方法：前瞻性非随机对照研究。收集2023年9月至2025年12月在济南明水眼科医院行白内障超声乳化摘除联合PC-IOL植入的白内障患者，根据植入的不同IOL分为三焦点组、Vivity 组、Synergy组。术后1 wk，1、3 mo进行随访，测量术后裸眼远视力(UDVA)、裸眼中视力(UIVA)、裸眼近视力(UNVA)、客观散射指数(OSI)、调制传递函数截止频率(MTF-cut off)、斯特列尔比(SR)及100%、20%、9%对比度视力(CVA)； 绘制术后离焦曲线； 问卷调查术后视觉相关生活质量及脱镜率。

结果：本研究纳入白内障患者101例101眼\〖年龄30-73(53.8±9.7)岁\〗，男59例，女42例。三焦点组33例33眼，年龄30-71(51.7±11.3)岁，男21例，女12例； Vivity组37例37眼，年龄36-71(54.2±9.0)岁，男18例，女19例； Synergy组31例31眼，年龄30-73(55.9±8.5)岁，男20例，女11例。术后三组间UDVA、UIVA无差异(均P>0.05)； 三组间UNVA比较有差异(P<0.05)； 不同时间点，UDVA有差异(P<0.05)，UIVA、UNVA无差异(均P>0.05)。术后3 mo时，三组间OSI、MTF-cut off、SR、100% CVA、20% CVA、9% CVA比较有差异(均P<0.001)。术后1 mo离焦曲线示三焦点组在+1--3 D区间曲线衔接平稳，远中近视力良好； 三组在中视力区间(-1--1.5 D)，曲线平滑，过渡自然，且LogMAR视力均保持在0.2以上； 在近视力区间(-2.5--3.5 D)，三焦点组、Synergy组显著优于Vivity组。三组间VF-14量表总体评分无差异(P>0.05)，在夜间驾驶机动车或非机动车方面，Vivity组优于三焦点组及Synergy组。三焦点组、Vivity组、Synergy组术后脱镜率分别为92.3%、54.1%、80.0%(P<0.05)。

结论：不同类型PC-IOL均能有效提高白内障患者术后的全程视力，三焦点IOL与EDOF IOL的客观视觉质量存在差异，部分患者术后存在光学干扰现象而导致夜间驾驶存在一定困难，患者主观视觉感受均较高。

METHODS:A prospective, non-randomized controlled study. Cataract patients who underwent phacoemulsification combined with PC-IOL implantation at Jinan Mingshui Eye Hospital from September 2023 and December 2025 were included. These patients were divided into three groups according to the type of IOL: the Trifocal IOL group,the Vivity group, and the Synergy group. Follow-ups were conducted at 1 wk,1 and 3 mo postoperatively. Uncorrected distance visual acuity(UDVA), uncorrected intermediate visual acuity(UIVA), and uncorrected near visual acuity(UNVA), objective scatter index(OSI), modulation transfer function cut off(MTF-cut off), and Strehl ratio(SR), as well as contrast visual acuity(CVA)at 100%, 20%, and 9% contrast were assessed. Postoperative defocus curves were plotted. Vision-related quality of life and spectacle independence were evaluated using questionnaires.

RESULTS: This study included 101 cataract patients(101 eyes),aged 30-70(53.8±9.7)y,with 59 males and 42 females.The Trifocal group consisted of 33 patients(33 eyes), aged 30-71(51.7±11.3)y, with 21 males and 12 females; the Vivity group consisted of 37 patients(37 eyes), aged 36-71(54.2±9.0)y, with 18 males and 19 females; and the Synergy group consisted of 31 patients(31 eyes), aged 30-73(55.9±8.5)y, with 20 males and 11 females.No significant differences were observed among the three groups in UDVA or UIVA(all P>0.05). Significant differences were found in UNVA among groups(P<0.05). UDVA differed significantly across different time points(P<0.05), while there were no significant differences in UIVA and UNVA(all P>0.05). At 3 mo postoperatively, significant differences were found among the three groups in OSI, MTF -cut off, SR, and CVA at all contrast levels(all P<0.05). The defocus curve at postoperative 1 mo showed that the Trifocal group had a smooth and continuous profile from +1.0 D to -3.0 D, providing good distance, intermediate, and near vision. All groups demonstrated smooth transitions in the intermediate range(-1.0 D to -1.5 D), with LogMAR visual acuity better than 0.2. In the near range(-2.5 D to -3.5 D), the Trifocal and Synergy groups performed significantly better than the Vivity group. No significant differences were observed in VF-14 questionnaire scores among groups(P>0.05). For night driving(motorized or non-motorized), the Vivity group performed better than the Trifocal and Synergy groups. Spectacle independence rates were 92.3% in the Trifocal group, 54.1% in the Vivity group, and 80.0% in the Synergy group(P<0.05).

CONCLUSION: All types of PC-IOLs can effectively improve postoperative full-range visual acuity in cataract patients. There are discrepancies in the objective visual quality between Trifocal IOLs and extended depth of focus(EDOF)IOLs. Some patients suffer from postoperative optical disturbances, which result in certain difficulties with night driving, although patients generally report favorable subjective visual perceptions.