Toric Intraocular Lens Research Articles

Comparison of Refractive Outcomes After Phacoemulsification and Combined 25-Gauge Phacovitrectomy with Implantation of Plate-Haptic Toric Intraocular Lenses

Comparison of Refractive Outcomes After Phacoemulsification and Combined 25-Gauge Phacovitrectomy with Implantation of Plate-Haptic Toric Intraocular Lenses

Real-world outcomes of cataract surgeries using a new type of enhanced monofocal toric intraocular lens.

In this single-center study, 62 eyes of 41 patients with regular astigmatism, who received cataract surgery with TECNIS Eyhance Toric II intraocular lens (IOL) insertion between January 1, 2022, and June 30, 2023, were retrospectively investigated. At 3months postoperatively, there were significant improvements in the mean logMAR uncorrected distance visual acuity (VA) (from 0.64 ± 0.42 to 0.11 ± 0.13, p < 0.001) and logMAR corrected distance VA (from 0.28 ± 0.30 to 0.03 ± 0.06, p < 0.001). An 81.9% reduction in astigmatism (from 1.66 ± 0.49D corneal cylinder preoperatively to - 0.30 ± 0.39D refractive cylinder at 3months postoperatively, p < 0.001) was observed. In the vector analysis, the average of difference vector was 0.27 ± 0.35D, and the average correction index was 1.09 ± 0.22, revealing a minimal overcorrection. Mean IOL misalignment at 3months postoperatively was 0.68 ± 4.17°, and average absolute misalignment was 3.41 ± 2.44°. Defocus curves showed < 0.2 logMAR range between - 0.85 and 1.27 diopters, and distance-corrected near and intermediate VA were 0.38 ± 0.14 and 0.17 ± 0.13, respectively. These results indicate that the new enhanced monofocal toric IOL is a safe and effective treatment for astigmatic eyes with cataract.

Predicting accuracy of spherical equivalent after cataract surgery using the online Zcalc calculator for toric IOLs

Predicting accuracy of spherical equivalent after cataract surgery using the online Zcalc calculator for toric IOLs

Intraocular Lens Rotational Stability after Cataract Surgery with and without Primary Posterior Continuous Curvilinear Capsulorrhexis.

To evaluate intraocular lens (IOL) rotational stability and capsular fusion process after cataract surgery with and without primary posterior continuous curvilinear capsulorrhexis (PPCCC). Fujian Provincial Hospital, Fujian, China. Prospective, intraindividual, randomized clinical trial. This study included 56 adult patients (112 eyes) with bilateral cataract undergoing phacoemulsification cataract surgery with PPCCC in one eye (PPCCC group) and conventional cataract surgery in the contralateral eye (NPCCC group). IOL axis orientation and fusion footprint length were measured at 1 day, 1 week, 1 month, 3 months, and 1 year after surgery using OPD-Scan III, while capsular bend index (CBI) was assessed at the same time points using Pentacam AXL. No between-group difference was found in the absolute rotation from 1 day to 1 year (2.93 ± 1.72 vs 2.66 ± 1.61 degrees, P=0.54). The absolute rotation from 1 week to 1 month in NPCCC group was higher than that in PPCCC group (1.65 ± 0.68 vs 1.27 ± 0.32 degrees, P=0.01). At 1 month after surgery, both fusion footprint length (9.11 ± 2.74 vs. 10.67 ± 2.06 mm, P = 0.02) and CBI (2.92 ± 0.60 vs. 3.25 ± 0.59, P = 0.03) were lower in NPCCC group. Cataract surgery involving PPCCC demonstrates comparable outcomes to conventional procedures regarding long-term IOL rotational stability, therefore is a promising option for adult cataract patients scheduled for toric IOL implantation. PPCCC slightly reduces IOL rotation in the early postoperative period, which can be attributed to accelerated capsular fusion.

Clinical Comparison of a Small-Aperture Intraocular Lens Versus a Monofocal Control.

To evaluate range of visual acuity, visual quality, and safety of the IC-8 small-aperture (SA) intraocular lens (IOL) (Apthera; Bausch & Lomb, Inc) in patients with cataract. This was a prospective, multicenter, open-label, parallel-group, non-randomized, examiner-masked, 12-month clinical study conducted at 21 sites in the United States. Included patients (N = 453) received either the SA IOL (targeted to -0.75 diopters) in one eye and a monofocal or monofocal toric IOL (targeted to plano) in the fellow eye (SA IOL group, n = 343) or bilateral monofocal/monofocal toric IOLs (control group, n = 110). At 6 months, the SA IOL group achieved superior binocular uncorrected intermediate and near visual acuity (P < .0001) and equivalent binocular uncorrected distance visual acuity versus the control group. In SA IOL eyes, 99.1% achieved monocular corrected distance visual acuity of 0.3 logarithm of the minimum angle of resolution or better. The SA IOL and control groups had comparable binocular photopic and mesopic contrast sensitivities at 6 months both with and without glare. The SA IOL group reported few visual symptoms overall, although at higher rates than in the control group. The SA IOL group exhibited improved intermediate and near vision, comparable distance vision and binocular contrast sensitivities, and few visual symptoms or adverse events versus the bilateral monofocal/monofocal toric IOL group, suggesting that the SA IOL is an effective option for presbyopia correction at the time of cataract surgery. [J Refract Surg. 2024;40(11):e824-e835.].

Evaluation of Long-term Rotational Stability and Functional Performance of Two Toric Multifocal IOL Models Beyond 5 Years.

To assess visual outcomes and stability of lens alignment more than 3 years after implanting either the AT Lisa Tri Toric (Carl Zeiss Meditec) or the Acrysof IQ Restor Toric (Alcon Laboratories, Inc) intraocular lens (IOL). Patients who had received either the AT Lisa Tri Toric or the Acrysof IQ Restor Toric IOL were included in the study. The average follow-up period was 5.4 years for the AT Lisa Tri Toric group and 7.9 years for the Acrysof IQ Restor group. The examinations covered included: subjective refraction, monocular and binocular corrected and uncorrected visual acuity at far (4 m), intermediate (75 cm), and near (40 cm) distances, binocular best-corrected defocus curve analysis (4 m), contrast sensitivity evaluation, assessment of IOL axial position, and presence of positive dysphotopsia. A total of 42 eyes were evaluated. Both groups exhibited good long-term lens axial stability. The AT Lisa Tri Toric group had a mean misalignment of 4.8 ± 3.2° from the preoperatively determined axis, whereas the Acrysof IQ Restor Toric group had an average misalignment of 5.4 ± 4.5° (no statistically significant difference, P = .578). Mean achieved spherical equivalent was -0.19 ± 0.36 diopters (D) for the AT Lisa Tri Toric group and 0.15 ± 0.39 D for the Acrysof IQ Restor Toric group. In the AT Lisa Tri Toric group, 18 eyes (72%) achieved an uncorrected distance visual acuity of 0.10 logarithm of the minimum angle of resolution (20/25 Snellen) or better, compared to 15 eyes (88%) in the Acrysof IQ Restor Toric group. Overall, 21 eyes (84%) in the AT Lisa Tri Toric group and 14 eyes (83%) in the Acrysof IQ Restor Toric group achieved a postoperative spherical equivalent refraction between -0.50 and +0.50 D. Both the AT Lisa Tri Toric and the Acrysof IQ Restor Toric IOLs showed good long-term stability and functional outcomes. They proved to be effective options for restoring vision at far, intermediate, and near distances, providing a viable solution for presbyopia correction even several years after implantation. [J Refract Surg. 2024;40(11):e845-e853.].

A comparison of operating room toric placement tools: CALLISTO eye vs. e Wavetec AnalyzOR (CORTCO)

BackgroundTo evaluate procedure times for two cataract planning systems (ZEISS CALLISTO eye and the Wavetec AnalyzOR) in predicting residual astigmatism (prediction error) and other visual outcomes in patients with corneal astigmatism (maximum allowable up to 3.0D) at postoperative month 1.MethodsThis was a prospective, single center, parallel treatment group, bilateral and unilateral, randomized, 1-month study on patients scheduled to undergo routine, small-incision cataract surgery with a toric intraocular lens implantation. Both groups underwent preop measurements with the IOLMaster 700 (Zeiss, Jena, Germany) and surgery with the LenSx device (Alcon). Lens selection in the CALLISTO eye group was based on Zeiss VERACITY Surgery Planner (a web-based tool) and on the Wavetec AnalyzOR component of the ORA system (a real-time intraoperative aberrometer) for those eyes in the ORA group. All procedure and intraoperative times were measured with a stopwatch. Postoperative visual outcomes were evaluated between 1 and 2 months after surgery.ResultsThere were 23 eyes in the CALLISTO group and 28 eyes in the ORA group. The mean surgical time for the CALLISTO group was 28.09 ± 1.72 min compared to 34.41 ± 1.52 min for the ORA group (P = 0.01). Toric lens placement mean time in the CALLISTO group was 2.47 ± 0.34 min compared to 3.88 ± 0.29 min in the ORA group (P = 0.0034). At month 1 postoperatively, the manifest refractive spherical error (MRSE) in the CALLISTO eye group 0.022 ± 0.388 diopters (D) compared to -0.174 ± 0.322 D in the ORA group; these were not statistically different. There was a higher percentage (75%) of eyes with an MRSE within 0.25D in the ORA group compared to the CALLISTO eye group (56.5%); at all other levels outcomes were numerically higher in the CALLISTO eye group.ConclusionsLess surgical time was needed when using the CALLISTO eye than the ORA when performing cataract surgery with toric lens implantation. There were similar visual outcomes between the groups and no statistical differences.

How do intraocular lens materials influence the outcome of cataract surgery?

This review summarizes the evidence on the effect of intraocular lens (IOL) material on the outcomes of cataract surgery, as well as on the surgical procedure itself. Differences in capsular biocompatibility between IOL materials lead to variations in capsular stability and posterior capsule opacification (PCO), while differences in uveal biocompatibility affect postoperative inflammatory response. Refractive outcomes are affected by both incision size and the rotational stability of toric IOLs. Small incision sizes favour hydrophilic IOLs. Rotational stability of hydrophobic and hydrophilic IOLs were comparable in recent studies. Visual outcomes are affected by chromatic aberrations, dysphotopsia, lens opacifications and PCO. Hydrophilic IOLs are associated with reduced chromatic dispersion. Hydrophobic IOL opacifications are caused by sub-surface glistenings, while hydrophilic IOL opacifications are due to surface calcifications. Some surgeries, including pars plana vitrectomy and lamellar corneal transplants, were shown to increase the risk of IOL calcifications, although the mechanism is still unknown. Hydrophilic IOLs have greater ease of manipulation, greater resistance to IOL damage, and higher uveal biocompatibility. Hydrophobic IOLs show better PCO prevention than hydrophilic IOLs, and should be preferred in highly myopic eyes where Nd:YAG capsulotomy might increase the risk of retinal detachment.

Cost-effectiveness of low-astigmatism correction with toric or spherical intraocular lenses combined with corneal incisions: an economic evaluation.

To assess the cost-effectiveness of the treatment of low corneal astigmatism (≤1.5 diopters) at the moment of cataract surgery. Qvision, Ophthalmology Department, VITHAS Almería Hospital, Spain. Economic evaluation. A decision tree was used to assess the cost-effectiveness of implanting spherical vs toric intraocular lenses (IOLs) or spherical lens combined with the following corneal incisions: limbal-relaxing incisions conducted manually (M-LRI) or assisted by femtosecond laser (F-LRI), arcuate keratotomies conducted manually (M-AK) or assisted by femtosecond laser (F-AK), and intrastromal arcuate keratotomies (F-iAK). Outcomes of cost were selected from a patient perspective considering the gross cost of each one of the surgeries at European centers, and the effectiveness variable was the probability of achieving a visual acuity of 20/20 postoperatively. A sensitivity analysis was conducted to assess the uncertainty considering the evidence retrieved from the transition probabilities of the model, effectiveness, and cost. F-AK or toric IOLs were the most effective treatments, increasing an 16% or 9%, respectively, in the percentage of eyes attaining 20/20 vision. The M-LRI, F-iAK, and F-LRI procedures were strongly dominated while the M-AK and toric IOL were weakly dominated by the F-AK. A patient with low corneal astigmatism would need to be willing to pay 360€ (95% CI, 231-1224) with F-AK and 472€ (95% CI, 149-4490) with toric IOLs for a 10% increase in the probability of achieving 20/20 vision. From patient perspective, F-AK was generally the most cost-effective treatment, although toric IOLs can dominate in some countries.

Rotational stability of plate-haptic toric intraocular lenses implantation with a capsular tension ring: a prospective randomized paired-eye study.

To compare the rotational stability and visual outcomes of plate-haptic toric intraocular lenses (IOLs) with and without a capsular tension ring (CTR) in paired eyes. Eye and Ears, Nose, and Throat Hospital of Fudan University, Shanghai, China. Prospective, randomized, paired-eye study. Patients with bilateral cataracts and coexisting regular corneal astigmatism were enrolled. The two eyes of each patient were randomly assigned to the CTR or non-CTR (NCTR) group. Both eyes of each patient were subjected to phacoemulsification and toric IOL implantation. CTRs were implanted into the eyes of the CTR group. All patients were followed-up for 12 months; the uncorrected distance visual acuity (UDVA), residual astigmatism (RAS), and rotational degree of the toric IOL were recorded. In total, 186 eyes of 93 patients were eligible for analysis. At each visit, UDVA improved significantly after surgery in all eyes (p < 0.001). The mean rotational degree and RAS were significantly smaller in the CTR group at the 2-week visit (p < 0.05). The toric IOLs achieved rotational stability at 1 week postoperatively in the CTR group while at 2 weeks postoperatively in the NCTR group. In the subgroup analyses, CTR co-implantation significantly reduced the 2-week IOL rotation in eyes meeting specific ocular measurements. CTR co-implantation could increase the rotational stability of plate-haptic toric IOLs, by reducing the amount of the IOL rotation in the early postoperative period and accelerating the stabilization of IOLs in the capsular bag.

Comparison of the Accuracy Between the Z CALC2 Calculator and Barrett Toric Calculator in Toric IOL Calculation.

To compare the accuracy of the Z CALC2 calculator and Barrett toric calculator in toric intraocular lens (IOL) calculation. Eighty-five eyes of 85 patients who underwent uneventful cataract surgery with toric IOL implantation were included. The accuracy was compared between the Z CALC2 calculator and Barrett toric calculator under two calculation modes: using simulated keratometry (SimK) from the IOLMaster 700 (Carl Zeiss Meditec AG) for posterior corneal astigmatism (PCA) prediction and employing total corneal astigmatism (total corneal refractive power [TCRP] or measured PCA) obtained from the Pentacam (Oculus Optikgeräte GmbH). The centroid of prediction errors, percentage of eyes with prediction errors within ±0.50 diopter (D), mean prediction error, and mean absolute prediction error were calculated. Subgroup analysis was conducted based on the orientation and magnitude of anterior corneal astigmatism and axial length. When using SimK, the two calculators with predicted PCA showed comparable accuracy. When employing total corneal astigmatism, the Barrett toric calculator with measured PCA showed a lower centroid error (0.15 vs 0.38 D), a higher percentage of eyes with prediction errors within ±0.50 D (47.1% vs 32.9%, P = .018), and a lower mean prediction error (0.57 vs 0.71 D, P = .033) compared to the Z CALC2 calculator with TCRP in the 4-mm zone. In subgroup analysis, when employing total corneal astigmatism, the Barrett toric calculator with measured PCA exhibited superior accuracy, especially in the with-the-rule and anterior corneal astigmatism of 2.00 D or less subgroups. When using SimK, the Z CALC2 calculator and Barrett toric calculator yield comparable accuracy. The Barrett toric calculator with measured PCA may be more recommended when employing total corneal astigmatism. [J Refract Surg. 2024;40(10):e681-e691.].

Intraoperative Aberrometry versus Preoperative Biometry for Intraocular Lens Power Calculations: A Report by the American Academy of Ophthalmology

To evaluate the published literature to compare intraoperative aberrometry (IA) with preoperative biometry-based formulas with respect to intraocular lens (IOL) power calculation accuracy for various clinical scenarios. Literature searches in the PubMed database conducted in August 2022, July 2023, and February 2024 identified 157, 18, and 6 citations, respectively. These were reviewed in abstract form, and 61 articles were selected for full-text review. Of these, 29 met the criteria for inclusion in this assessment. The panel methodologists assigned a level of evidence rating to each of the articles; 4 were rated level I, 19 were rated level II, and 6 were rated level III. Intraoperative aberrometry performed better than traditional vergence formulas, including the Haigis, HofferQ, Holladay, and SRK/T, and similarly to the Barrett Universal II and Hill-RBF with respect to minimization of spherical equivalent (SE) refractive error. For toric IOLs, IA outperformed formulas that only considered anterior corneal astigmatism and was similar to formulas like the Barrett Toric Calculator (BTC), which empirically account for the contribution from the posterior cornea. In eyes with a history of corneal refractive surgery, IA performed similarly to the Barrett True-K and slightly better than other tested methods, including the Haigis-L, Shammas, and Wang-Koch-Maloney formulas. Intraoperative aberrometry corresponds well with modern vergence formulas, including the Barrett Universal II, Hill-RBF, BTC, and Barrett True-K. It has greater accuracy than traditional vergence-based IOL power calculation formulas in eyes with and without a history of corneal refractive surgery. Proprietary or commercial disclosure may be found after the references.

One-Year Results of a Posterior Chamber Toric Phakic Intraocular Lens Implantation in Patients with Keratoconus.

To determine clinical and refractive results after the implantation of EyeCryl Phakic Toric intraocular lens in patients with stable keratoconus. The study included all patients diagnosed with keratoconus who underwent implantation of an EyeCryl Phakic Toric intraocular lens (Biotech Healthcare Holding; Ahmedabad, India) in at least one eye and had a follow-up of at least 12 months. Visual and refractive data were collected for all patients, along with corneal tomography measurements using Pentacam, and vault measurement using optical coherence tomography. This retrospective study was conducted at a high-volume private refractive surgery center in Medellín, Colombia. A total of 83 eyes from 47 patients were included in the study. The majority (71.1%) were female, with a mean age of 31.2 ± 5.1 years. After 12 months of follow-up post-surgery, the spherical equivalent improved significantly from -8.19 ± 4.04 D to -0.06 ± 0.48 D (p < 0.001). Furthermore, 77% of eyes had a post-surgical spherical equivalent within ±0.50 D, while 92% had residual astigmatism ≤0.50 D. Twelve months after surgery, mean manifest astigmatism was -0.28 ± 0.27 D. Uncorrected visual acuity also showed improvement, from 1.11 ± 0.35 LogMAR to 0.14 ± 0.11 LogMAR. Moreover, 52.4% of eyes demonstrated an improvement of at least one line in best-corrected visual acuity. Notably, no intraoperative or postoperative complications were observed in the study population. The implantation of EyeCryl Phakic Toric intraocular lenses represents a highly effective and safe option for correcting refractive errors in patients with a history of keratoconus. Refractive accuracy is excellent, and a significant proportion of patients experienced an improvement in their best-corrected vision by at least one line.

Refractive Error after Toric Intraocular Lens Implantation in a Patient with Bilateral Posterior Keratoconus

Refractive Error after Toric Intraocular Lens Implantation in a Patient with Bilateral Posterior Keratoconus

Clinical Outcomes of Iris-Supported Phakic Toric Intraocular Lenses in Corneal Ectasia.

Our aim was to evaluate the visual and refractive outcomes of iris-fixated phakic toric intraocular lenses (IOLs)for visual rehabilitation in eyes with stable corneal ectasia. We conducted a study looking at the clinical outcomes of iris-fixated toric IOLs (Artisan) in 33 eyes of 27 patients diagnosed with mild-to-moderate corneal ectasia at a single center (Queen Victoria Hospital, East Grinstead, UK). The main outcome measures were functional improvement [accuracy of post-operative spherical equivalent (SE), astigmatic correction, topographic parameters, uncorrected and corrected distance visual acuity (UCVA, CDVA)] and safety of the procedure: endothelial cell count and intra- and post-operative complications. Eighteen males and nine females of mean age 38.85 were included in the study with a mean follow-up of 18months. All patients had ectasia due to keratoconus except one with post-refractive laser ectasia. Twelve patients had crosslinking, eight had intracorneal rings, and eight had previous keratoplasties. Mean pre-operative logMAR UCVA was 0.75 ± 0.35 improving to 0.02 ± 0.17 (p = 0.000). Mean pre-operative logMAR CDVA was 0.16 ± 0.17 improving to 0.02 ± 0.17 (p = 0.000). Mean pre-operative (SE) was -3.5 ± 3.9 improving to -2.75 ± 1.39 (p = 0.000) with up to 36-42months of follow-up. The mean value of endothelial cell density in the overall sample was 2252.54 ± 473.24cells/mm2 pre-operatively and 2126.75 ± 365.21cells/mm2 at 24-36months of follow-up visit. Two patients have intra-operative hyphemia secondary to iris prolapse. Implantation of iris-fixated phakic toric IOLs has shown high efficacy and safety in patients with mild-to-moderate astigmatism in corneal ectasia.

Digital versus manual axis marking for toric phakic intraocular lens alignment: a prospective randomized intraindividual trial.

This study compares visual and refractive outcomes and postoperative axis alignment for toric Implantable Collamer Lens (ICL) implantation in astigmatic myopia using manual versus digital marking techniques. Department of Ophthalmology, Medical University of Graz, Austria. Prospective randomized single-centered intraindividual comparison. Patients undergoing bilateral toric ICL implantation for myopia with astigmatism ≥ 0.5 diopters (D) were enrolled. Patients received both marking techniques and randomization was performed. Postoperative retroillumination photography assessed axis alignment, and visual and refractive parameters were evaluated. Duration of the surgeries was recorded. The study includes 20 patients and 40 eyes. Preoperative visual and refractive parameters showed no significant differences. Postoperatively, residual astigmatism (p=0.824) and spherical equivalent (p=0.309) were comparable. No notable differences between right and left eyes in terms of preoperative (p=0.371) and postoperative (p=0.824) astigmatism were observed. Although slight, corrected distance visual acuity (CDVA) increased in both groups postoperatively (p=0.381). Gain in CDVA was comparable between marking techniques (p=0.637). Safety and efficacy indices were comparable (p=0.991 and p=0.189, respectively). Postoperative axial misalignment was 2.8±3.1 degrees in the digital- and 4.4±5.1 degrees in the manual group (p=0.260). Vector analysis showed no significant differences between manual and digital marking. Duration remained uninfluenced by the marking technique (p=0.970) and side of surgery (p=0.682). In conclusion digital and manual marking techniques provided comparable results in axis alignment, surgical duration and visual and refractive outcomes. Both methods are viable for precise axis alignment, with digital marking offering a potential advantage in efficacy.

Comparison of two digital alignment systems for toric intraocular lens implantation

PurposeTo compare the two most used digital alignment systems regarding precision, repeatability and loss of track.Methods15 eyes of 15 patients older than 21 years with cataracts were included in this...

A survey of intraocular lens preferences of UK refractive surgeons for cataract surgery and refractive lens exchange

BackgroundTo explore intraocular lens (IOL) preferences of United Kingdom-based (UK) refractive surgeons in cataract and refractive lens exchange (RLE) surgery.MethodsAn online survey on IOL preferences (and reasons for their choice) in cataract and RLE surgery was distributed. It also enquired about implementing mini-monovision with extended depth of field (EDoF) IOLs, about utilising IOL mix-and-match (different IOL types in each eye), and at what level of corneal astigmatism they prefer toric lenses.ResultsFollowing an 81.6% response rate, thirty responses were analysed; median years of refractive surgery experience was 12.5. The most popular IOL choices for cataract surgery were EDoF lenses (30%), monofocals (20%), and trifocals (20%). The most cited reason for each was better overall visual outcomes (88.9%), fewer unwanted symptoms (66.7%) and best spectacle independence (66.7%), respectively.For RLE, EDoF remained most popular (36.7%), followed by trifocals (30%), and multifocals (16.7%) with the same reasons for choice cited above.Mini-monovision with EDoF lenses was well-regarded (83% recommend for most/select patients), unlike utilising IOL mix-and-match (60% did not recommend). 40% prefer toric IOLs for astigmatism of 1 dioptre (D) or higher, whilst 30% opt for them at < 1D.ConclusionsExperienced UK refractive surgeons prefer newer IOLs with enhanced optics; ≥50% of respondents favoured either EDoF or trifocals for a ‘typical’ cataract or RLE patient. Notably, respondents have a low corneal astigmatism threshold for toric lenses. Mini-monovision with EDoF IOLs was well-regarded, whilst mix-and-match of different IOL types was less recommended.

Functional outcomes and quality of life after AcrySof IQ Vivity intraocular lens implantation in a real-world study

The extended depth-of-focus AcrySof IQ Vivity intraocular lens technology offers promising features for presbyopia management, evaluated in this research in a 6 months real-world setting. Prospective interventional mono-centric study including 40 patients who underwent elective bilateral phacoemulsification. We performed one pre-operative visit (V0) and one evaluation six months post-operatively (V1), evaluating uncorrected and corrected visual acuity for near (UNVA/CNVA), intermediate (UIVA/CIVA) and far (UDVA/UCVA), slit-lamp evaluation, tomography with static pupillometry, endothelial cell count and contrast sensitivity chart. In order to assess post-operative Quality of Life, we administered the patients McAlinden’s Quality of Vision test and Morlock’s Patient-Reported Spectacle Independence Questionnaire. We divided eyes in with Toric-IOL and with non-Toric IOL. A total of 36 eyes received non-tonic IOL implantation, whereas 44 eyes received toric IOL implantation. There were no statistically significant disparities observed in visual outcome measures and contrast sensitivity between the toric group and the non-toric group. Furthermore, we assessed the predictive preoperative refractive astigmatism (PPRA) and residual refractive astigmatism (RRA) in both cohorts, and no statistical significance was found between the two cohorts (p = 0.08). Twenty-one (53%) patients reported total independence from their glasses at all distances. The mean difference between the predicted and measured refractive error, as calculated by spherical equivalent, was 0.09 D. AcrySof IQ Vivity is a well-tolerated and effective IOL with optimal refractive target for both distant and intermediate vision, needing slight spherical addition for the best near vision. Great questionnaire-based satisfaction was reported by the patients.

Comparison of visual efficacy and patient’s satisfaction between two toric IOLs, enhanced for intermediate vision and monofocal

BackgroundTo compare the visual efficacy and patient satisfaction between 2 toric IOLs (TIOL), enhanced for intermediate vision or monofocal.MethodsA retrospective chart review was performed of 100 eyes from 68 astigmatic patients who underwent cataract surgery with implantation of a Tecnis Eyhance Toric II IOL (Johnson & Johnson Vision, Irvine, CA, USA) (Group 1, 50 eyes) or Tecnis TIOL (Group 2, 50 eyes). The uncorrected distant (UDVA), intermediate (UIVA), and near (UNVA) visual acuities; residual refractive astigmatism; defocus curve; and IOL axis rotation were evaluated at 1 week, 1 month, 2 months, and 3 months postoperatively.ResultsThe postoperative UDVA and UNVA refractive astigmatism values of the two groups were better than the preoperative measurements (P < 0.05), but there was no statistical difference between the two groups (P > 0.05). The postoperative UIVA of group 1 (0.18 ± 0.15 logMAR) was significantly better than that of group 2 (0.30 ± 0.25) (P < 0.05). The mean postoperative IOL rotation of group 1 (2.51 ± 0.79°) was lower than that of group 2 (3.02 ± 0.84°) (P < 0.05). Overall satisfaction of group 1 (1.27 ± 0.47) was better than that of group 2 (2.02 ± 0.53) (P < 0.05).ConclusionsThe Tecnis Eyhance Toric II IOL demonstrated less postoperative IOL rotation and excellent uncorrected intermediate vision compared with the Tecnis TIOL. Near visual acuity and overall satisfaction with the Tecnis Eyhance Toric II IOL were also higher than those with the Tecnis TIOL.