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Visual outcomes and wavefront analysis of a multifocal toric intraocular lens

Poster Details

First Author: A.Marques PORTUGAL

Co Author(s):    E. Marques   T. Ferreira           

Abstract Details


This study aims to evaluate the visual outcomes in patients submitted to cataract surgery in which a toric diffractive apodized mIOL (AcrySof IQ ReSTOR, Alcon) was implanted.


Egas Moniz Hospital (Lisbon, Portugal); Red Cross Hospital (Lisbon, Portugal).


This prospective clinical study included patients with regular corneal astigmatism between 0.75 - 2.50D submitted to phacoemulsification and IOL implantation due to senile cataract. Preoperative distance, intermediate and near uncorrected (UVA) and corrected (CVA) visual acuities were recorded using ETDRS charts under photopic conditions (85 cd/m2). Manifest refraction, slit-lamp examination, tonometry and fundus evaluation were also performed. The IOL powers were chosen according to the manufacturer's online calculator, aiming for a postoperative refraction of -0.25D. The same examinations were repeated after surgery, as well as wavefront analysis using the Nidek OPD-III scan and classification of dysphotopic phenomena according to the Likert 5 point scale.


A total of 26 patients (52 eyes) were evaluated, with a mean age of 64.36±7.55 years. Preoperative distance CVA was 0.44±0.18 (logMAR). mean corneal astigmatism was 1.79±0.53D (0.75-2.50D). The implanted IOL spherical power varied between +6.00 and +30.00D. Average postoperative distance, intermediate and near UCVA (logMAR) were 0.06±0.1, 0.15±0.1 and 0.01±0.08, respectively, with an average spherical equivalent of -0.18±0.41D and a residual cylinder of -0.44±0.38D. A good IOL rotational stability was registered, with a mean absolute rotation of 3.12±2.26 degrees. Wavefront analysis revealed values similar to the previously published for the monofocal Acrysof IQ, with a root mean square of 0.49±0.20m for higher-order aberrations, 0.30±0.23m for coma and 0.37±0.25m for trefoil. In this series, a 100% spectacle-independence rate was achieved postoperatively with most patients referring minimal dysphotopic symptoms.


In our study, nearly 90% of the patients obtained excellent distance and near UCVA with overall good intermediate UCVA after cataract surgery with toric diffractive apodized mIOL implantation. Adequate rotational stability and minimal dysphotopic symptoms were also registered. All patients were spectacle-free postoperatively. FINANCIAL INTEREST: NONE

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