Long-Term Functional Results And Rotational Stability Of Capsular Bag-Fixated Toric Intraocular Lenses In Duet Procedure

We included 34 eyes of 20 refractive lens exchange and cataract patients who underwent duet procedure with monofocal toric IOL (RayOne toric, Tecnis ZCT800 or Hoya XY1AT) implantation into the capsular bag and trifocal-diffractive Sulcoflex IOL implantation into the ciliary sulcus. Image-guided navigation was used to achieve intraoperative alignment of the toric IOLs. The manifest refraction, uncorrected and corrected distance visual acuity, and uncorrected and distance-corrected near and intermediate visual acuity were determined. The position of the axis of the toric IOL was determined using the Pentacam device. We evaluated retroillumination images and compared the results to the preoperatively planned axis position.

Median follow-up was 27 months postoperatively. The spherical equivalent of manifest refraction was -0.04 ± 0.34 diopters postoperatively, and the refractive cylinder was -0.14 ± 0.22 diopters on average. Binocular uncorrected and corrected distance visual acuity were 0.05 ± 0.11 logMAR and 0.02 ± 0.09 logMAR, respectively. The binocular UNVA and DCNVA were 0.01 ± 0.12 and 0.02 ± 0.13 logMAR, respectively. The UIVA was -0.01 ± 0.11 logMAR and the DCIVA was -0.03 ± 0.11 logMAR. Mean deviation from the calculated cylinder axis was 3.8± 3.5 ° with a maximum deviation of 15.0°. 94% of all eyes showed a rotation of less than 10°. Re-rotation of the toric capsular bag-fixated IOL has not been necessary due to good uncorrected visual acuity.

The long-term rotational stability of capsular bag-fixated toric IOLs in polypseudophakic eyes was comparable to results reported for different toric IOL models. Thus, the polypseudophakic approach did not affect the rotational stability of capsular bag-fixated IOLs. We observed good long-term functional results at all distances.