Analysis of Astigmatism Correction and Visual Acuity With Toric Multifocal IOLs

Monday, April 20, 2015: 3:29 PM
Room 4 (San Diego Convention Center)
Satish S. Modi, MD, FRCS (C), CPI
Magda Michna, PhD, FBCLA

To evaluate astigmatism correction and visual acuity after bilateral implantation of toric multifocal intraocular lenses (IOLs) secondary to cataract surgery.

This was a prospective, unmasked, nonrandomized, 1-year follow-up study of patients aged 21 years with planned phacoemulsification surgery for bilateral cataracts. Cylinder power and alignment of AcrySof IQ ReSTOR toric IOLs (Alcon; SND1T3, 0.75−1.28 D; SND1T4, 1.29−1.80 D; SND1T5, 1.81−2.32 D; SND1T6, 2.33−2.82 D) were determined using a web-based calculator; patients with no astigmatism or corneal astigmatism 0.74 D received AcrySof IQ ReSTOR nontoric IOLs. Astigmatism correction and uncorrected monocular near and distance visual acuity (UCNVA and UCDVA) were assessed 1 year after implantation of toric (n=386) or nontoric (n=188) IOLs.

Overall cylinder reduction relative to target was 77.1%; reduction was ≥74.7% with SND1T3/SND1T4 IOLs and ≥81.3% with SND1T5/SND1T6 IOLs. Overall rates of cylinder reduction within 0.5 and 1.0 D of target were 77.0% and 95.8%, respectively. Rates of cylinder reduction within 0.5 and 1.0 D of target were ≥79.2% and ≥95.4% with SND1T3/SND1T4 and ≥63.7% and ≥91.2% with SND1T5/SND1T6. UCDVA achieved with toric versus nontoric multifocal IOLs was within the clinical performance target margin of 0.1 logMAR. UCDVA was ≤0.12 logMAR with SND1T3/SND1T4 and ≤0.15 logMAR with SND1T5/SND1T6; UCNVA was ≤0.19 logMAR with SND1T3/SND1T4 and ≤0.20 logMAR with SND1T5/SND1T6.

AcrySof IQ ReSTOR toric IOLs were effective in correcting preexisting corneal astigmatism in the range of 0.75–2.82 D after lens phacoemulsification. The tested toric IOL models achieved similar uncorrected monocular visual acuity 1 year postimplantation.