Spectacle Independence After Implantation of Multifocal Toric IOL in Patients With Corneal Astigmatism

Friday, April 17, 2015
KIOSKS (San Diego Convention Center)
Sergio Kwitko, MD

Purpose
To assess spectacle indepedence following implantation of a multifocal toric intraocular lens (IOL) in patients with corneal astigmatism.

Methods
Patients with corneal astigmatism (>0.75 D) underwent phacoemulsification and bilateral or unilateral IOL implantation with the M-flex T-IOL (Rayner Intraocular Lenses Ltd.,Hove,UK). All patients underwent refractive assessment and corneal topography preoperatively and postoperatively. Outcome measures included uncorrected VA (UCVA), spherical and cylindrical refraction, and spherical equivalent refraction (SE) at 3-month follow-up.

Results
71 eyes (47 patients, mean age 63 years, range 35–89 years) were analyzed. Thirty-three patients underwent bilateral M-flex-T IOL implantation, and the remaining fourteen underwent unilateral M-flex-T IOL implantation with a non-toric multifocal IOL in the fellow eye. Clinically and statistically significant improvement in spherical refraction (+1.86 ± 2.10 D preoperative vs +0.07 ± 0.18 D postoperative, p<0.001), cylindrical refraction (-1.26 ± 1.60 D pre vs -0.18 ± 0.55 D post, p<0.001). The intended cylinder correction was achieved in the majority of patients, with patients with higher corneal cylinder having more undercorrection Emmetropia (±0.50 D) was achieved in 92.96% of eyes. At 3-month postop, 94.37% and 90.14% of eyes had distance and near UCVA of 20/30 or better and J2 or better, respectively.

Conclusion
M-flex-T IOL significantly reduced sphero-cylindrical refraction and spectacle dependence in patients with corneal astigmatism undergoing lens extraction.