Astigmatism Correction, IOL Rotation, Visual Tasks, and Glistenings After Bilateral Implantation of Toric or Nontoric Multifocal IOLs

Monday, April 20, 2015: 3:44 PM
Room 4 (San Diego Convention Center)
Robert J. Cionni, MD
Magda Michna, PhD, FBCLA

Purpose
To evaluate stability of astigmatism correction and lens rotation with toric IOLs, compare patient-reported difficulty with visual tasks, and incidence of glistening in patients implanted with toric or nontoric intraocular lenses (IOLs).

Methods
This prospective, nonrandomized, 2-arm, parallel-group, nonmasked study assessed outcomes after bilateral implantation of AcrySof® IQ ReSTOR® multifocal toric and nontoric IOLs (Alcon). Patients were aged ≥21 years with bilateral cataracts surgically removed by phacoemulsification and preoperative astigmatism either <0.74 D (nontoric IOL group, n=188) or from ≥0.75 to 2.82 D (toric IOL group, n=386). Assessments include astigmatism correction at 1 year and IOL rotation from postimplantation month 3 to month 6 were assessed in the toric IOL group; Visual Tasks (VISTAS) questionnaire responses at 6 months and observation of any IOL glistenings up to 1 year postoperatively.

Results
Astigmatism correction within 0.5 and 1.0 D of target was achieved in 85.4% and 98.3% of eyes, respectively, at 1−2 days postsurgery, and 77.0% and 95.8% at 1 year. 94% of eyes had toric IOL rotation ≤5°. 6-month VISTAS scores improved from baseline with both IOLs; most patients reported no difficulty without corrective aids or never used corrective aids across a range of distances. No glistenings were observed in 95.7% and 97.3% of patients (toric and nontoric, respectively) in first implanted eyes, or in 96.0% and 97.3% of patients in second implanted eyes. No glistenings were considered clinically significant.

Conclusion
Astigmatism correction and toric IOL rotation were stable at follow-up visits. Toric and nontoric AcrySof® IQ ReSTOR® IOLs improved patient-reported VISTAS scores from baseline across a range of distances.