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First Author: P.Chiam UK
Co Author(s): S. Quah C. O'Donnell S. Kaye
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To evaluate the visual and refractive outcomes of a customised toric multifocal intraocular lens (IOL) implanted following refractive lens exchange and cataract surgery.
Macclesfield Hospital, Victoria Road, Macclesfield, Cheshire SK10 3BL, UK. Optegra Manchester Eye Hospital, 2 The Avenue, Didsbury, Manchester M20 2EY, UK
Thirty six eyes of 25 patients underwent phacoemulsification with toric Lentis Mplus multifocal IOL implantation. Preoperative corneal keratometry was measured using Zeiss IOLMaster 500. Patients were refracted before and after the operation. Monocular uncorrected distance (UDVA), intermediate (UIVA) and near (UNVA) visual acuities were recorded preoperatively and at least 4 weeks postoperatively. Complications, residual refractive astigmatism and reported spectacle independence were evaluated.
The meanḟSD age was 61.1ḟ8.6 years. The preoperative UDVA was logMAR 0.77ḟ0.51, UIVA 0.41ḟ0.25 and UNVA 0.78ḟ0.21. Postoperative UDVA was logMAR 0.09ḟ0.11 (p<0.01), UIVA 0.06ḟ0.13 (p<0.01) and UNVA 0.15ḟ0.09 (p<0.01). The average magnitude of preoperative corneal astigmatism was 2.15ḟ0.63 D and postoperative was 0.24ḟ0.40 D (p<0.01). The vector for preoperative mean astigmatism was 1.33 D at 90.3 degree, and surgically induced astigmatism 1.39 D at 1.1 degree. The achieved postoperative vector mean astigmatism was 0.07 at 18.0 degree. A residual astigmatism magnitude of <1.00D was achieved in 96% of eyes. The remaining eyes had astigmatism magnitude ranging from 1.00 to 1.50D. Postoperatively, 89% of eyes achieved UDVA 20/30 or better, 86% eyes achieved UIVA of 20/25 or better and 88% of eyes achieved UNVA of J3 or better. The absolute angle of error was 15.9 degree. The index of success was 0.05. There were no complications recorded during the operations or at the postoperative visits. Spectacle independence for distance, intermediate and near vision was achieved in all patients.
Implantation of the toric Lentis Mplus multifocal IOL following phacoemulsification produced predictable results and is an effective way to manage pre-existing corneal astigmatism.