Visual Performance and Rotational Stability of a Multifocal Toric Intraocular Lens

Abstract

Purpose: To evaluate the visual results, refractive predictability, rotational stability, and spectacle independence of patients who had cataract surgery with implantation of a diffractive multifocal toric intraocular lens (IOL) (Tecnis Multifocal Toric ZMT 150-400; Abbott Medical Optics, Santa Ana, CA).

Methods: This prospective study included 60 eyes of 30 patients with cataract and regular corneal astigmatism who had phacoemulsification with bilateral implantation of a Tecnis Multifocal Toric IOL. Over a 6-month follow-up period, the main outcome measures were uncorrected and corrected monocular and binocular distance (UDVA and DCVA), intermediate at 80 cm (UIVA and DCIVA), and near at 40 cm (UNVA and DCNVA) visual acuities, spherical equivalent (SE) refraction, residual astigmatism, rotational stability, defocus curves, contrast sensitivity, presence of photic phenomena, and use of spectacles.

Results: Results at 6 months showed mean UDVA of 0.07 ± 0.1 logMAR (range: 0.3 to 0.0 logMAR), mean UIVA of 0.18 ± 0.09 logMAR (range: 0.3 to -0.1 log-MAR, and mean UNVA of 0.03 ± 0.09 logMAR (range: 0.2 to -0.1 logMAR). Refractive predictability was excellent with a mean SE of 0.05 ± 0.47 diopters (D) (range: -0.75 to +1.00 D) and a mean refractive cylinder of -0.44 ± 0.49 D (range: -1.25 to 0.00). Mean rotation was 3.18° ± 3.28°. Photic phenomena were moderate or severe in 30% of patients. All patients were spectacle independent at the 6-month follow-up visit at all distances in this case series.

Conclusions: The implantation of the Tecnis multifocal toric IOL in patients with cataract and corneal astigmatism provided excellent distance and near visual acuities with good intermediate visual acuity. Predictability of refractive results, rotational stability, and optical performance were excellent, allowing all patients in this series to achieve spectacle independence. [J Refract Surg. 2016;32(7):444-450.].