AIMS: To compare the visual effect and subjective satisfaction of cataract patients with different refractive states after trifocal intraocular lens (IOL) implantation. METHODS: This retrospective study describes 134 eyes of 86 patients that were implanted with trifocal IOL (TFNT00). Patients were allocated into three groups according to their preoperative axial length (AL): A group (AL ≤ 24 mm), B group (24 mm <
AL <
26 mm), and C group (AL ≥ 26 mm). Postoperative visual acuity, defocus curve, visual quality and subjective satisfaction were collected and compared, and the postoperative follow-up time was at least 3 months (3 months to 3 years). RESULTS: The uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA) of A group was significantly better than B group (P = 0.008 and P = 0.016). The UNVA of C group was significantly better than B group (P = 0.047). The defocus curve showed that the visual acuity of three groups from 40 cm to 5 m was better than 0.16 (LogMAR). The near vision satisfaction of B group was significantly lower than A group and C group (P<
0.001 and P = 0.004). CONCLUSIONS: For cataract patients with different refractive states, trifocal IOL implantation can provide good visual and refractive outcomes. For cataract patients with low and moderate myopia, the UIVA and UNVA were worse, and the subjective satisfaction of near vision was also worse than the hyperopia and emmetropia and the high myopia.