Visual outcomes after implantation of a novel refractive toric multifocal intraocular lens (original) (raw)

2014, Arquivos Brasileiros de Oftalmologia

The goal of modern cataract surgery is to gain spectacle independence for distance, intermediate, and near vision, which can be achieved with the implantation of multifocal intraocular lenses (IOLs). However, approximately 15%-29% cataract patients have more than 1.50 diopters (D) of corneal or refractive astigmatism (1-3). A residual astigmatism error of 1.50 to 3.0 D after cataract surgery may decrease uncorrected visual acuity (UCVA) to 20/70 or 20/100 and may interfere with spectacle independence after multifocal IOL implantation (4). To overcome this problem, various surgical options to control astigmatism during cataract surgery are available (4,5). Patients with a considerable amount of corneal astigmatism who wish to undergo multifocal IOL implantation have several options, including a clear corneal cataract incision along the steep meridian (5) , astigmatic keratotomy (AK) (6,7) , opposite clear corneal incisions (8) , limbal relaxing ABSTRACT Purpose: To assess the postoperative outcomes of a novel toric multifocal intraocular lens (IOL) in patients with cataract and corneal astigmatism. Methods: This prospective nonrandomized study included patients with cataract, corneal astigmatism, and a motivation for spectacle independence. In all patients, a Rayner M-flex ® T toric IOL was implanted in the capsular bag. Three months after surgery, the distance, intermediate, and near visual acuities; spherical equivalent; residual refractive astigmatism; defocus curve; and contrast sensitivity were evaluated. A patient satisfaction and visual phenomena questionnaire was administered to all patients. Results: Thirty-four eyes of 18 patients were included in this study. Three months after surgery, the mean corrected distance visual acuity (logMAR) was 0.00 ± 0.08 at 6 m, 0.20 ± 0.09 at 70 cm, and 0.08 ± 0.11 at 40 cm. Uncorrected distance vision acuity was 20/40 or better in 100% eyes. The preoperative mean refractive cylinder (RC) was-2.19 (SD: ± 0.53). After a 3-month follow-up, the average RC was-0.44 D (SD: ± 0.27; p<0.001). Contrast sensitivity levels were high. At the last follow-up, 87.5% patients were spectacle-independent for near, intermediate, and distance vision, and approximately 44% patients reported halos and glare. Conclusion: Toric multifocal IOL implantation in patients with cataract and cor neal astigmatism using the Rayner M-flex ® T toric IOL was a simple, safe, and accurate option. This technology provides surgeons with a feasible option for meeting patient expectations of an enhanced lifestyle resulting from decreased spectacle dependence.