Trifocal Toric IOL for Presbyopia Correction: Clinical and Refractive Results
Purpose
To evaluate the efficacy and effectiveness of refractive lensectomy with toric trifocal intraocular lens (IOL) implantation with AT LISA tri toric 939MP (Carl Zeiss Meditec) for the correction of presbyopia.
Methods
Prospective non-randomized study, including all patients submitted to bilateral and symetric implantation of the AT LISA tri toric 939MP after crystaline lens extraction for the correction of presbyopia. Inclusion criteria: minimum follow-up 3 months, BCVA pre-operative of 20/25 or superior, corneal astigmatism > 1,00 D and angle to angle horizontal and vertical distance > 11,00 mm (OCT Visante, Carls Zeiss). Parameters evaluated: uncorrected (UCVA) and corrected (BCVA) distance visual acuity for far, intermediate (80 cm) and near (40 cm) distances, manifest refraction, contrast sensitivity charts under photopic and mesopic conditions, defocus curve, the degree of IOL rotation after surgery. All surgeries were performed under topical anesthesia.
Results
A total of 40 eyes were analyzed, with a follow-up that ranges from 1 to 6 months. The mean axial length was 22,99 mm (range: 20,77-26.28 mm), mean IOL cylinder implanted was 2.,32 (range from 1,00 to 3,50 D). Postoperative refractive results: mean spherical error -0,08 D, mean cylindrical subjective refractive error -0.49 D. Postoperative uncorrected monocular vision: 0.94, 0.94 and 0.75 for distances far, intermediate and near, respectively. Defocus curve demonstrates an uncorrected visual acuity of 20/25 or better in binocular vision for all distances. All patients are glasses independent for all tasks of near and intermediate distance. The rate of halos/glare reported was less than 20% of patients. We observed no rotation of the IOL during follow-up. Contrast sensitivity was within normal range for all light conditions.
Conclusion
The trifocal lens AT LISA tri toric 939MP proved to be effective and safe in the correction of presbyopia, revealing a high level of visual acuity for distances far, intermediate and near. The toric IOL platform provides the same visual and refractive results as the spherical model, showing a safe and effective correction of corneal astigmatism.