Evaluating Refractive and Visual Outcomes After Bilateral Implantation of an Apodized Diffractive Multifocal Toric Intraocular Lens with a Moderate Add in the Dominant Eye and a Higher Add in the Fellow Eye.

Abstract

PurposeTo review refractive, visual acuity, defocus curve and subjective visual quality results after bilateral implantation of an apodized diffractive toric intraocular lens (IOL) with a moderate add in the dominant eye and a higher add in the non-dominant eye.SettingOne site in Gainesville, GA, USA.DesignSingle arm, non-randomized prospective study.MethodsThis was a single-arm prospective study of visual acuity and subjective visual quality after implantation of a toric low-add apodized diffractive multifocal IOL in the dominant eye and a higher add IOL of the same type in the non-dominant eye three months after surgery. Binocular visual acuity at 4 m, 60 cm and 40 cm was tested. Other tests included refraction, defocus curve measurement and evaluation of the quality of vision. Toric IOL orientation was also measured.ResultsA total of 29 subjects were enrolled. There were no statistically significant differences in the mean keratometry, corneal astigmatism or IOL sphere power implanted in the dominant and non-dominant eyes. Vision was preferred without any correction in more than half of the eyes tested (32/58, 55%). The residual refractive astigmatism was ≤ 0.50 D in 100% of eyes. Seventy-five percent of subjects (22/29) had 0.10 logMAR (20/25 Snellen) binocular uncorrected visual acuity at all tested distances. Glare and haloes were the most common visual disturbances, but most subjects (22/29, 76%) reported that they were not bothered by any visual disturbances. In 97% of eyes (56/58), the measured difference in orientation between 1 month and 3 months was less than 5 degrees, with no change more than 14 degrees.ConclusionThis blended bifocal IOL modality appears to be well-tolerated by subjects with a good range of vision and minimal bother from visual disturbances.