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