49 women; mean age, 66.3 ± 7.4 years) were followed for 6 months. Trifocal IOLs with focal points at near, intermediate, and distance were implanted bilaterally in eyes with less than 1 diopter of corneal astigmatism. The visual acuity (VA) at distance, 60 and 40 centimeters (cm), and contrast sensitivities were measured. Patients completed quality-of-life questionnaires preoperatively and postoperatively., Results: The mean bilateral logarithm of the minimum angle of resolution VA at 5 meters (m), 60 cm, and 40 cm were, respectively: uncorrected, - 0.104 ± 0.095, - 0.065 ± 0.111, and - 0.042 ± 0.105; and distance-corrected, - 0.197 ± 0.076, - 0.112 ± 0.111, and - 0.073 ± 0.111. The contrast sensitivities at distance and near were within the normal range at all spatial frequencies under photopic conditions. Patients reported complete spectacle independence in 75.0% of cases. Total use of spectacles was reported by 1.5% and partial by 20.6%; the purpose of spectacle use was primarily for near visual tasks. Mild-to-moderate glare was reported by 65.7% of patients and halos by 70.1%; only 1.5% of subjects reported severe glare and halos., Conclusions: This new trifocal IOL provides equally good uncorrected VAs at distance, intermediate, and near, and decreases spectacle dependence in daily life. Patients frequently report mild-to-moderate glare and halos, and patients should be informed about these before implantation.

Purpose: To conduct a nationwide prospective cohort study of multifocal intraocular lens (mfIOL) implantation to determine clinical outcomes and patient satisfaction and assess factors affecting patient satisfaction., Design: Prospective, multicenter cohort study., Methods: Setting: institutional; patient population: a total of 1051 consecutive patients (1631 eyes) who underwent cataract surgery with mfIOL implantation at 65 Japanese institutions from January 2017 to June 2018. The inclusion criteria were patient age of 20 years and older and cataract surgery with mfIOL implantation. The exclusion criteria were the absence of informed consent, completed postoperative questionnaires, and no record of the IOL models implanted., Observation Procedures: the uncorrected and corrected distance visual acuities (UDVAs and CDVAs) at 5 m; uncorrected VAs at 50, 40, and 30 cm; and questionnaires regarding subjective visual symptoms, spectacle independence, and surgical satisfaction were assessed 3 months postoperatively., Main Outcome Measure: odds ratios for the overall surgical satisfaction were computed for the preoperative/postoperative factors., Results: We analyzed data from 1384 eyes of 871 patients. The UDVAs and CDVAs, respectively, improved significantly at 3 months postoperatively. The intermediate and near VAs varied with the IOL models; 68.4% of patients were almost or totally spectacle-independent; 3.9% of patients reported surgical dissatisfaction. In patients implanted bilaterally with the same mfIOLs, postoperative blurred vision and/or decreased contrast was the most important factor in the overall surgical satisfaction., Conclusions: MfIOLs provided good visual outcomes and high satisfaction rates in this large patient cohort. The difference in the outcomes with the extended depth-of-focus IOLs did not differ significantly from the bifocal IOLs. The postoperative blurred vision is important to the overall surgical satisfaction., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the binocular visual function and depth of focus after staged implantation of diffractive multifocal intraocular lenses (MIOLs) with 3 different add powers following cataract removal., Design: Prospective comparative case series., Methods: Setting: Institutional., Study Population: Both eyes of 56 patients that underwent staged implantation of bifocal IOLs., Intervention: In the first eye, MIOLs with a +4.0-diopter (D) add power were implanted. Based on outcomes at 1 week postoperatively and patient preference for near vision, 1 of 3 near add powers-+4.0 D (group MM), +3.25 D (group ML), or +2.75 D (group MK)-was implanted in the fellow eye., Main Outcome Measure(s): Three months postoperatively, the binocular uncorrected and distance-corrected visual acuities (BUCVA and BDCVA, respectively) at 5.0, 1.0, 0.5, 0.4, and 0.3 meters; binocular defocus curves; contrast sensitivity; and near stereopsis were measured., Results: The MM, ML, and MK groups included 21, 18, and 17 patients, respectively. The mean BUCVA in the MM group was significantly (P = .003) worse than that in the MK group at 0.5 meter. The BDCVAs at 0.5 meter in the ML and MK groups were significantly (P < .02) better than that in the MM group. The defocus curves with the -2.0 D refraction differed significantly (P < .001) between the MM and MK groups. The binocular contrast sensitivity and stereopsis values did not differ significantly., Conclusions: Staged implantation of different add powers obtained better binocular intermediate visual acuity without degradation of visual function., (Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: To assess the safety and efficacy of femtosecond laser-assisted cataract surgery (FLACS) in Japanese eyes., Study Design: Retrospective case series., Methods: The clinical records of 529 consecutive eyes of 312 Japanese patients who underwent FLACS from 2013 to 2016 were reviewed. The completion rates of anterior capsulotomy and corneal incisions using the femtosecond laser (LenSx, Alcon) and the number of attempts to achieve secure docking between the cornea and laser system were recorded. The uncorrected and corrected distance visual acuities (VAs) and uncorrected and distance-corrected near VAs 1 week postoperatively were evaluated., Results: Anterior capsulotomies were completed in 98.7% of eyes. The corneal incisions were incomplete in 8.3%, which included eyes with arcus senilis and neovascularization. The mean corneal endothelial cell reduction rate was 5.5%. Multiple docking attempts were required in 22.9% of eyes, while canthotomy was performed in two eyes. The postoperative VAs were favorable., Conclusion: FLACS was safe and reliable in Japanese eyes. Further improvements in docking are required to accommodate small corneas and narrow palpebral spaces.

Purpose: To assess the clinical outcomes of currently used refractive surgery procedures performed in 2015., Design: Prospective, multicenter cohort study., Methods: This prospective study included 15 011 eyes of 7622 consecutive patients who underwent laser in situ keratomileusis (LASIK), surface ablation, refractive lenticule extraction (ReLEx), or phakic intraocular lens (IOL) implantation at 42 major institutions. We determined the safety, efficacy, predictability, stability, and adverse events of these surgeries preoperatively and at 1 week and 1 and 3 months postoperatively., Results: Mean logMAR corrected distance visual acuity 3 months after LASIK, surface ablation, ReLEx, posterior chamber phakic IOL, or iris-supported phakic IOL implantation was -0.18 ± 0.07, -0.16 ± 0.08, -0.17 ± 0.09, -0.21 ± 0.08, and -0.10 ± 0.12, respectively; the corresponding values for logMAR uncorrected distance visual acuity were -0.15 ± 0.11, -0.12 ± 0.12, -0.12 ± 0.13, -0.15 ± 0.12, and 0.01 ± 0.21, respectively. The percentages within ±1.0 diopter (D) of the attempted correction were 96%, 93%, 97%, 99%, and 84% after LASIK, surface ablation, ReLEx, posterior chamber phakic IOL, and iris-supported phakic IOL implantation, respectively. Refractive change from 1 week to 3 months was -0.08 ± 0.07, 0.21 ± 0.63, -0.04 ± 0.41, 0.01 ± 0.31, and 0.01 ± 0.46 D, respectively. No vision-threatening complications occurred during the observation period., Conclusions: Although more prolonged follow-up is still necessary, currently used refractive surgery procedures have good safety and efficacy outcomes, yielding predictable and stable results. Contemporary LASIK, surface ablation, ReLEx, and phakic IOL implantation appear to be feasible options for the treatment of refractive errors., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose: To evaluate the visual performance in eyes with diffractive intraocular lenses (IOLs) after laser in situ keratomileusis (LASIK)., Methods: This single-center retrospective study evaluated eyes that had diffractive multifocal IOL implantation after previous LASIK or not treated with LASIK (controls). The outcomes' measures were the visual acuities (VAs) at distance and near, spherical equivalent (SE) and contrast sensitivity at one month postoperatively., Results: The study evaluated 40 eyes of 33 patients. The mean uncorrected logMAR VAs were -0.05 ± 0.13/0.00 ± 0.14 (LASIK group/control group) at distance and 0.10 ± 0.13/0.16 ± 0.18 at near. There was no statistically significant difference between the 2 groups at the VAs. The SE of the LASIK group was -0.06 ± 0.39 D, significantly lower than the control group (0.22 ± 0.45 D) (p < 0.05). The contrast sensitivity of the LASIK group at high spatial frequency was lower than the control group (p < 0.05)., Conclusion: After LASIK, the diffractive multifocal IOL provided good uncorrected distance and near VAs. However, decrease in contrast sensitivity should be considered.

Purpose: To evaluate the surface light scattering associated with diffractive multifocal intraocular lenses (IOLs) and visual function 6 years after implantation., Setting: Private practice., Design: Retrospective comparative case series., Methods: Patients received a hydrophobic acrylic IOL and were followed for more than 6 years. Six years postoperatively, the intensity of the surface light scattering was measured using a Scheimpflug camera-based anterior segment analyzer. The corrected distance (CDVA) and near (CNVA) visual acuities and contrast sensitivity were assessed., Results: Twenty eyes of 10 patients received a diffractive multifocal IOL (Acrysof Restor SA60D3, study group), and 16 eyes of 8 patients received a monofocal IOL (Acrysof SA60AT, control group). Six years postoperatively, the anterior surface light scattering was more than 100 computer compatible tape units in both groups, with no significant difference between groups (P=.417). The mean CDVA and CNVA in the study group were -0.06 logMAR ± 0.04 (SD) and -0.04 ± 0.05 logMAR, respectively; however, the CNVA in both groups decreased compared with that at 1 year, as did the CDVA in the control group. Contrast sensitivity was within normal range at all spatial frequencies in both groups. There were no significant correlations between surface light scattering and the changes in corrected visual acuities (distance or near) between 1 year and 6 years postoperatively in either group., Conclusion: Although there was significantly increased surface light scattering 6 years postoperatively, the visual function with a diffractive multifocal IOL was comparable to that with a monofocal IOL., (Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To assess whether corrected visual acuity after implantation of diffractive multifocal intraocular lenses (IOLs) varies with patient age., Setting: Tokyo Dental College, Suidobashi Hospital, Tokyo, Japan., Design: Cross-sectional study., Methods: Eyes receiving a diffractive multifocal IOL after cataract extraction were divided into 5 age decades: 30s (30 to 39 years), 40s, 50s, 60s, and 70s. Corrected distance (CDVA), distance-corrected near (DCNVA), and corrected near (CNVA) visual acuities 1 month postoperatively were compared between the age decades. Contrast sensitivity was evaluated at 3 months. Eyes with a monofocal IOL served as controls., Results: The mean CDVA was significantly better in the 30s and 50s than in the 60s and 70s (P<.033). There was significant decline in DCNVA in the 60s and 70s compared with the 30s (P<.03). The CNVA was better in the 30s than in the 50s, 60s, and 70s (P<.003), better in the 40s than in the 60s and 70s (P<.008), and better in the 50s than in the 70s (P=.001). No change in CDVA was found with the monofocal IOL. Contrast sensitivity was significantly higher in the 30s than in the 60s and 70s at 6 cycles per degree (cpd) (P<.025) and in the 50s to 70s at 18 cpd (P<.027)., Conclusion: Corrected visual acuities and contrast sensitivity were worse in older patients than in younger patients. Visual acuities with the monofocal IOL were not associated with patient age., Financial Disclosure: Dr. Bissen-Miyajima has received lecture fees from Abbott Medical Optics, Inc. Neither of the other authors has a financial or proprietary interest in any material or method mentioned., (Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the stability of visual performance after implantation of a diffractive aspheric silicone multifocal intraocular lens (MIOL)., Methods: Thirty eyes of 15 patients received the Tecnis MIOL ZM900 (Abbot Medical Optics) after cataract extraction at Tokyo Dental College Suidobashi Hospital. The uncorrected and best-corrected distance visual acuities (UCDVA, BCDVA); uncorrected, distance-corrected and best-corrected near VAs (UCNVA, DCNVA and BCNVA); spherical equivalent refraction, spectacle independence, contrast sensitivity and posterior capsule opacification (PCO) were measured at 1 week; 1, 3 and 6 months; and 1 and 2 years postoperatively., Results: Two years postoperatively, the UCDVA was 0.01 logMAR, BCDVA -0.09 logMAR, UCNVA 0.19 logMAR, DCNVA 0.1 logMAR and BCNVA 0.04 logMAR. There was no significant change from 1 week through 2 years. The percent of spherical equivalent refraction error within ± 0.5 diopter was 63.4% at 2 years. No patient required spectacles for reading; two patients have used spectacles for intermediate vision when necessary. One eye underwent Nd:YAG laser posterior capsulotomy because of PCO., Conclusion: The visual performance after implantation of the Tecnis MIOL was stable for 2 years. A low rate of PCO contributed to the long-term visual performance., (© 2010 The Authors. Journal compilation © 2010 Acta Ophthalmol.)

Purpose: To evaluate the changes in contrast visual acuity (CVA) based on the amount of myopic correction with laser in situ keratomileusis (LASIK)., Methods: In this prospective study, patients with myopia ranging from -2.0 to -14.0 diopters (D) were divided into 2 groups: those with myopia less than -6.0 D (n = 20) and those with myopia greater than -6.0 D (n = 13). The CVA was measured preoperatively and 1 week and 1 and 3 months postoperatively using Variable Contrast Visual Acuity Charts., Results: The patients with less than -6.0 D of myopia had a CVA decrease of 15% 1 week postoperatively, which recovered by 1 month, and a decrease of 2.5% 1 week and 1 month postoperatively, which recovered by 3 months. The patients with more than -6.0 D of myopia had a decrease of 15% and 2.5% at all postoperative times., Conclusions: After LASIK to correct myopia of greater than -6.0 D, there may be a persistent decrease in intermediate and low CVA. Patients should be informed preoperatively of this possible decrease in CVA.

Purpose: To determine the clinical usefulness of a five-zone refractive multifocal intraocular lens., Methods: After more than 1 year of follow-up, we evaluated the visual function of 22 patients (36 eyes) who had received the MPC-25NB intraocular lens for distance and near visual acuity, kinetic visual acuity, and near contrast sensitivity, and for patient satisfaction., Results: Of 31 study eyes with less than 1.5 diopters of preoperative keratometric astigmatism, 28 (90.3%) achieved an uncorrected distance visual acuity of 20/40 or better; best-corrected distance visual acuity was 20/20 or better in 31 (86.1%) of 36 eyes. Near visual acuity with distance correction was 20/40 or better in 20 (60.6%) of 33 eyes. Kinetic visual acuity in these patients was comparable to that in patients with monofocal intraocular lenses. Distance visual acuity and near contrast sensitivity were below normal or within the low normal range. There was no significant difference in contrast visual acuity measured by variable contrast visual acuity charts between MPC-25NB and monofocal intraocular lens-implanted eyes (P > .05). Four (22.2%) of 18 patients did not require spectacles when the intraocular lens was implanted for emmetropia. Despite some complaints about near or night vision, all patients expressed satisfaction., Conclusions: The MPC-25NB lens provides a level of distance vision comparable to that of a monofocal intraocular lens and a useful level of near visual acuity without spectacles. However, we should carefully evaluate the indication for use of MPC-25NB in patients who require good near vision or night vision.

We compared pre- and postoperative visual acuities in 45 cataract patients without ocular pathology except lens opacity (group 1) and 20 patients with ocular pathologies and lens opacity (group 2) using Variable Contrast Visual Acuity Charts. Charts 1 and 4 have 90% contrast; chart 4 has white optotypes on a black background (reverse polarity), charts 2 and 3 have 15% and 2.5% contrast, respectively. The mean preoperative visual acuities of groups 1 and 2 measured with the high-contrast Landolt optotypes ranged from 0.02-0.80 and 0.22-0.40, respectively. Visual acuity improvements between the pre- and postoperative periods ranged from 1.37-1.61 and 0.52-1.24 octaves in groups 1 and 2, respectively, with the different charts. Visual acuity improvement was poorest with chart 3. The group 1 mean preoperative visual acuity measured with chart 2 was 1.11 octaves lower than with chart 1. In group 2, the visual acuity reduction was 1.81 octaves. The relation between the visual acuities measured with the high-contrast intermediate-contrast optotypes are important for predicting postoperative visual acuity improvement. An abnormal contrast acuity profile may indicate the presence of additional ocular pathologies.

Purpose: To evaluate the efficacy of intraocular lens (IOL) implant procedures, analyzing visual function of the operated eyes and the resulting binocular vision., Method: The authors measured aniseikonia and stereoacuity in patients with both bilateral and unilateral posterior chamber intraocular lenses (PC IOLs). The aniseikonia was measured with the New Aniseikonia Test; the stereoacuity was evaluated with the Titmus Stereotest., Results: In 41 patients with bilateral PC IOLs, aniseikonia measured with the New Aniseikonia Test ranged from 0% to 4% (mean, 0.76%; standard deviation = 1.04%). The average stereoacuity evaluated with the Titmus test was 7.68 circles (less than 60 seconds; range, greater than 800 to 40 seconds of arc), with 36 of 41 patients (87.8%) showing a stereoacuity less than or equal to 100 seconds of arc. In 37 patients with unilateral PC IOLs, the aniseikonia ranged from 0% to 6% (mean, 0.97%; standard deviation = 1.13%). Their stereoacuity also ranged from greater than 800 to 40 seconds (mean, 7.67 circles) (less than 60 seconds). In this group, 34 of 37 (91.8%) patients showed a stereoacuity less than or equal to 100 seconds of arc., Conclusion: Although the problem of aniseikonia still remains, a significant number of patients attain good binocular function after unilateral and bilateral PC IOL implantation.

Contrast visual acuities were measured in 100 eyes of 75 patients who attained a best-corrected visual acuity of greater than or equal to 0.8 (20/25) after intraocular lens (IOL) implantation. The variable contrast visual acuity chart (VCVAC), with three contrast levels of 90, 15, and 2.5% and reverse polarity of 90% contrast, was used to measure contrast visual acuities. The follow-up period ranged from 3 to 35 months (mean 7.41). The mean visual acuities measured with the 90, 15, and 2.5% charts were 0.92 (SD = 0.11), 0.59 (SD = 0.13), and 0.33 (SD = 0.14), respectively. The mean visual acuity measured with the 90% reverse polarity chart was 0.97 (SD = 0.11). The decreases in visual acuities compared with the 90% contrast were 0.64 and 1.48 octaves in the 15% and the 2.5% contrast charts, respectively. The pattern of the contrast acuity profile was comparable to normal subjects, but in 28 of 100 (28%) eyes, the visual acuities measured with the reverse polarity chart were slightly better than those measured with the standard 90% contrast chart, suggesting that the glare effect still exists after IOL implantation, though to a lesser degree than in cataractous eyes.

Contrast sensitivity and glare sensitivity are often abnormal in cataract patients. However, despite significant subjective complaints, relatively good visual acuities often are obtained with high-contrast optotypes. Using Variable-Contrast Visual Acuity Charts (VCVAC), we measured visual acuities of 40 eyes of 24 normal subjects (visual acuity greater than or equal to 1.0) aged 41 to 72 years, and 40 eyes of 28 cataract patients (visual acuity greater than or equal to 0.6) aged 44 to 81 years. The VCVAC consists of 4 different charts (1-4). The contrast is 90% in charts 1 and 4, 15% in chart 2 and 2.5% in chart 3. Chart 4 is the reverse polarity of chart 1. The decrease of visual acuity compared with the high-contrast chart (chart 1) was larger in the cataract group with both in the 15% contrast (0.52 vs. 0.71 octave) and the 2.5% contrast (1.21 vs. 1.75 octaves). In cataract group, 23/40 eyes (57.5%) showed better visual acuity with chart 4 than that of chart 1. In addition to high-contrast optotypes, acuity measurements using intermediate- to low-contrast optotypes, combined with the reverse polarity chart, seem effective in analyzing the visual disabilities caused by early cataract.

Hiroko Bissen-Miyajima,1 Yuka Ota,1 Saori Yaguchi,1 Kunihiko Nakamura,1 Noriyuki Sasaki2 1Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan; 2Alcon Japan Ltd, Tokyo, JapanCorrespondence: Hiroko Bissen-Miyajima, Department of Ophthalmology, Tokyo Dental College, Suidobashi Hospital, Kandamisaki‑cho 2‑9‑18, Chiyoda‑ku, Tokyo, 101‑0061, Japan, Tel +81-3-5275-1856, Email bissen@tdc.ac.jpPurpose: To evaluate the effectiveness and safety of the AcrySof IQ PanOptix toric intraocular lens (IOL) with cylinder power of 1.0 D (TFNT20) in a Japanese population with low corneal astigmatism and compare with historical control data for nontoric IOLs.Setting: Tokyo Dental College Suidobashi Hospital, Tokyo, Japan.Design: Prospective, single-center study.Methods: Patients ≥ 20 years old received TFNT20 IOL in at least 1 eye based on Alcon Toric calculator (Holladay Total surgically induced astigmatism). Effectiveness endpoints included the percentage of eyes with refractive cylinder ≤ 0.25 D at 30– 60 days after surgery, which was compared with a historical control threshold rate of 29.2% for nontoric IOLs and refractive cylinder ≤ 0.50 D. Monocular uncorrected distance visual acuity (UDVA; 5 m), uncorrected intermediate visual acuity (UIVA; 60 cm), uncorrected near visual acuity (UNVA; 40 cm), and adverse events were evaluated.Results: Of 41 eyes implanted with TFNT20 IOLs, 37 eyes (90%) achieved refractive cylinder ≤ 0.25 D at 30– 60 days after surgery, demonstrating the superiority of TFNT20 compared with historical data (P< 0.0001). Refractive cylinder of ≤ 0.50 D was achieved by 41 eyes (100%). At 30– 60 days, mean ± SD monocular CDVA was − 0.15 ± 0.07 logMAR, UDVA was − 0.09 ± 0.09 logMAR, UIVA was − 0.00 ± 0.07 logMAR, and UNVA was 0.03 ± 0.07 logMAR. Six eyes (15%) had elevated postoperative intraocular pressure, which returned to normal and was not device-related.Conclusion: TFNT20 IOLs successfully reduced postoperative refractive cylinder and provided good distance, intermediate, and near uncorrected VAs in Japanese patients with low corneal astigmatism.Keywords: trifocal IOL, toric IOL, low corneal astigmatism, toric calculator, visual acuity