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First Author: P.Chelazzi ITALY
Co Author(s): L. Caraffa P. Sivelli E. Destro
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Clinical performance of a new multifocal toric intraocular lens
Private practice surgery center, Milan, Italy
12 eyes of six patients with cataract and at least 0.75 diopters (D) of preexisting corneal astigmatism were evaluated three months after surgery. Each patient had bilateral implantation of Tecnis multifocal toric one-piece aspheric IOL. Uncorrected distance visual acuity (UDVA), intermediate (UIVA) and near (UNVA) visual acuities were measured. Residual refractive astigmatism was evaluated with subjective refraction, toric axis at slitlamp, optical biometer and corneal topography. Defocus curve were assessed under photopic and mesopic conditions over a range of +2.00 to -5.00D in 0.50D steps. Contrast sensitivity function was evaluated under photopic conditions. Patient satisfaction was assessed using the Visual Function 14 score (VF-14). Complications and subjective symptoms were also considered.
Three months after surgery, the mean UDVA was 0,01 logMAR and 83,3% of eyes reached a UDVA ? 20/25. The mean UIVA was 0.50 logMAR and the mean UNVA 0.20 logMAR. The mean refractive astigmatism decreased significantly postoperatively, from -1.8D to -0.43D. The mean IOL misalignment from the toric axis was 2.8 degrees. No significant change in keratometric cylinder was observed. Photopic contrast sensitivity was better binocularly than monocularly at all distances. Spectacle independency was reached by more than 80% of patients. Symptoms as glare, halos and starburst were reported from all patients differently.
Implantation of Tecnis multifocal toric IOL in patients with cataract and significant corneal astigmatism was an effective and safe procedure. Distance and near visual outcomes obtained were excellent, intermediate visual outcomes were less gratifying. A high level of satisfaction was reached by all patients, but a period of neuroadaptation could be necessary to obtain better visual function results. Motivation to achieve spectacle independence is likely to be the deciding factor.