Clinical Outcomes Of Cataract Surgeries Using A New Type Of Enhanced Depth Of Focus Toric Intraocular Lens

Over the years, toric IOL (intraocular lens) has become an increasingly common option for management of corneal astigmatism during cataract surgery. The current study describes the visual outcomes, residual astigmatism and ocular aberrations following implantation of a new enhanced depth of focus (EDOF) toric IOL, the Tecnis® Eyhance™ Toric II IOL. 

This was a single-center, retrospective cohort study conducted in the Department of Ophthalmology at Yonsei University College of Medicine in Seoul, South Korea. All cataract surgeries were performed by a single surgeon (TIK).

We retrospectively enrolled 55 eyes of 37 patients with regular astigmatism ranging from 1.00 D (diopters) to 3.00 D, who underwent cataract surgery with insertion of the Eyhance™ Toric II IOL between February 2022 and December 2022. All patients completed a 3-month postoperative visit where clinical parameters, including uncorrected and best-corrected distance visual acuity (UCVA and BCVA), distance-corrected intermediate (at 66cm) and near  (at 33cm) visual acuity (DCIVA and DCNVA), ocular aberrations, lens alignment, and defocus curves were measured. In the vector analysis, the correction index (CI) was calculated as the surgically induced astigmatism divided by the target-induced astigmatism.

At the 3-month postoperative visit, significant improvements were observed in UCVA (from 0.61 ± 0.42 to 0.16 ± 0.16; p < 0.01), BCVA (from 0.21 ± 0.24 to 0.03 ± 0.05; p < 0.01), and refractive cylinder (from -1.62 ± 0.85D to -0.33 ± 0.37D; p < 0.01) compared with preoperative measurements. Mean DCIVA (0.18 ± 0.07) and DCNVA (0.40 ± 0.13) were similar to preliminary studies conducted on Eyhance™ IOLs. Mean CI was 1.03 ± 0.23, indicating a minimal overcorrection. Mean absolute IOL rotation at 3-month postoperative visit was 4.40 ± 2.99°. Defocus curves showed <0.2 logMAR range between -1.0D to +0.5D. Ocular total high-order aberrations, coma, and spherical aberration at 3 months were also significantly reduced compared to preoperative values.

In this study, the new EDOF toric IOLs demonstrated the ability to achieve significant improvements in BCVA, mean cylinder, and high-order aberrations. The current study shows that the Eyhance™ Toric II IOLs are a safe and effective treatment for cataract patients with astigmatic eyes.