To demonstrate the surgical technique of the implantation of the trifocal IOL with the 7-mm large optic.

The retrospective case series study included 94 eyes of 59 patients who underwent the routine laser-assisted cataract surgery through 5.0 mm capsulotomy and were implanted with Triva-aXAY IOL (HumanOptics Holding AG, Erlangen, Germany) using the 3L implantation method. The 3L method consisted of three consecutive steps before and during the IOL implantation. The 3L implantation videos were analysed to determine the surgery course. The visual acuity and dysphotopsia occurrence were assessed at 6 months postoperatively.

The mean monocular CDVA, DCIVA and DCNVA were 0.0 ± 0.04 logMAR, 0.11 ± 0.12 logMAR and 0.07 ± 0.09 logMAR. Regarding dysphotopsia, 36% of patients reported no dysphotopsia at all. ‘No or mild’ halo, glare and starburst were reported in 79%, 64% and 64% of patients, respectively. The median time of IOL implantation (IQR) was 47.5 s (39; 68 s).

The innovative 3L implantation technique enables the surgeons to implant the IOL with the large optic or bulky platform easily, safely and without additional manipulation. Video abstract in Supplement online material.