Trifocal Toric Intraocular Lens Research Articles

Comparison of visual and refractive outcomes of diffractive bifocal toric and trifocal toric intraocular lenses 12 months after implantation in patients with moderate to high myopia

To compare the visual and refractive outcomes of bifocal toric and trifocal toric intraocular lenses (IOL) in patients with moderate to high myopia at 12months after implantation. This is a prospective and comparative study. In 120 eyes with moderate to high myopia and astigmatism, bifocal toric IOLs (n = 60 eyes) or trifocal toric IOLs (n = 60 eyes) were implanted. Eyes with axial lengths from 24.0 to 26.5mm were included. Postoperative examinations measured near, intermediate, and distance visual acuity (VA), along with refractive measurements, binocular defocus curves, and patient satisfaction with the National Eye Institute Visual Function Questionnaire. For uncorrected- and corrected distance intermediate VA, the trifocal group showed significantly better VA at 1, 3, 6, and 12months than the bifocal group. Driving subscale scores from the questionnaire were significantly better in the trifocal than the bifocal group. Concerning the binocular defocus curve, uncorrected distance VA was significantly higher in the trifocal than bifocal group at test distances of -1.5 D. Both trifocal and bifocal toric IOLs effectively corrected the near, intermediate, and distance vision in patients with moderate to high myopia and astigmatism. However, intermediate vision was significantly better in eyes with trifocal than bifocal toric IOLs.

Effect of defocus combined with rotation on the optical performance of trifocal toric IOLs.

To objectively analyze the optical quality of the FineVision Toric intraocular lens (IOL) with two cylinder powers when different combinations of rotations and residual refractive errors are induced. This study assessed the FineVision Toric IOL with two different cylinder powers: 1.5 and 3.0 diopters (D). Three different rotation positions were considered: centered, 5° and 10° rotated. An optical bench (PMTF) was used for optical analysis. The optical quality of the IOLs was calculated by the modulation transfer function (MTF) at five different focal points (0.0, 0.25, 0.50, 0.75, and 1.00 D). The MTF averaged value of the reference situation was 38.58 and 37.74 for 1.5 and 3.0 D of cylinder, respectively. For the 1.5 D cylinder, the combination of 5° of rotation with a defocus of 0.25, 0.50, 0.75, and 1.0 D induced a decrease on the MTF of 12.39, 19.94, 23.43, 24.23 units, respectively. When induced rotation was 10°, the MTF decrease was 17.26, 23.40, 24.33, 24.48 units, respectively. For the 3.0 D cylinder, the combination of 5° with 0.25, 0.50, 0.75, and 1.0 D of defocus, induced a decrease on the MTF of 12.51, 18.97, 22.36, 22.48 units, respectively. When induced rotation was 10°, the MTF decrease was: 18.42, 21.57, 23.08, and 23.61 units, respectively. For both FineVision Toric IOLs there is a certain optical tolerance to rotations up to 5° or residual refractive errors up to 0.25 D. Situations over these limits and their combination would affect the visual quality of patients implanted with these trifocal toric IOLs.

Trifocal toric intraocular lens implantation for cataract in a young patient with congenital nystagmus

<br>We report a case of Trifocal Toric IOL implantation in a patient having cataract with congenital nystagmus. A detailed ocular assessment for pre- and postoperative uniocular and binocular visual acuity, nystagmus characteristics, abnormal head posture, fundus examination, IOP measurement, and biometry was carried out. Preoperative visual acuity was 6/12p and 6/18p in right and left eye, respectively, with binocular visual acuity of 6/12p. Postoperative visual acuity was 6/12 in right and 6/9 in the left eye, respectively. Binocular visual acuity was 6/9 for far and N6 at 40 cm for near after implantation of a trifocal toric IOL. No change in nystagmus characteristics was observed.<br>

Tolerance to Residual Refractive Errors After Trifocal and Trifocal Toric Intraocular Lens Implantation.

The objective of this study was to assess the impact of 0.50 diopter (D) positive or negative defocus on visual function in patients implanted with trifocal and trifocal toric intraocular lenses (IOLs). The study included patients implanted with the AcrySof IQ PanOptix IOL or the PanOptix Toric. Visual acuity (VA) at high (100%), medium (50%) and low (10%) contrast, contrast sensitivity function (CSF), and halo perception were assessed three months after surgery. Explorations were performed with corrected distance visual acuity (CDVA), with a positive defocus of +0.50D (myopization) and with a negative defocus of -0.50D (hyperopization). The study included 60 eyes of 60 patients (30 eyes with PanOptix and 30 eyes with PanOptix Toric). For both groups, VA was better for all contrast settings at the CDVA situation (P<0.05 in all cases). For low spatial frequencies, no differences in CSF were found among the three refractive situations in either group. For higher frequencies, the results showed an overall trend for better CSF results for the CDVA situation. The halo effect was lower for the CDVA situation if compared to myopization and hyperopization in both the PanOptix and the PanOptix Toric groups (P<0.05 for all cases). There is an impact on visual quality and halo perception in patients implanted with trifocal or trifocal toric IOLs even for low residual refractive errors.

Impact of Trifocal and Trifocal Toric Intraocular Lenses on Spectral-domain OCT Retinal Measurements.

Monofocal, trifocal, and trifocal toric intraocular lenses (IOLs) induce similar changes on overall retinal optical coherence tomography (OCT) measurements. The purpose of this study was to assess whether trifocal and trifocal toric IOLs affect the measurement of retinal parameters using spectral-domain OCT. This cross-over study included patients undergoing implantation of a trifocal IOL: AcrySof IQ PanOptix, a trifocal toric IOL: AcrySof IQ PanOptix Toric, and a monofocal IOL: AcrySof IQ. The monofocal group was considered as the control group. The refractive target was emmetropia in all cases. Mean average macular thickness, macular volume, and retinal nerve fiber layer (RNFL) thickness were measured with the Cirrus HD-OCT. All measurements were performed before and 3 months after the surgery. The study analyzed 150 eyes of 150 patients (50 for each IOL group). Macular thickness and macular volume showed statistically significant differences before and after the surgery for the 3 groups (P<0.05 in all cases). RNFL thickness was found to be similar before and after the surgery in all groups (P>0.05 in all cases). Mean difference values (before and after the surgery) in the monocular, trifocal, and trifocal toric group for macular thickness, macular volume, and RNFL thickness were 4.9±7.8, 7.9±10.0, and 7.7±13.7 µm, respectively; 0.1±0.2, 0.2±0.4, and 0.2±0.3 mm3, respectively; and 0.8±5.5, 1.3±6.0, and 0.8±6.7 µm, respectively. Mean differences were found to be similar for the 3 groups. The trifocal and the trifocal toric IOLs under study did not induce an additional impact on spectral-domain OCT retinal measurements compared with monofocal IOLs.

Trifocal toric intraocular lenses in eyes with low amount of corneal astigmatism.

To evaluate the refractive and visual outcomes following cataract surgery and implantation of a trifocal toric intraocular lens (IOL) in eyes with low degrees of corneal astigmatism. Twenty-six eyes of 22 patients who underwent implantation a trifocal toric IOL (FineVision PODFT, PhysIOL s.a., Liege, Belgium) were enrolled. Phacoemulsification with femtosecond laser, capsular tension ring insertion and intraoperative aberrometry were performed in all cases. All IOLs used showed a cylinder power of 1.00 D. Main outcome measures were refractive error and corrected-distance visual acuity (CDVA) and uncorrected-distance visual acuity (UDVA) values. Eyes were evaluated at 4mo post-surgery. Totally 50% of eyes showed a spherical equivalent (SE) within ±0.13 D and all of them within ±0.50 D. The mean SE and refractive cylinder were -0.02±0.23 and -0.16±0.22 D, respectively. Vector analysis revealed that 100% of eyes were within ±0.50 D for the SE and cylindrical components (J0 and J45). Refractive changes were not correlated with keratometric changes (P>0.05) showing that the reduction in astigmatism comes from the trifocal toric IOL. Of 81% and 96% of eyes showed UDVA and CDVA of 20/20, respectively. The postoperative mean values of monocular distance Snellen decimal UDVA and CDVA were 0.97±0.05 and 0.99±0.02 (about 20/20), respectively. Our study suggests that the use of this trifocal toric IOL in patients with low amount of astigmatism provides accurate refractive outcomes and enables them to achieve excellent visual acuity.

Optical tolerance to rotation of trifocal toric intraocular lenses as a function of the cylinder power.

The aim was to assess the impact of 5- and 10-degree rotations in the optical quality of a trifocal toric intraocular lens with different amounts of cylinder. Two Physiol Toric intraocular lenses with 1.5 and 3.0 D of cylinder were analysed in three different positions: centred, 5 and 10 degrees rotated. The optical quality of the intraocular lenses was evaluated with the PMTF optical bench through specific perpendicular targets. The analysis was performed by the through-focus modulation transfer function curves and the modulation transfer function corresponding to distance vision (0 D of vergence). For a centred situation, the through-focus modulation transfer function curves of both intraocular lenses showed the classical three peaks corresponding to the powers of the two principal meridians of the intraocular lenses. When 5 and 10 degrees of rotation were induced, the three peaks were attenuated in both cases. The case with the intraocular lens with 3.0 D of cylinder and 10 degrees of rotation showed the worst optical quality and a significant loss of trifocality. The modulation transfer function values obtained for distance vision also showed the worst optical quality for the intraocular lens with 3.0 D of cylinder and 10 degrees of rotation. Rotations over 5 degrees decreased the optical quality of trifocal toric intraocular lenses, being this reduction moderate from 5 to 10 degrees for low levels of cylinder (≤1.5 D). For mid-high levels of cylinder (≥3.0 D), rotations over 5 degrees cause a significant loss of optical quality at all object distances.

Automated refraction after trifocal and trifocal toric intraocular lens implantation.

To analyze the correlation between automated refraction and manifest refraction after implantation of a trifocal intraocular lens or its toric version. This cross-sectional study involved 105 eyes of 105 patients. Subjects were divided in two groups: 62 with trifocal (AcrySof PanOptix) and 43 with trifocal toric (AcrySof PanOptix Toric) intraocular lenses. Automated refraction was employed as starting point for obtaining the manifest refraction. Automated refraction and manifest refraction measurements were analyzed and compared using the vector analysis 3 months after the surgery. In both groups, the higher differences between automated refraction and manifest refraction measurements were found for the cylinder and the spherical equivalent (M). Cylinder values for PanOptix were: -0.60 ± 0.36 D with automated refraction and -0.17 ± 38 D with manifest refraction (p < 0.001); for PanOptix Toric, the values were: -0.49 ± 0.31 D with automated refraction and -0.05 ± 0.21 D with manifest refraction (p < 0.001). M values for PanOptix were: -0.23 ± 0.31 D with automated refraction and -0.03 ± 0.16 D with manifest refraction (p < 0.001); for PanOptix Toric, the values were: -0.13 ± 0.40 D with automated refraction and 0.01 ± 0.12 D with manifest refraction (p < 0.001). For the PanOptix group, intraclass correlation coefficients were: 0.51 (sphere), 0.64 (cylinder), 0.42 (M), 0.62 (J0), and 0.37 (J45). For the PanOptix Toric group, the intraclass correlation coefficients were: 0.39 (sphere), 0.61 (cylinder), 0.39 (M), 0.53 (J0), and 0.09 (J45). The results of this study suggest that patients implanted with the trifocal and the trifocal toric intraocular lens under study showed similar automated refraction results between them, with a slight trend to more negative amounts of cylinder and M. Nevertheless, clinicians should carefully confirm all parameters of the refraction with manifest refraction.

Comparison of visual and refractive outcomes of 2 trifocal intraocular lenses.

To compare clinical outcomes after cataract surgery and bilateral implantation of 2 diffractive trifocal toric intraocular lenses (IOLs). Hospital da Luz, Lisbon, Portugal. Double-arm, randomized, prospective case series. A total of 60 patients were randomly allocated to receive bilateral implantation of either the FineVision Pod FT toric IOL (PhysIOL) or the AcrySof IQ PanOptix toric IOL (Alcon). Visual and refractive outcomes, contrast sensitivity, IOL misalignment, and quality of vision outcomes (QoV questionnaire) were evaluated at 3 months postoperatively. Surgically induced astigmatic changes were evaluated by vector analysis. Each group (FineVision toric and AcrySof IQ PanOptix toric) comprised 30 patients (60 eyes). No significant differences between groups were found regarding uncorrected and corrected distance and near visual outcomes (P ≥ .333). Mean postoperative distance-corrected intermediate visual acuity at 60 cm was 0.04 ± 0.09 logarithm of the minimum angle of resolution (logMAR) and 0.09 ± 0.11 logMAR in the PanOptix and Pod FT group, respectively (P = .032). Mean IOL axis misalignment was 1.59 degrees ± 2.15 degrees (PanOptix group) and 1.89 degrees ± 3.31 degrees (Pod FT group) (P = .821). Mean magnitude of error of astigmatic correction was -0.09 diopters (D) and -0.11 D in the PanOptix group and Pod FT group, respectively (P = .333). Contrast sensitivity, QoV scores for the presence of photic phenomena, and the level of spectacle independence were similar in both groups (P > .05). Both trifocal toric IOLs allowed complete patient visual restoration, and good spectacle independence and good visual quality outcomes. The PanOptix IOL provided superior intermediate visual acuity for distances around 60 cm.

Refractive and Visual Outcomes After Bilateral Implantation of a Trifocal Intraocular Lens in a Large Population.

PurposeTo review refractive, visual acuity, defocus curve and contrast sensitivity results after bilateral implantation of a trifocal intraocular lens (IOL) in a large population.SettingOne site in Santiago, Chile.DesignSingle arm, non-randomized retrospective chart review.MethodsThis was a single-arm retrospective chart review of clinical outcomes after bilateral implantation of a trifocal IOL (Panoptix®), both toric and non-toric versions. Binocular visual acuity at 4 m, 60 cm and 40 cm was tested. Other tests included refraction, mesopic and photopic contrast sensitivity, and defocus curve measurement.ResultsThe review included 500 eyes of 250 patients implanted with the trifocal IOL and 200 eyes of 100 patients implanted with the trifocal toric IOL, with no clinically significant differences between groups. Ninety-six percent of all eyes were within 0.50D of the intended spherical equivalent correction. In the toric group, 94% of eyes (187/200) had a residual refractive cylinder ≤0.50D, compared to 81% of eyes (406/500) in the non-toric group. Four out of five patients (80.6%, 282/350) had a binocular uncorrected VA of 0.1 logMAR (20/25) at all test distances. Mean defocus was 0.1 logMAR or better from vergences from 0.00 to −3.00 D (corresponding to vision from distance to about 33 cm). With a cutoff of 0.2 logMAR, 96% of patients had a range of vision 2.5 D or greater. Contrast sensitivity was similar between the toric and non-toric lenses, and similar to age-matched normal results.ConclusionThe non-toric and toric trifocal IOLs provided good distance, intermediate and near vision to patients, with a wide range of vision and good contrast sensitivity.

Evaluation of a Prospective Study on Trifocal Toric Intraocular Lens Implantation in Patients with Cataract and High Corneal Astigmatism

Evaluation of a Prospective Study on Trifocal Toric Intraocular Lens Implantation in Patients with Cataract and High Corneal Astigmatism

Trifocal toric intra-ocular lens implantation in pediatric traumatic cataract

PurposeTo present the case of a 6-year-old child who presented with a traumatic cataract and was treated with trifocal toric intra-ocular lens implantation. ObservationsThe child's uncorrected distance visual acuity improved from +0.7 logMAR preoperatively to 0.00 logMAR after cataract surgery, with spectacle independence and no reported side effects Conclusions and importanceIn carefully selected pediatric patients with traumatic cataracts, trifocal toric intra-ocular lenses may offer some benefit over standard monofocal lenses

Visual quality and patient satisfaction with a trifocal intraocular lens and its new toric version

To assess and compare the visual quality and subjective outcomes of a trifocal spherical intraocular lens (IOL) and its new toric version. Clínica Rementería, Madrid, Spain. Prospective case series. Patients had bilateral implantation of the AcrySof IQ PanOptix spherical or toric IOL. Three months postoperatively, monocular and the binocular uncorrected and corrected distance, intermediate, and near visual acuities; binocular defocus curves; and binocular contrast sensitivity function (CSF) were assessed. Patient satisfaction was evaluated with the Catquest 9SF questionnaire. The study comprised 250 eyes (166 with spherical IOL; 84 with toric IOL) of 125 patients. Both groups had good monocular visual acuity at all distances with no statistically significant differences between groups. The mean monocular uncorrected acuity in the spherical group was 0.06 logarithm of the minimum angle of resolution (logMAR)±0.07 (SD), 0.20±0.10 logMAR, and 0.05±0.07 logMAR for far, intermediate, and near, respectively, and in the toric group, 0.07±0.10 logMAR, 0.23±0.20 logMAR, and 0.07±0.12 logMAR, respectively. Defocus curves showed a visual acuity of 0.1 logMAR or better between -2.5 diopters (D) and +0.5 D with no differences between groups. The CSF values were within normal ranges with both IOLs. The questionnaire showed high rates of patient satisfaction with no differences between groups. The visual outcomes with the 2 IOLs were similar. With optimum implantation and alignment, the trifocal toric IOL seems to provide visual quality and patient satisfaction that is equivalent to that with the nontoric version with the same platform.

Predictability of different calculators in the minimization of postoperative astigmatism after implantation of a toric intraocular lens.

PurposeTo assess the efficacy of five calculators for toric intraocular lenses (IOL).MethodsRetrospective comparative case series in cataract patients undergoing implantation of trifocal toric IOLs (PhysIOL FineVision POD FT). Inclusion criteria were age-related cataract and a corneal astigmatism between 0.90D and 4.50D. Refractive astigmatism predictability of five different toric calculators or calculation methods were compared. Furthermore, two groups were differentiated according to the type of astigmatism. The mean absolute error and the centroid errors in the predicted residual astigmatism from each calculator were evaluated.ResultsFifty-one eyes of 43 patients were included in the study. For the standard toric calculator using anterior keratometry values only, the centroid prediction error was 0.39D±0.41@166º, which was reduced by the application of the PhysIOL toric calculator that includes the Abulafia-Koch regression formula and adjustment for the effective lens position (0.05D±0.34@167º), and also by the application of the Barrett toric calculator (0.07D±0.28@160º). Regarding the techniques that directly evaluate posterior corneal surface, the Holladay toric calculator, using total corneal power provided by a color-LED topographer, generated better results (0.10D±0.44@156º) than those using Scheimpflug camera data (0.23D±0.56@158º). Similar results were found for both types of astigmatism.ConclusionThe PhysIOL and the Barrett toric calculators taking into account the posterior corneal astigmatism by mathematical models, yielded lower astigmatic prediction errors compared to a standard toric calculator based on anterior keratometry data only. When total corneal power measurements were used, prediction errors were lower with color-LED than with Scheimpflug based topography.

Implantation of a trifocal toric intraocular lens to a patient with pigment dispersion syndrome

Aim. To present a clinical case of treatment of pigment dispersion syndrome by clear lens extraction and implantation of a toric intraocular lens in a patient with myopic astigmatism. &#x0D; Methods. A 33-year-old patient with a diagnosis of moderate myopia, complex mild myopic astigmatism, pigment dispersion syndrome of both eyes. &#x0D; Results. The first stage was laser peripheral iridotomy of both eyes. On follow-up pathological irido-zonular contact and increases intraocular pressure by 2 mm persisted. The second stage included clear lens extraction and implantation of a toric multifocal intraocular lens to both eyes. In 2 months, distance and near visual acuity was 1.0, intraocular pressure was normal, no pathological irido-zonular contact was observed according to the ultrasound biomicroscopy. &#x0D; Conclusion. Implantation of an intraocular lens in patients with myopia and pigment dispersion syndrome is both a method of preventing pigment glaucoma and myopia correction; patients with pigment dispersion syndrome after peripheral iridotomy should monitor the state of the anterior segment of the eye and the effectiveness of the treatment by ultrasound biomicroscopy.

Comparison of 3-month visual outcomes of a spherical and a toric trifocal intraocular lens

To evaluate visual outcomes and satisfaction after implantation of 2 trifocal intraocular lenses (IOLs): a spherical IOL and a toric IOL. IOA Madrid Innova Ocular, Madrid, Spain. Prospective, controlled clinical trial. Patients (>50years) were implanted bilaterally with either a trifocal spherical hydrophilic IOL (FineVision POD F) if corneal astigmatism was 1.0 diopter (D) or less, or with a trifocal toric hydrophilic IOL (FineVision POD FT) if astigmatism was more than 1.0 D. Outcomes analyzed 3months after surgery included monocular and binocular visual acuities at distance, near, and intermediate, both uncorrected and corrected. Defocus curves, contrast sensitivity, and patient satisfaction were also assessed. There was no statistically significant difference between groups in monocular uncorrected distance (UDVA) (P=.38), monocular corrected distance (CDVA) (P=.22), or distance-corrected intermediate (DCIVA) (P=.95) visual acuities; however, the distance-corrected near visual acuity (DCNVA) was slightly better in the spherical IOL group (P=.008). The UDVA was 20/25 or better in 89% of eyes in the spherical IOL group and 93% in the toric IOL group. The DCIVA was 20/32 or better in 92% of eyes in the spherical IOL group and 93% in the toric IOL group at 80cm (Radner Vissum chart), and 20/32 or better in 100% of eyes in both groups at 63cm (Colenbrander chart). The DCNVA (Radner chart) was 20/32 or better in 89% of eyes in the spherical IOL group and 90% of eyes in the toric IOL group. There was no difference between the groups in contrast sensitivity, defocus curves, cylinder, or satisfaction results. Patients had significant improvement in visual acuity and gained functional uncorrected visual acuity across all distances in both groups. Satisfaction was high with both IOLs.

Patient outcomes following implantation with a trifocal toric IOL: twelve-month prospective multicentre study

PurposeTo evaluate clinical outcomes with a premium diffractive–refractive trifocal toric intraocular lens (IOL) over a 12-month period.MethodsMulticentre prospective clinical trial including 227 eyes of 114 patients undergoing cataract surgery with bilateral implantation of the AT LISA tri toric 939MP IOL (Carl Zeiss Meditec, Jena, Germany). One patient was implanted unilaterally. Outcome measures were: visual acuity, manifest refraction, reading performance, contrast sensitivity, defocus curve, patient satisfaction and subjective quality of vision. Alpins vector analysis was used to evaluate astigmatic changes.Results12-month follow up results of binocular uncorrected distance, intermediate and near visual acuity were ≤0.3 logMAR in 99.0%, 98.10% and 91.40% of eyes, respectively. 79.7% of eyes had a cylinder value of ±0.50 D at 12 months post-surgery. Contrast sensitivity was in the normal range at 6 months post-surgery. The defocus curve exhibited a smooth transition between far and near foci. Vector analysis showed a mean magnitude of error of −0.16 ± 0.48 D. Mean binocular distance-corrected reading visual acuity was 0.15 ± 0.13 logRAD at 6 months postoperatively. 93.3%, 89.4% and 84.6% of patients expressed satisfaction (good or very good) with distance, intermediate and near vision, respectively, 12 months after surgery. Most (≥95%) patients felt that visual disturbances, including halos, glare, focusing difficulties and depth perception, caused little or no disturbance.ConclusionsThe diffractive–refractive trifocal toric IOL, AT LISA tri toric 939MP, provides effective distance, intermediate and near visual acuity in eyes with corneal astigmatism. Patient satisfaction was high and 98.1% of patients expressed satisfaction with the IOL implanted.

Имплантация новой трифокальной торической интраокулярной линзы «AcrySof IQ PanOptix Toric» в современной 3D-хирургии катаракты (клинический случай)

Имплантация новой трифокальной торической интраокулярной линзы «AcrySof IQ PanOptix Toric» в современной 3D-хирургии катаракты (клинический случай)

Clinical Comparison of a Trifocal and a Trifocal-Toric Intraocular Lens Based on the Same Diffractive Platform

Purpose To evaluate and compare the visual performance of a trifocal and a trifocal-toric intraocular lens (IOL) based on the same diffractive platform. Methods Prospective non-randomized comparative study enrolling 142 eyes of 77 patients (age 40-73 years) undergoing uneventful phacoemulsification lens surgery. Two groups were differentiated according to the implanted IOL: trifocal group, 98 eyes (50 patients) implanted with the trifocal diffractive IOL AT LISA tri 839MP (Carl Zeiss Meditec), and trifocal-toric group, 44 eyes (27 patients) implanted with the trifocal-toric diffractive IOL AT LISA trifocal-toric 939MP (Carl Zeiss Meditec). Visual and refractive changes were evaluated 3 months postoperatively. Results No significant differences between groups were found in postoperative refraction (p ≥ 0.144), monocular and binocular uncorrected intermediate visual acuity (UIVA; p = 0.519 and 0.398, respectively) and binocular uncorrected near visual acuity (UNVA; p = 0.073). In contrast, significantly better monocular and binocular uncorrected distance visual acuity (UDVA; p ≤ 0.002), as well as monocular UNVA (p = 0.005), were found in the trifocal group. A postoperative spherical equivalent within ± 1.00 D was found in 98 % and 100 % of eyes in the trifocal and trifocal-toric groups, respectively. Postoperative binocular UDVA, UIVA and UNVA of 20/30 or better were found in 100, 95 and 100 % of eyes, and in 96.3, 95.8 and 90.9 % of eyes in the trifocal and trifocal-toric groups, respectively. Conclusions The evaluated trifocal and trifocal-toric IOLs both provide a successful restoration of the visual function after cataract surgery, with good levels of refractive precision, as well as UIVA and UNVA.

Comparison of visual and refractive outcomes after implantation of a new diffractive trifocal toric lens, a trifocal lens and a monofocal toric lens

PurposeTo evaluate a diffractif trifocal toric intraocular lens (IOL) comparated with a trifocal IOL and a monofocal toric IOL.MethodsThis retrospective comparative study included patients with visually significant cataract or presbyopia who were scheduled for lensectomy and implantation of IOL. They were included in 3 groups according to the IOL implanted: multifocal group, multifocal toric group and toric group. At 1 month postoperatively, visual acuity (VA) at long and near distance, and refractive outcomes were examined.Results70 eyes of 45 patients were included. 21 eyes in the multifocal group, 22 in the multifocal toric group, and 27 in the toric group. The mean age of patients was 70.7 years +/− 10.6 (range 52–91 years). Postoperatively, the mean refractive astigmatism decreased to 0.71D, 0.77D and 0.72D respectively in the 3 groups. The distance uncorrected VA was 0.13logMar +/− 0.11 for multifocal group, 0.13logMar +/− 0.16 for multifocal toric group and 0.12logMar +/− 0.11 for toric group. There were no statistically differences between the 3 groups for the uncorrected distance VA, and between multifocal group and multifocal toric group for the uncorrected near VA.ConclusionsDiffractif trifocal toric IOL provided useful VA at any distance. The addition of a toric surface to the aspheric diffractive multifocal IOL resulted in a comparable visual performance.